Manager, Payor Analytics & Reimbursement

Shirley Ryan AbilityLab is the global leader in physical medicine and rehabilitation for adults and children with the most severe, complex conditions. By joining our team, you’ll be part of our life-changing mission and vision. You’ll contribute to an innovative, multifaceted culture that is second to none — one that embraces collaboration, excellence, discovery and compassion. You’ll play a role in something that’s never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes — as we Advance Human Ability, together.Job Description SummaryThe Manager, Reimbursement and Payor Analytics will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Manager will partner with Revenue Cycle Operations leadership to provide financial and analytic support and ensure proper accounting of accounts receivables. They will lead payor analytics for the contracting team and develop and maintain financial models related to potential changes in federal programs or managed care. Proactively identifies opportunities for revenue growth based on changing regulations. The Manager will play a lead role in the preparation, submission, and management of Medicare and Medicaid cost reports for the hospital.The Manager, Reimbursement and Payor Analytics will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.The Manager, Reimbursement and Payor Analytics will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties.Job DescriptionThe Manager, Reimbursement and Payor Analytics will:Serve as central connection point between Finance, Accounting, and Revenue Cycle leadershipWork with Finance leadership to develop and implement of reimbursement strategies across all payor types including Medicare, Medicaid, and commercial insuranceMonitor legislative and regulatory changes affecting Medicare/Medicaid reimbursement, model and communicate expected impact, and implement necessary strategiesThrough partnership with a third party, generate and analyze detailed AR reports using RCA software to identify trends, bottlenecks, and manage the net AR month end accounting close processPlay key role in the development, review, and submission of annual Medicare/Medicaid cost reports, ensuring accuracy and compliance with CMS guidelines and regulationsCoordinate with external auditors during Medicare/Medicaid audits and respond to audit findingsPartner with Revenue Cycle leadership to implement and manage Medicare bad debt policy and procedures.Analyze KPIs for accounts receivable, bad debt, denials, and collection ratesProvide financial & strategic support in payor contract negotiations to optimize payment termsAssist in the review of annual CDM price increase processProvide reimbursement expertise in strategic financial modeling (new partnerships, expansion, etc.)Present complex financial information to senior leadership and provide strategic recommendationsReporting RelationshipsReports to Vice President, Financial & Strategic InsightKnowledge, Skills & Abilities RequiredBachelor's degree in Healthcare Administration, Finance, or related fieldMaster's degree in related field and/or CPA preferredBackground in hospital financial operations with 5+ years of healthcare experience, with at least 2 of those years in a reimbursement role being strongly preferred; advanced degrees and/or specific relevant experience can substitute for total years of experience.Working knowledge of CMS regulations, cost reporting principles, and healthcare reimbursement methodologiesWorking knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuationFamiliarity with healthcare billing and coding practices and technologiesExperience in Medicare Cost Report preparation and review preferredExperience with RCA or similar software for AR accounting and analysis preferredStrong understanding of hospital operations and healthcare financial managementExperience with electronic health record (EHR) systemsExcellent analytical and problem-solving abilitiesStrong interpersonal and negotiation skillsAbility to communicate effectively and work collaboratively with all levels of the organizationFull understanding of accounting principles relating to revenue and accounts receivableAbility to manage multiple priorities in a fast-paced environmentWorking ConditionsNormal office environment with little or no exposure to dust or extreme temperature.Hybrid work scheduleThe above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.Pay and Benefits*:Pay Range: $95,500.00 - $158,600.00Benefits:Shirley Ryan AbilityLab offers a comprehensive benefits program that is competitive with our industry peers in our geographic locations: *Benefits and benefits’ eligibility can vary by position. Actual compensation will be determined by equity and qualifications of the role.Equal Employment Opportunity EmployerShirley Ryan AbilityLab is an Equal Employment Opportunity Employer. All applicants will be afforded equal employment opportunity without discrimination because of race, color, religion, sex, marital status, national origin or ancestry, citizenship status, age, disability, sexual orientation, gender identity, genetic information, military status, order of protection status, unfavorable discharge from military service, or any other characteristics protected by law.EEO is the Law | EEO is the Law - Know Your Rights | View our Full PolicyShirley Ryan AbilityLab is an Affirmative Action Employer as required by law.SummaryLocation: Chicago, ILType: Full time