Strategic Reimbursement & CDM Manager

Adventist HealthCare; Gaithersburg (MD); Hybrid; USD 106,000 - 158,000; Full time

Benefits offered by this job

Free employee parking

Tuition Reimbursement

Employee Assistance Program (EAP)

Job summary

Adventist HealthCare seeks an experienced Reimbursement and CDM Manager to oversee reimbursement activities for HSCRC and related regulatory reporting. You will lead CDM governance, pricing, and charge capture across the enterprise, collaborating with Revenue Integrity, Revenue Cycle, clinical departments, Compliance, and IT.

The role requires expertise in HSCRC methodologies, Medicare reimbursement, and Epic CDM, with strong leadership of multidisciplinary teams and a focus on accuracy and

Qualifications

• Knowledge of HSCRC reimbursement methodologies and Maryland rate setting.
• Experience with Medicare reimbursement and hospital pricing practices.
• Experience with cross-functional governance and audits.

Responsibilities

• Monitor GBR performance, unit rate compliance, and reimbursement trends for HSCRC and CMMI/AHEAD.
• Prepare monthly reimbursement and revenue packets including journal entries.
• Oversee CDM governance, pricing, revenue codes, and charge capture with multiple stakeholders.
• Participate in annual coding updates, audits, and CMS/HSCRC reporting.
• Assist with HSCRC Annual Filing, Medicare Cost Reports, and related regulatory submissions.
• Support CMS Hospital Price Transparency files and ongoing compliance.

Skills

HSCRC reimbursement knowledge

Regulatory reporting

Cross-functional partnership

Data interpretation

Education

Bachelor's degree in Accounting/Finance/Healthcare Administration

Tools

Epic Resolute Hospital Billing

Epic CDM

Job description

Adventist HealthCare seeks an experienced Reimbursement and CDM Manager to oversee reimbursement activities for HSCRC and related regulatory reporting. You will lead CDM governance, pricing, and charge capture across the enterprise, collaborating with Revenue Integrity, Revenue Cycle, clinical departments, Compliance, and IT.

The role requires expertise in HSCRC methodologies, Medicare reimbursement, and Epic CDM, with strong leadership of multidisciplinary teams and a focus on accuracy and