Director of Reimbursement and Cost Reporting Facility: Beth Israel Lahey Health - Non Executive Charlestown, MA 01/10/2024

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Job Type : Regular

Regular

Scheduled Hours : Work Shift :

Work Shift :

Day (United States of America)The Director, Revenue Finance and Reimbursement, will be a core member of the Revenue Finance leadership team of Beth Israel Lahey Health (BILH).

BILH is a new integrated health system with $6 billion in revenues and includes academic medical centers, acute and specialty hospitals, outpatient facilities, physician groups, performance networks, and community partners.

As part of the leadership team, the Director will assist the VP and AVP to integrate BILH’s six separate revenue valuation and reimbursement units to form a unified, enterprise-level department aligned around shared goals and a commitment to :

• 1)Deliver high quality net revenue valuation and related finance models based on transparent and efficient methodologies;
• 2)Produce data and analytics that deliver actionable business insights to BILH hospital, physician, and system leaders;

3)Provide strategic solutions that optimize reimbursements by applying a deep knowledge of both government and commercial payment systems; and,

4)Provide Medicare, Medicaid, and payment system expertise in support of BILH provider and system strategic and operational objectives.

Reporting to the AVP of Revenue Finance and Analysis, the Director will lead a team of 4-5 individuals with expertise in both government reimbursement and net revenue analysis.

Working with the VP and AVP, the Director will develop long- and short- term Medicare, Medicaid, and other government reimbursement revenue strategies, oversee preparation and submission of all regulatory filings, and will provide system-wide guidance on revenue enhancement opportunities and regulatory requirements.

The Director will also be responsible for net revenue valuation and analytics for a core set of BILH facilities. Responsibilities include overseeing the net revenue and third-party valuations, annual net revenue budgeting, audit support, and other month and year end net revenue activities.

In this role, the Director will be responsible for supporting and educating health systems’ finance and operational leadership, establishing open lines of communication with hospital CFOs and other facility leadership, and ensuring alignment between System Revenue Finance and hospital and health system goals and objectives.

Job Description :

Essential Duties & Responsibilities including but not limited to :

1. Communicate the department’s vision and goals and ensure employees can relate them to their team and individual goals.

Provide day to day management including creating departmental goals and objectives, developing performance standards, and motivating and engaging the team to achieve goals.

2. Oversee all aspects of net revenue valuation and analysis for BILH facilities. Demonstrate and apply an in-depth understanding of the net revenue reserve and other valuation methodologies to : (1) ensure adequate reserve levels, (2) identify and communicate insights and trends to hospital and executive leadership, and (3) promote adherence to enterprise-wide policies & procedures.

3. Develop and implement a methodology to identify, standardize, and produce high value and high volume reports and / or data resources.

Success will be built upon a collaborative approach that engages both internal and external customers to identify and appropriately scope opportunities.

Examples include standardizing data to support Medicare, Medicaid and other regulatory filings, supporting financial and government auditor data requests, and servings as a liaison to the System & Analytics Optimization department.

Specific Duties :

4. Produce and / or review monthly, annual, and other reserve estimates, journal entries, general ledger account reconciliations, variances analyses, etc.

for hospital and professional entities.

5. Prepare and present to department and hospital leadership the monthly net revenue estimates and analysis with a focus on providing actionable insights.

6. Direct, oversee, and review the patient accounts receivable reserve calculation process for BILH hospitals and professional entities.

7. Oversee the completion of the annual net revenue budget and assist with forecasting processes for net revenue projections for hospital and professional business units

8. Serve as a contact to support all third party audits including Financial and Government Audits, etc.

9. Identify and design strategic reimbursement initiatives including Medicare & Medicaid DSH, GME, UC, bad debt reimbursement, and wage index reclassifications

10. Design processes and tools to optimize appropriate transplant program and medical education reimbursements, with a focus on harmonizing across BILH as appropriate.

11. Review and assist in the preparation and filing of the Medicare and Medicaid cost reports, surveys, and questionnaires, assuring the timeliness and accuracy of each.

12. Manage of all aspects of the Massachusetts 1115 waiver and HSN program.

13. Develop a dashboard of all key Medicare and Medicaid metrics and monitor threshold critical to determining payment levels.

14. In all interactions, foster teamwork, effective communication, and cohesiveness in support of BILH’s patients, caregivers, and administrative teams.

Education : Bachelor’s Degree in Accounting or Finance or related fields.

Licensure, Certification & Registration : n / a

Experience :

• 10+ years of progressively increasing experience in healthcare; including demonstrated focus in revenue finance related areas, such as net revenue, government reimbursement, revenue cycle, etc.
• 7-10+ years of managerial experience, including a demonstrated ability to communicate a vision and motivate teams to achieve common goals.
• Demonstrated experience and interest in developing methodologies to standardize and optimize data tools and reporting requirements to achieve effective and efficient solutions.

Skills, Knowledge & Abilities :

• Must be able to handle multiple, complex tasks and priorities
• Requires superior interpersonal skills to effectively supervise staff and work and communicate with all levels of management
• Must be a highly self-motivated individual with the ability to function in a fast-paced environment with limited supervision and direction
• Must have strong analytical skills
• Must be able to effectively mentor staff and foster a supportive and growth-oriented environment
• Must have superior computer skills on various software products and systems including MS Office, HFS, EPIC, and Crowe (not required)
• Must be a dedicated team player with the willingness and desire to learn and grow within the organization

FLSA Status : Exempt

Exempt

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities.

Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment.

about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives.

Your skill and compassion can make us even stronger.

Equal Opportunity Employer / Veterans / Disabled