Director Medicaid Reimbursement

1103 Team Member Services; Orlando (FL); On-site; USD 148,000 - 275,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

PTO from Day One

403-B Retirement Plan

Parental Leave

Career development

Well-being resources

Mental health resources

Pet benefits

Job summary

AdventHealth seeks a senior reimbursement leader to guide a team focused on Medicaid payment matters. You will ensure accurate data, payments, settlements, and regulatory compliance while collaborating with auditors and external consultants to optimize reimbursement strategies.

The role requires 10+ years in healthcare finance, 5+ years in leadership, and a CPA is preferred. This is a full-time, on-site position based in Altamonte Springs, FL.

Qualifications

• Bachelor's in Accounting, Finance, or related field is required.
• 10+ years of healthcare finance experience, with reimbursement focus.
• 5+ years of leadership or management experience.
• CPA preferred.

Responsibilities

• Lead a team of reimbursement professionals with guidance and development.
• Maintain up-to-date knowledge of federal and state Medicaid regulations.
• Ensure data, payments, settlements, audits, and financial entries are completed.
• Communicate technical positions to Medicaid auditors to support positions.
• Identify strategic opportunities to optimize reimbursement and sustainability.
• Coordinate with outside consultants and hospital associations as needed.
• Collaborate with leadership to develop and execute reimbursement strategy.
• Educate Finance, Revenue, and Operational Leaders on regulations and impacts.

Skills

Leadership

Financial analysis

Communication

Regulatory knowledge

Mentoring & coaching

Education

Bachelor's in Accounting/Finance

Master's degree (preferred)

Job description

Our Promise to You

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Benefits and Perks

• Benefits from Day One: 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

Schedule & Location

Schedule: Full time Shift: Day (United States of America) Address: 900 HOPE WAY City: ALTAMONTE SPRINGS State: Florida Postal Code: 32714

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.
• Maintain 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.
• Communicate technical positions/arguments effectively to Medicaid auditors to support positions.
• Leverages reimbursement expertise to identify strategic opportunities supporting long-term reimbursement optimization and sustainability.
• Propose year end estimated Medicaid third party financial settlement to be audited by AdventHealth’s external auditor for inclusion in the audited financial statements.
• Proactively seeks to improve strategy and reduce risks.
• This includes 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.
• Responsible for ensuring that the potential of future take backs, is understood, communicated, and managed appropriately.
• Educates Finance, Revenue, Cycle & Operational Leaders on regulations & impacts.
• Communicate with key stakeholders on opportunities and impact, both regarding current issues as well as fundamentals of reimbursement for those in new roles.
• Strategic Thinking deployed identifying new reimbursement mechanisms, ensuring the proper development, management and optimization of existing programs (coordinate, grow, reduce risk) and identify when and whether to join appeal cases.
• Consults with leadership, providing guidance how to ensure stability of existing programs and strategic options to consider, to fulfill our mission.
• Provides mentoring and coaching to staff, develops future financial leaders, recruits top-tier talent.
• Utilizes excellent communication skills, including adjusting or adapting messaging for different stakeholders.
• Participates in and/or lead special projects as assigned.

Education

Education: Bachelor's [Required] Master's [Preferred] Field of Study: in Accounting, Finance, or related field

Work Experience

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 management role [Preferred] Strong background in accounting and financial analysis [Required]

Licenses and Certifications

Licenses and Certifications: Certified Public Accountant (CPA) [Preferred]

Physical Requirements

Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/23km2677

Pay Range

Pay Range: $147,867.20 - $275,038.40

Background Screening Requirement

Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

Equal Opportunity Statement

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Mission

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.