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
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