Director Medicaid Reimbursement

Job Description Serves as AdventHealth subject matter resource for Medicaid reimbursement matters. This role is focused on Medicaid payment areas. Leads a team of reimbursement professionals, providing guidance, training, and development opportunities. Maintains a strong working knowledge of current laws and regulations of the federal and state Medicaid programs. Ensures data, payments, settlements, audits, and financial entries are completed. Communicates technical positions and arguments effectively to Medicaid auditors to support positions. Leverages reimbursement expertise to identify strategic opportunities supporting long-term reimbursement optimization and sustainability. Proposes year-end estimated Medicaid third-party financial settlements to be audited by AdventHealth’s external auditor for inclusion in the audited financial statements. Proactively seeks to improve strategy and reduce risks, including managing outside consultants and engaging with hospital associations. Creates solutions in compliance with regulations. Collaborates with key stakeholders to support the reimbursement initiative and to identify, plan, and execute reimbursement strategy. Collaborates with other large system reimbursement leadership to identify best practices and incorporate learnings within the organization. Engages in continuous knowledge development regarding healthcare industry developments, best practices, tools, and techniques. Ensures that the potential of future take-backs is understood, communicated, and managed appropriately. Educates Finance, Revenue, Cycle & Operational Leaders on regulations and impacts. Communicates with key stakeholders on opportunities and impact, regarding current issues as well as fundamentals of reimbursement for those in new roles. Provides strategic thinking to identify new reimbursement mechanisms, ensuring the proper development, management, and optimization of existing programs while identifying when and whether to join appeal cases. Consults with leadership, providing guidance on ensuring stability of existing programs and strategic options to consider, to fulfill our mission. Provides mentoring and coaching to staff, develops future financial leaders, and recruits top-tier talent. Utilizes excellent communication skills, including adjusting or adapting messaging for different stakeholders. Participates in and/or leads special projects as assigned. Benefits Medical, Dental, Vision Insurance Life Insurance Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Position Details Schedule: Full time Shift: Day Location: 900 Hope Way, Altamonte Springs, FL 32714 Education Bachelor’s Degree (Required) Master’s Degree (Preferred) Field of Study Accounting, Finance, or related field Work Experience 10+ years of relevant experience in healthcare finance, preferably in reimbursement including Medicare, Medicaid reimbursement and regulatory cost reporting (Required) 5+ years of proven leadership skills in a management role (Preferred) Strong background in accounting and financial analysis (Required) Licenses and Certifications Certified Public Accountant (CPA) (Preferred) Physical Requirements Work requirements are available at Pay Range $146,405.57 - $272,307.13 Equal Opportunity Employment This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. #J-18808-Ljbffr AdventHealth