Manager, Governmental Reimbursement & Cost Reporting, Marlton

Virtua; Marlton (NJ); Hybrid; USD 105,000 - 168,000; Full time

Benefits offered by this job

Hybrid work option

Competitive benefits package

Annual incentive plan

Job summary

Virtua Health seeks a Manager of Reimbursement to lead Medicare cost reporting and regulatory compliance for a large acute care system in New Jersey. You will own the annual Medicare and NJ cost reports, coordinate audits, and guide reimbursement strategy with Corporate Finance.

The ideal candidate has 5–7 years in hospital reimbursement, advanced knowledge of NJ and federal regulations, and experience with cost reporting, Wage Index, and CMS systems. Hybrid work available.

Qualifications

• Must possess knowledge and understanding of the Medicare Cost Report, NJ Acute Care Reporting and other regulatory requirements.
• Required Education: Bachelor's of Business Administration in Accounting or Finance required. Certification as public or managerial accountant or Master's Degree in Business Administration in related field is preferred.

Responsibilities

• Coordinate and complete data for the Medicare/Medicaid Cost Reports and all reimbursement surveys.
• Lead 3rd party audits with government intermediaries and schedule audits.
• Monitor and trend the impact of Medicare/Medicaid regulations.
• Provide monthly, quarterly, and special reports for operational management.
• Serve as System Administrator in reimbursement systems (Cost report system and CMS systems).
• Support data-driven improvements in reimbursement operations.

Skills

Regulatory knowledge

Analytical thinking

Communication skills

Windows/Excel

Attention to detail

Education

Bachelor's in Accounting or Finance

CPA or CMA preferred

Tools

Oracle

EPIC

Excel

Word

Job description

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community.If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 otherlocations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through ourEat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.

Location:

Lippincott - 406 Lippincott Drive

Remote Type:

Hybrid

Employment Type:

Employee

Employment Classification:

Regular

Time Type:

Full time

Work Shift:

1st Shift (United States of America)

Total Weekly Hours:

40

Schedule:

Hybrid - three days onsite, two days remote.

Job Information:

Must possess knowledge and understanding of the Medicare Cost Report, NJ Acute Care Reporting and other regulatory requirements.

Job Summary:

The Manager of Reimbursement serves as the health system's primary subject matter expert for Medicare reimbursement, governmental regulations, and complex reimbursement methodologies. This role maintains full ownership for the preparation, review, and submission of the annual Medicare and NJ State cost reports, as well as oversight of related reimbursement and audit activities.

The position requires advanced knowledge of acute care hospital reimbursement, New Jersey reimbursement methodologies, and evolving federal and state regulatory requirements. Working closely with Corporate Finance leadership and external regulatory agencies, the Manager of Reimbursement identifies opportunities to optimize reimbursement outcomes, interprets regulatory changes, and provides strategic guidance that supports the organization's financial performance and long-term reimbursement strategy.

This is a highly specialized reimbursement leadership role. The ideal candidate will possess demonstrated end-to-end ownership of Medicare cost reporting and extensive experience in hospital reimbursement within a complex acute care health system environment, i.e.; Chapter 160 cost reports, Wage Index submissions, NJ DSH, Occupational Mix surveys, PPS calculations, IME/GME appeals, and regulatory analysis.

Position Responsibilities:

Responsible for coordination and completion of the data for the Medicare/Medicaid Cost Reports and all reimbursement surveys and empowers the staff to make recommendations for improvements.

Coordinates all 3rd party audits with government intermediaries. Lead contact person with scheduling audit, gathering all requested information, fielding questions, and analyzing impact of audit adjustments.

Monitors and trends the impact of Medicare and Medicaid regulations. Reviews and analyzes relevant information related to Medicare regulatory compliance issues.

Provides monthly, quarterly, and special request reports related to patient detailed data for Operational Management through data reporting.

Implements new systems related to financial controls and assists in matters as they relate to reimbursement operations. Serves as System Administrator in various reimbursement systems for IE: Cost report system and other CMS systems.

Position Qualifications Required:

Required Experience: Five to seven years of Reimbursement experience required with one to three years supervisory experience preferred. Must possess knowledge and understanding of the Medicare Cost Report, NJ Acute Care Reporting and other regulatory requirements. Ability to work independently to achieve goals and prioritize work assignments. Excellent organizational, analytical, problem-solving, and communication skills. Must have a working knowledge of Windows, Word, and Excel. Thorough knowledge of general ledger software packages. Oracle and/or EPIC experience a plus.

Required Education: Bachelor's of Business Administration in Accounting or Finance required. Certification as public or managerial accountant or Master's Degree in Business Administration in related field is preferred.

Annual Salary: $104,613 - $167,938The actual salary/rate will vary based on applicant's experience as well as internal equity and alignment with market data.

This position is eligible to participate in one of Virtua's annual incentive compensation plan (AICP). The amount is subject to the terms and conditions of the plan document.

Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions.

Eligibility for benefits is governed by the applicable plan documents and policies.