Director | Reimbursement

Scheduled Weekly Hours:

Join Our Team as Director of Reimbursement!

As the Director of Reimbursement, you will oversee all aspects of reimbursement processes, ensuring compliance with Medicare and Medicaid regulations, optimizing reimbursement strategies, and managing cost reporting. Your expertise in 340B programs and reimbursement optimization will be crucial in driving financial performance and supporting our mission to deliver high-quality patient care.

What you will do:

• Oversee monthly contractual allowance and reserve analysis for third-party payers.

• Conduct month-end financial analysis of revenue, contractual allowances, and bad debt.

• Prepare estimated cost report settlements for month-end close.

• Review cost report preparation and compliance with federal and state laws. Support third-party contract negotiations through detailed cost and charge analysis.

• Maximize reimbursement activities, especially for government programs.

• Prepare documentation for year-end audits of contractual allowances and settlements.

• Develop annual budget assumptions for contractual allowances, charity care, and bad debt.

• Act as liaison to fiscal intermediaries and auditors on reimbursement matters. Lead and manage the reimbursement team, supporting the larger finance team in reimbursement issues and optimization efforts.

Core Competencies for All Leaders:

• Organizational Strategy and Implementation: Recognizes market trends, judges the impact on their area of responsibility, contributes to responsive strategic plans, develops operational plans, and ensures alignment and commitment of all staff.

• Fiscal Management: Effectively uses established processes to ensure accountability for effective operations and resource management.

• Human Resource Management: Selects, aligns, develops, motivates, manages, and retains a team of highly skilled employees.

• Excellence in Service and Quality: Achieves seamless delivery of quality patient care, safety, excellence in patient experience, and customer service. Utilizes Continuous Quality Improvement principles and platform planning in decisions, improvements, and system design.

• Organizational Leadership: Provides leadership and accomplishes objectives by ensuring the integration of processes and initiatives while modeling collaboration. Participates and supports in brand/service delivery teams as requested.

• Compliance: Maintains accountability for implementation of requirements of regulatory agencies. Serves as liaison to the community.

What you will need:

• Bachelors degree in accounting, finance, or related field

• 10+ years' experience in healthcare, finance, or public accounting is preferred; as well as experience with third party reimbursement, cost reports, etc.

• Preference to those with experience in critical access hospital/rural health system reimbursement, ideally within an integrated healthcare system

Why Emplify Health?

• Tailored Benefits Package: We offer a comprehensive benefits package that varies based on your location. To learn more about the specific benefits available in your area, please inquire with the recruiter during the application process.

• Flexible work location: While this role offers some flexibility in work location, candidates must reside within a reasonable commuting distance of La Crosse or Green Bay, WI due to frequent on-site needs.

At Emplify Health, we believe in leading with love and fostering a culture of belonging and excellence. If you share our values and are looking for an opportunity to make a significant impact on our workforce, we invite you to submit your application.

ONE SYSTEM, ONE VISION: Emplify Health is a large and growing health system with a strong presence in the region. We operate 11 hospitals, more than 100 clinics, and employ over 14,000 teammates across 35 counties in 4 states.

If you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267

We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values - belonging, respect, excellence, accountability, teamwork and humility - our pillars set our foundation and our future.

Equal Opportunity Employer