Director of Managed Care Reimbursement

This is a fully remote position, open to applicants in Texas.

📋 Description

• Create and implement strategic initiatives aimed at enhancing the company’s revenue stream.

• Report directly to the Vice President of Managed Care Operations.

• Work in partnership with the Managed Care team.

⛳️ Requirements

• A minimum of five years (5) of experience in Finance, Medical Economics, or Revenue Cycle.

• Proficient in modeling and analytics.

• Ability to synthesize data effectively.

• High level of expertise in navigating private, federal & state fee schedules, along with supporting guidelines across diverse payer mixes nationwide.

• Provide the VP with strategic analyses and evaluations of trends.

• Interpret reimbursement changes and their effects on revenue streams.

• Communicate policy updates across various functions.

• Familiarity with numerous reimbursement models and methodologies, including but not limited to: Daily Max, Fee for Service, RBRVS, Medicaid, value-based payment models, escalators, bundled payments, and shared savings.

• Lead initiatives to identify and recover underpayments.

• Supervise the Payment Compliance and Chargemaster teams.

• Assist the VP in conducting due diligence for strategic partnerships.

• EMR experience; familiarity with Raintree is a plus.

• Experience with Business Intelligence tools.

• Advanced skills in Microsoft applications, including Excel, Pivot Tables, and Vlookup.

• Strong project management capabilities.

• Excellent critical thinking and analytical skills, with a strategic approach to work.

• Outstanding oral and written communication abilities.

• Proven organizational, interpersonal, and management skills.

• Over 5 years of experience in a healthcare environment.

🏝️ Benefits

• Medical, dental, vision, 401(k), paid time off, and additional benefits are available, subject to the provisions of the Company's plan.