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Director Revenue Planning Reimbursement and Managed Care

Company: West Park Hospital-WY-US
Location: Schenectady
Posted on: April 8, 2021

Job Description:

Director Revenue Planning Reimbursement and Managed Care Schenectady , NY Reimbursement Senior Management Full Time (40 Hours) , Days Posted 03/13/2021 BASIC FUNCTION: The Director of Revenue Planning, Reimbursement and Managed Care ("DRPRMC" or "Director") is responsible for the activities of the Reimbursement Department for Ellis Hospital ("Ellis" of "Hospital"), including revenue planning, managed care contracting and third-party payer management and compliance. This includes but is not limited to (1) directing the staff and activities of the Reimbursement Department, (2) insuring compliance with all third-party regulatory reporting requirements in a timely and accurate manner, (3) ensuring the Hospital is maximizing reimbursement from third-party payers by following and utilizing reimbursement guidelines, (3) preparing net revenue figures for monthly financial statements, (4) preparing the net revenue budget as part of the Ellis' annual budgeting process, (5) working with external auditors as necessary, (6) assisting with revenue projections related to the development of new service lines, (7) assessing emerging or alternative third-party payment mechanisms with the potential to create incremental business for Ellis, (8) developing effective working relationships with Ellis' various third-party payers, (9) negotiation new or renewal agreements with all third-party payers as necessary, (10) monitoring contractual agreements and applicable at-risk dollars to maximize Hospital revenue, (11) act as advisor to Chief Financial Officer on reimbursement and managed care issues. EDUCATION AND EXPERIENCE REQUIREMENT(S): The DRPRMC must have a bachelor's degree in Accounting, Finance, Business Administration or related field with 5 to 7 years' experience working in healthcare reimbursement, principally in a hospital setting. A graduate degree, HFMA Fellowship or licensure as a Certified Public Accountant is desirable. The Director must possess expertise in hospital reimbursement (Medicare, Medicaid, 340B, etc.), managed care concepts, revenue modeling and payer contract management. Excellent oral and written communication skills and the ability to provide leadership are necessary.

Keywords: West Park Hospital-WY-US, Schenectady , Director Revenue Planning Reimbursement and Managed Care, Executive , Schenectady, New York

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