Manager, Healthcare Reimbursement and Regulatory Compliance

RSM; Florida; On-site; USD 120,000 - 180,000; Full time

Job summary

RSM's National Healthcare Consulting practice seeks a Manager, Healthcare Reimbursement and Regulatory Compliance to help health systems optimize Medicare-related reimbursements and regulatory adherence.

The role partners with clients to deliver strategic insights, oversees project work plans, and mentors teams while driving quality and growth across the client base.

Qualifications

• 5+ years of healthcare reimbursement and regulatory experience; consulting experience preferred.
• Certification related to healthcare financial management (HFMA) is expected.

Responsibilities

• Serve as a trusted advisor to healthcare clients regarding reimbursement, regulatory compliance, strategic initiatives, and operational challenges.
• Partner with clients and engagement teams to deliver high-quality consulting services and client deliverables.
• Assist in developing and delivering training materials related to reimbursement, compliance, and process improvements.
• Create, manage, and execute project work plans with timely, high-quality client service delivery.
• Prepare and maintain internal and external project status reports and communications.
• Lead, coach, and mentor project team members while coordinating priorities, deliverables, timelines, and quality standards.
• Support junior team members’ professional development by sharing industry knowledge and best practices.
• Participate in business development and client discussions regarding reimbursement, regulatory compliance, and industry challenges.
• Represent RSM professionally while supporting client relationships and identifying opportunities to expand services.

Skills

Healthcare reimbursement

Regulatory compliance

Client advisory

Project leadership

Team mentorship

Education

HFMA certifications

Job description

RSM's National Healthcare Consulting practice is seeking a Manager, Healthcare Reimbursement and Regulatory Compliance to join our growing team. This role provides healthcare regulatory and reimbursement consulting services to healthcare organizations across the country. Our healthcare regulatory recovery services focus on identifying high-impact Medicare cost report opportunities, including Critical Access Hospital reimbursement, disproportionate share hospital reimbursement, Medicare bad debts, wage index optimization, and other reimbursement-related matters.

As part of the National Healthcare Consulting practice, you will collaborate with experienced professionals who bring deep expertise in healthcare finance, reimbursement methodology, regulatory compliance, and healthcare operations. You will work directly with healthcare providers to help them maximize reimbursement opportunities, navigate complex regulations, and achieve their strategic and financial objectives.

We are looking for a client-focused professional with strong reimbursement and regulatory expertise who enjoys solving complex problems, building trusted client relationships, and contributing to practice growth.

Responsibilities

• Serve as a trusted advisor to healthcare clients regarding reimbursement, regulatory compliance, strategic initiatives, and operational challenges.
• Partner collaboratively with clients and engagement teams to deliver high-quality consulting services and client deliverables.
• Assist in the development and delivery of training materials related to reimbursement, compliance, and process improvements.
• Create, manage, and execute project work plans while ensuring timely and high-quality client service delivery.
• Prepare and maintain internal and external project status reports and communications.
• Lead, coach, and mentor project team members while coordinating priorities, deliverables, timelines, and quality standards.
• Support the professional development of junior team members by sharing industry knowledge, best practices, and project management techniques.
• Participate in business development activities and client discussions regarding reimbursement, regulatory compliance, and industry challenges.
• Represent RSM professionally while supporting new and existing client relationships and identifying opportunities to expand services.

Required Qualifications

• 5+ years of healthcare reimbursement and regulatory experience; consulting experience preferred.
• A Job relevant certification (including but not limited to Healthcare Financial Management Association (HFMA) certifications)

Preferred Qualifications

Candidates may also bring one or more of the following experiences or credentials:

• Critical Access Hospital expertise.
• Rural healthcare reimbursement and regulatory experience.
• Hands-on experience completing Medicare, Medicaid, and/or Blue Cross reimbursement reports.
• Strong knowledge of third-party reimbursement methodologies and procedures.
• Strong leadership and people management experience.
• Proficiency with Microsoft Office applications and healthcare reimbursement software programs.
• Proven experience leading and/or supervising client service teams.
• Ability and willingness to travel.
• Ability to analyze and interpret complex financial and reimbursement data.
• Ability to interpret healthcare regulations, reimbursement guidance, and industry trends.
• Demonstrated success building strong client and team relationships.
• Understanding of the economics and operations of a professional services consulting practice.
• Strong record of delivering projects accurately, on time, and in alignment with client expectations.
• Experience developing consulting opportunities with new and existing clients.
• Excellent organizational, communication, facilitation, and interpersonal skills.
• Ability to work independently while effectively collaborating across teams.
• Creative problem-solving skills and sound professional judgment.