Clive Behavioral

Senior Program Manager - Reimbursement - Acute


PayCompetitive
LocationKing Of Prussia/Pennsylvania
Employment typeFull-Time

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  • Job Description

      Req#: 291755
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Competitive compensation and excellent benefits package, including Medical, Dental, Vision, and Prescription Drug Plan
      - 401k plan with company match to support your retirement savings
      - Opportunity for career advancement and growth within the organization
      - Challenging and rewarding work environment that values employee contributions
      - Work with one of the nation's largest and most respected providers of hospital and healthcare services

      What to Expect (Job Responsibilities):
      - Complete Medicare and Medicaid cost report submissions for assigned hospitals and manage related audits and desk reviews
      - Provide independent consulting services on hospital reimbursement matters to corporate business office and hospital executives
      - Oversee and develop Medicare alternate payment methodologies, focusing on bundled payments
      - Coordinate and develop reimbursement strategies for Medicare quality-based payment methodologies
      - Participate in the oversight and maintenance of Medicaid supplemental payment programs for assigned facilities

      What is Required (Qualifications):
      - Bachelor's degree with 10+ years of experience in Medicare cost reporting and reimbursement concepts
      - Comprehensive knowledge of Medicare prospective payment systems, including Inpatient Acute DRGs and Outpatient APCs
      - Thorough understanding of Medicare statutes, regulations, and administrative rules
      - Intermediate-to-advanced knowledge of Microsoft Excel
      - Proficiency in HFS cost report software or its equivalent

      How to Stand Out (Preferred Qualifications):
      - Familiarity with McKesson G/L and Siemens Invision systems
      - Knowledge of Medicaid supplemental payment concepts and state directed payments
      - Understanding of quality-based Medicare reimbursement concepts

      #HealthcareServices #ReimbursementManagement #CareerOpportunity #CompetitivePay #GrowthOpportunities

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  • About the company