[Hiring] Manager Enterprise Reimbursement @WVU Medicine

Role Description

This position is responsible for ensuring that all WVUHS hospitals are in compliance with all state and federal regulatory reporting requirements relating to reimbursement. Extensive knowledge of third party reimbursement regulations is required. This position is also responsible for managing net revenue, development of budget, reserve analysis and identifying and implementing revenue enhancement opportunities.

Qualifications

• Bachelor’s Degree in Business with a major in Accounting or Finance.
• Five (5) years of experience in healthcare finance or accounting.
• MBA or CPA (preferred).

Requirements

• Ensures that all Hospitals are in compliance with all state and federal regulations related to reimbursement.
• Manages the preparation and analytical review of all external Medicare Cost Reports, WV HCA filings and all other state or federal reimbursement filings for all hospitals.
• Reviews and analyzes all state and federal reimbursement regulations to ensure compliance and presents financial impact of changes in regulations.
• Communicates directly with external auditors, third party payors and WV HCA staff in regard to financial matters.
• Coordinates the development of the net revenue budget.
• Establishes a process for ongoing monitoring of gross and net revenue, including an analysis of reserves for contractuals, bad debt and charity.
• Coordinates with patient financial services and accounting the processing of changes in third party payment requirements and the impact on financial reporting and financial statements.
• Ensures that the financial terms of managed care contracts are thoroughly and accurately analyzed and monitored.
• Ensures that the long range financial planning process includes accurate and up to date reimbursement assumptions.
• Coordinates projects related to revenue enhancement opportunities.
• Works with legal counsel and the fiscal intermediary to identify and resolve outstanding Medicare appeal issues.
• Develops and maintains an ongoing staff development program and an orientation program for the reimbursement staff.
• Consistently monitors and documents performance of staff members and utilizes appropriate reward and disciplinary measures as needed.
• Demonstrates an ability to create an atmosphere that fosters motivation of staff to work at optimal efficiency and encourages staff to regularly establish and achieve departmental goals.
• Provides leadership and direction to professional staff and maintains a professional working relationship with all staff, always responds to staff concerns in a professional and timely manner; maintains appropriate interdepartmental communication.

Benefits

• Scheduled Weekly Hours: 40
• Shift: Exempt/Non-Exempt
• United States of America (Exempt)