Remote System Director, Reimbursement

Mercy Health; United States; Remote; USD 170,000 - 220,000; Full time

Benefits offered by this job

Competitive pay and incentives

403(b) with employer contributions

Paid time off and parental/FMLA leave

Job summary

Mercy Health is seeking a System Director Reimbursement to lead the assigned state portfolio within the enterprise reimbursement function, overseeing cost reporting, Medicare/Medicaid payment integrity, regulatory analysis, and settlements. You will guide Directors, Managers, and Senior Analysts, ensuring adherence to enterprise standards and CFO transparency.

The role emphasizes strategic advisory, governance of cost reports, and AI-enabled analytics to improve financial visibility and

Qualifications

• Extensive progressive hospital reimbursement experience with leadership accountability for Medicare/Medicaid.
• Experience in cost reporting, settlements, regulatory analysis, audits in a multi-entity environment.
• Knowledge of hospital reimbursement across acute, post-acute, ambulatory, and physician settings.
• Ability to advise senior executives and CFOs with clear recommendations and decisions.
• Experience leading matrixed, shared-services teams and driving accountability.
• Ability to establish enterprise internal controls, QA governance, and audit-ready documentation.
• Foundational digital literacy, including AI/GenAI familiarity and prompt engineering.
• Experience governing AI/ML workflows in finance/reimbursement contexts.

Responsibilities

• Lead the reimbursement operating model for the assigned state portfolio and markets, ensuring accountability for cost reporting, CMS/Medicaid, regulatory analysis, audits, settlements, and advisory activities.
• Monitor CMS/Medicaid changes and provide proactive financial impact analysis to senior leaders before rules are finalized.
• Oversee cost report lifecycle governance and performance reporting to CFOs with timely escalation of material risks.
• Lead Medicare/Medicaid payment integrity oversight, including self-audit protocols and regulatory compliance monitoring.
• Maintain consolidated reimbursement forecasting and executive visibility for risk and opportunity across payer streams.
• Collaborate with Revenue Cycle, Legal, Compliance, and operations to align reimbursement positions and action plans.

Skills

Leadership

Analytics

AI/GenAI literacy

Cross-functional collaboration

Strategic thinking

Problem solving

Education

Bachelor’s degree in accounting/finance/health care administration

Master’s degree in related field

Tools

AI tools familiarity

Job description

Mercy Health is seeking a System Director Reimbursement to lead the assigned state portfolio within the enterprise reimbursement function, overseeing cost reporting, Medicare/Medicaid payment integrity, regulatory analysis, and settlements. You will guide Directors, Managers, and Senior Analysts, ensuring adherence to enterprise standards and CFO transparency.

The role emphasizes strategic advisory, governance of cost reports, and AI-enabled analytics to improve financial visibility and