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Reimbursement Manager - Regulatory
Description:
HFS Consultants focuses on helping health care organizations achieve and maintain economic strength while also managing the risks they confront in the challenging health care environment. Our services address five areas: revenue management, financial performance, regulatory reporting and compliance, operations improvement, efficiency and cost reduction.Our Regulatory reporting and compliance team has talented and dedicated individuals, supported with proprietary tools and advanced technology, who assist senior executives in all aspects of Federal & State revenue and compliance reporting.
We are currently seeking a qualified candidate for an excellent career opportunity as a Manager in our Oakland, CA headquarters and our new and rapidly growing Orange County office.
Responsibilities:
Manage and exceed client expectations
Develop and maintain strong working relationships with key client executives. Collaborate and develop work plans to meet our clients needs within a defined budget, and develop strategies to address risk. Understand and articulate industry trends and how they impact our clients business. Apply / communicate strategic objectives and organizational policies of HFS.People Development
Responsible for the growth and development of HFS professionals at all levels. Conduct performance reviews, contribute to performance feedback and serve as a leader and mentor. Foster teamwork, innovative thinking and knowledge sharing with team members to enhance service delivery. Successfully delegate to all levels of staff. Understand/follow workplace policies, as well as respect/protect confidential client information. Maintain an educational program to continually develop skills.Business Development
Achieve healthy, sustainable growth for HFS and our clients by understanding client needs, our service lines and actively advising, assessing and presenting ways that the firm can bring value. Develop long-term relationships and networks.Requirements:
- A Bachelor's degree in Business or a related field (a CPA, MBA, MHA and/or MPH degree is a plus)
- A minimum of 10 years of relevant, in-depth health care advisory experience, preferably with a Big 4 firm, a regional firm, or a senior administrative or financial executive at a large acute care or academic medical center
- Detailed knowledge of Medicare/Medicaid reimbursement principles. Strong technical skills in all areas of Medicare/Medicaid compliance reporting including billing compliance, cost reporting, Graduate Medical Education (GME), Medicare Bad Debt, Wage Index, Organ Acquisition, and Disproportionate Share (DSH) and knowledge of applicable regulations, reimbursement principles, laws, and proposed legislation
- Experience conducting Medicare/Medicaid appeals, reopening requests, and disputed issues on behalf of hospitals, preparing position papers and knowledge of the Provider Reimbursement Review Board (PRRB) proceedings preferred
- Acute care experience is a must, experience or knowledge of other healthcare providers (skilled nursing, home health, etc.) is a plus
- Strong financial, analytical, technical, and interpersonal skills are required
- Excellent client service and proven sales/business development skills are a must
- A demonstrated ability to manage large engagements, prioritize and supervise/motivate staff is a must
- Excellent written and verbal communication skills are required
- Demonstrated leadership skills and the ability to manage multiple projects is a must
- Strong financial, analytical, technical, and interpersonal skills is a must
- Excellent written and verbal communication skills is a must
The successful candidate must also be willing and able to travel.
Please send your resume to consultants@hfsconsultants.com for immediate consideration.