Strategic AVP, Government Reimbursement & Policy

Health Partners Plans; Philadelphia (Philadelphia County); On-site; USD 180,000 - 280,000; Full time

Job summary

Health Partners Plans seeks an Associate Vice President of Reimbursement to lead government reimbursement strategy, regulatory reporting, and payment optimization enterprise-wide. This role oversees Medicare/Medicaid cost reports, audits, and regulatory inquiries, guiding leadership on risks and opportunities with strong controls and documentation.

You will advise executive leadership, collaborate across finance, legal, operations, and clinical teams, and direct a team focused on achieving

Qualifications

• Bachelor's degree in accounting, finance, health administration, or a related field.
• 10 years of progressively responsible hospital reimbursement experience, including Medicare/Medicaid cost reporting, audits, settlements, and payment analysis.
• Experience leading professional reimbursement or finance staff, including goal setting, delegation, staff development, succession planning, and performance management.
• Experience directing complex financial close, audit, budgeting, forecasting, regulatory reporting, and cross-functional decision-support processes.
• Comprehensive knowledge of Medicare/Medicaid regulations, cost-reporting requirements, and hospital payment methodologies.
• Ability to interpret complex regulations, assess financial and operational effects, formulate defensible positions, and translate findings into actionable recommendations.
• Strong executive communication and presentation skills for senior leaders, auditors, and partners.
• Strong project-management and change-leadership skills for cross-functional initiatives.

Responsibilities

• Lead enterprise government reimbursement strategy, including Medicare/Medicaid opportunities across hospitals and regions.
• Oversee preparation, review, certification, and filing of Medicare/Medicaid cost reports and other government submissions.
• Direct cost-report audits, reopenings, appeals, and settlement activities with compliant documentation.
• Establish reimbursement policies, governance standards, and internal controls for reliable reporting.
• Monitor proposed/regulatory changes; advise leadership on risks, opportunities and actions.
• Provide leadership for DSH payments, GME, wage index, and other government payment methodologies.
• Coordinate with finance, accounting, revenue cycle, legal, compliance, and clinical leadership on reimbursement matters.
• Develop budgeting assumptions, long-range plans, forecasts, and period-end close analyses.
• Represent the organization with governmental agencies, auditors, contractors, and external stakeholders.
• Build and lead a high-performing reimbursement team with clear expectations and development opportunities.

Skills

Executive leadership

Medicare/Medicaid reimbursement

Regulatory compliance

Audits & cost reports

Cross-functional collaboration

Education

Bachelor's degree in accounting/finance/health administration

Job description

Health Partners Plans seeks an Associate Vice President of Reimbursement to lead government reimbursement strategy, regulatory reporting, and payment optimization enterprise-wide. This role oversees Medicare/Medicaid cost reports, audits, and regulatory inquiries, guiding leadership on risks and opportunities with strong controls and documentation.

You will advise executive leadership, collaborate across finance, legal, operations, and clinical teams, and direct a team focused on achieving