Director, Reimbursement-Financial Analysis Reimbursement-Corporate 42nd Street-Full-Time-Days

The Director is responsible for direction and management responsibility over the business and operational activities of a department (overall department management or a specific area within a department), or medical care unit.

• Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards.    
• Oversees the preparation and submission of all regulatory reports.    
• Performs direct development and implementation of all NPSR, HSN, and governmental revenue activities including accruals, reserves, and settlements at the hospital levels.      
• Plans, coordinates, and prepares year end audits with public accounting firms and third party auditors as they relate to AR operations.    
• Mediates and resolves conflicts regarding public accounting firms, third party auditors, and investigative parties.    
• Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third party payers.    
• Collaborates with other leaders with Steward, external agencies, vendors, and partner organizations to achieve improved financial outcomes.    
• Acts as primary contact for all reimbursement issues and advises the financial management team about changes in reimbursement environment and suggest courses of action.
• Trains all new employees about reimbursement issues and system usage.    
• Evaluates of all medical education reimbursement calculations, which includes scrutinizing all roll forward calculations, affiliation agreements, and residency caps.      
• Reviews all Medicaid and Medicare data to determine Medicare disproportionate share reimbursement.
• Reviews all third-party settlements to ensure their accuracy and standardize their presentation.    
• Oversees the preparation and review of each hospital's monthly net revenue modeling and helps to evaluate variances to budget.
• Oversees all audits performed by external firms and/or governmental agencies.      
• Prepares responses to both internal and external questions involving various reimbursement matters to ensure a timely and accurate resolution to all issues.    
• Interacts with division directors and departmental heads to obtain all data necessary to comply with various regulatory requirements.
• Takes the lead role in reviewing the annual Medicaid RFA to evaluate its impact and coordinate the system's response.   
• Assists with the evaluation and resolution of various compliance matters involving federally funded insurers like Medicare and Medicaid.
• Oversees the process to identify Medicare + Choice plan discharges so that Medicare senior plan IME billing takes place timely.
• Participates in the evaluation of all managed care proposals to ensure that all proposals will enable the system to cover costs and can be administered effectively.
• Completes annual evaluations for all direct reports.
• Develops the departmental annual operating and capital budgets.
• Creates new policies and procedures resulting from system and/or operational changes.     
• Makes all decisions governing hiring, promoting, demoting, and terminating staff.      
• Oversees the creation of standardized reports and analyses used to evaluate all RFPs.

• Education: Bachelor's degree in either business or financial related field.  A Master's degree in business, finance, or health care related field is preferred.
• Experience: 7 years of experience in health care finance or administration; experience in strategic planning and execution, formulating policy, building and developing financial plans, managing resources and leading successful teams. Big 4 experience a plus. CPA a plus
   

Compensation Statement

The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $153,723.00 - $230,584.00 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

Non-Bargaining Unit, 536 - Reimbursement - MSH, Mount Sinai Hospital

Please pay attention to fraud and not pay any money to any person or entity that is not trusted, inspect the commodity and ensure its safety before completing the deal, and report violating advertisements immediately..