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This job was posted by https://illinoisjoblink.illinois.gov : For more information, please see: https://illinoisjoblink.illinois.gov/jobs/12518386 By joining our team, you\'ll be part of our life-changing Mission and Vision. You\'ll work in a truly inclusive environment where diversity and equity are championed through words and actions. You\'ll contribute to an innovative culture that is second to none, one that embraces curiosity, discovery and compassion. You\'ll play a role in something that\'s never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together.

Job Description Summary

The Director, Reimbursement and Financial Analysis will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Director The Director, Reimbursement and Financial Analysis will serve as an expert to senior leadership on all reimbursement methodologies and trends. The Director will partner with Revenue Cycle Operations leadership to provide financial and analytic support and ensure proper accounting of accounts receivables. They will lead payor analytics for the contracting team and develop and maintain financial models related to potential changes in federal programs or managed care. Proactively identifies opportunities for revenue growth based on changing regulations. The Director will play a lead role in the preparation, submission, and management of Medicare and Medicaid cost reports for the hospital.

The Director, Reimbursement and Financial Analysis will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.

The Director, Reimbursement and Financial Analysis will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties.

Job Description

The Director, Reimbursement and Financial Analysis will:

• Serve as central connection point between Finance, Accounting, and Revenue Cycle leadership
• Direct the development and implementation of reimbursement strategies across all payor types including Medicare, Medicaid, and commercial insurance
• Monitor legislative and regulatory changes affecting Medicare/Medicaid reimbursement, model and communicate expected impact, and implement necessary strategies
• Through partnership with a third party, generate and analyze detailed AR reports using RCA software to identify trends, bottlenecks, and manage the net AR month end accounting close process
• Play key role in the development, review, and submission of annual Medicare/Medicaid cost reports, ensuring accuracy and compliance with CMS guidelines and regulations
• Coordinate with external auditors during Medicare/Medicaid audits and respond to audit findings
• Implement and manage Medicare bad debt policy and procedures.
• Analyze KPIs for accounts receivable, bad debt, denials, and collection rates
• Provide financial & strategic support in payor contract negotiations to optimize payment terms
• Assist in the review of annual CDM price increase process
• Provide reimbursement expertise in strategic financial modeling (new partnerships, expansion, etc.)
• Present complex financial information to senior leadership and provide strategic recommendations
• Lead financial forecasting, budgeting, and reporting for revenue cycle operations

Reporting Relationships

• eports to Vice President, Corporate Finance

Knowledge, Skills & Abilities Required

Bachelor\'s degree in Healthcare Administration, Finance, or related field

Master\'s degree in related field and/or CPA preferred

Background in hospital financial operations with 10+ years of healthcare experience, with at least 5 of those years in a reimbursement role being strongly preferred; advanced degrees and/or specific relevant experience can substitute for total years of experience.

Comprehensive knowledge of CMS regulations, cost reporting principles, and healthcare reimbursement methodologies

Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation

Familiarity with healthcare billing and coding practices and technologies

Experience in Medicare Cost Report preparation and review.

Experience with RCA software for AR accounting and analysis

Strong understanding of hospital operations and healthcare financial management

Experience with electronic health record (EHR) systems

Excellent analytical and problem-solving abilities

Strong interpersonal and negotiation s