Mount Carmel Health System

About Mount Carmel Health System

 

Job Category:

Financial Services, Leadership

Country:

United States

Postal Code:

43085

Approximate Salary:

Not Specified

Position Type:

Full Time

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Regional Director of Reimbursement - Ohio

Mount Carmel Health System - Columbus, Ohio

Posted: 07/12/2018

Department:

IN308_69028 Uro - Finance & Dss

Expected Weekly Hours:

40

Shift:

Position Purpose:

The Regional Director of Reimbursement serves as the primary contact to the Regional Chief Financial Officer along with the Regional Health Ministry (RHM) Vice Presidents of Finance and the Regional Ambulatory Services Leadership to provide them with an understanding of their business, net revenue estimates, balance sheet valuations, net revenue budgets, mid-month projections and regulatory changes. The role provides critical help to the Vice Presidents of Finance in understanding their business so appropriate and timely decisions can be made. The incumbent provides leadership to a Regional Shared Service Center managing the reimbursement function for up to ten Trinity Health RHMs (with net revenues of $2 billion annually). The position is responsible for managing and mentoring all Shared Service Center managers and staff and is also required to manage the relationships between the Shared Service Center and RHM Vice Presidents of Finance.

This position identifies and manages all financial and compliance risk associated with the reimbursement function, keeping senior leadership apprised of identified risk and tracks progress with risk management plans. It works closely with and supports other revenue functional areas including payer negotiations and contracting, patient financial services, utilization management and coding. It serves in an advisor capacity to RHMs in region and to the Reimbursement and Revenue Integrity Central Operations Team. The role identifies and implements leading practices, processes and technology necessary to achieve objectives and engage key stakeholders by leading effective change management. Responsible for leading and participating in initiatives to improve net revenues, reduce receivables and improve compliance associated with the Southeast Michigan professional (ambulatory) services.


ESSENTIAL FUNCTIONS


1. Knows, understands, incorporates and demonstrates the Trinity Health Mission, Vision and Values in leadership behaviors, practices and decisions.

2. Prepares the department budget and manages use of resources within budget targets.

3. Responsible for hiring, retaining, evaluating, mentoring and firing managers and staff within the department.

4. Responsible for managing all financial and compliance risk associated with the reimbursement function (for acute and professional services), notifying senior leadership of identified risks and tracking and monitoring progress of risk management plans.

5. Directs the preparation of RHM net revenue calculations and reviews with the Vice Presidents of Finance prior to financial statement due date. Directs the preparation of the budgeted net revenue calculation for the RHMs.

6. Manage the overall balance sheet position related to third party contractuals and related reserves. Provide updates to Senior Leadership to avoid any surprises.

7. Directs the preparation of RHM cost reports and other third party filings. Directs the preparation for third party audits and takes a lead role in resolving audit issues and developing appeals. Directs the preparation of reports, position papers, impact analysis and development of recommendations concerning specific reimbursement issues. Participates in developing group appeals for all Trinity Health concerning reimbursement disputes with third party payors.

8. Develops strategic reimbursement planning and analysis for short and long-term operating plans and capital projects (for acute and professional activities).

Job Description Details:

MINIMUM QUALIFICATIONS

Bachelor’s degree in Business Administration, Accounting or Finance or an equivalent combination of education and experience. Master’s degree is preferred.

Certification as a Certified Public Accountant (CPA) preferred.

Over ten (10) years of progressively more responsible experience in health care reimbursement management.  Experience managing multiple facilities preferred.

Ability to develop and interpret financial statements and reports.

Working knowledge of generally accepted accounting principles and a thorough understanding of third party reimbursement mechanisms and contracting strategies.

Ability to communicate in clear, concise terms with management and governance at all levels, including communication with C-Suite executives.

Ability to work effectively in a matrix organizational structure and influence others.

Well-developed conceptual and analytical skills.

High level of interpersonal, management and organizational skills are necessary with special focus on customer service orientation skills.

Must be able to operate effectively in a collaborative, shared leadership environment.

Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

Flexibility to work with a multitude of customers and issues and willingness to take on new responsibilities.

Ability to develop constructive alternatives and analyze situations and information.

Ability to work well in a fast-paced setting that warrants varied and/or extended hours, with frequently changing workload and priorities in order to keep pace with the environment and advance strategic priorities.

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs more than 120,000 colleagues at dozens of hospitals and hundreds of health centers in 21 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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