Senior Accountant

Description

SUMMARY: Supports financial operations across multiple rural hospitals in a Critical Access Hospital (CAH) setting. This role ensures compliance with healthcare funding programs such as Disproportionate Share Hospital (DSH) payments, Uncompensated Care (UC) funding, and the Texas 1115 Medicaid Waiver , while working with internal leadership and state agencies to maintain financial accuracy. Strong hospital accounting experience and knowledge of CAH regulations are essential.

ESSENTIAL DUTIES AND RESPONSIBILITIES:  

• Maintain accurate general ledger activity and financial records for assigned CAH facilities
• Prepare and analyze monthly, quarterly, and annual financial statements
• Monitor budget-to-actual performance and perform variance analysis
• Oversee data collection, reporting, and compliance for state and federal supplemental payment programs, including:
• Texas 1115 Waiver Programs
• Disproportionate Share Hospital (DSH)
• Uncompensated Care (UC) Pools
• Coordinate with internal departments to gather appropriate program documentation
• Submit timely reports and supporting materials to state agencies
• Assist in the preparation of cost reports and participate in audit activities
• Work collaboratively with hospital leaders to ensure financial transparency and readiness
• Support internal and external audit processes
• All other duties as assigned

Requirements

EDUCATION and/or EXPERIENCE QUALIFICATIONS:

• Bachelor’s degree in Accounting, Finance, or a related field
• 3+ years of accounting experience, preferably in a hospital or healthcare setting
• Strong understanding of GAAP and financial reporting
• Experience working with or around CAH reimbursement, Medicare/Medicaid, or related programs
• Advanced Excel skills and familiarity with financial systems
• CPA or active pursuit of certification (Preferred)
• Prior experience with state and federal healthcare funding programs (DSH, UC, 1115 Waiver) (Preferred)
• Familiarity with cost-based reimbursement models and rural hospital operations (Preferred)