Director, Government Reimbursement

Remote

Responsibilities

Analyze hospital eligibility for DSH payments, assess financial impact, and ensure complete and accurate capture of Medicaid days and other considerations.
Monitor Medicaid Directed Payment programs, optimizing revenue opportunities for participating providers.
Analyze financial data to identify trends and areas for improvement in the reimbursement process.
Build and maintain strong relationships with payers, government agencies, and other stakeholders.

Maintain expert-level knowledge of state and federal healthcare reimbursement policies, ensuring strict compliance with CMS guidelines, Medicaid Managed Care rules, and HRSA 340B program regulations..
Ability to work effectively in a fast-paced and ever-changing environment.
CPA Licensed Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements, to include the exploration, experimentation, and application of AI.
Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

This role will serve in a consultancy capacity, advising our clients—large health systems—in managing and optimizing healthcare reimbursement processes, focusing on Medicare, Medicaid, Disproportionate Share Hospital (DSH) programs, Medicaid Directed Payment programs, and 340B drug pricing and reimbursement.
Additionally, this position provides key support in the preparation and analysis of Medicare cost reports, ensuring compliance with federal regulations and maximizing financial performance for healthcare providers.
Assist in gathering and analyzing data for the preparation of Medicare cost reports, ensuring accurate reflection of hospital costs for reimbursement optimization.
Provide expert advice on reimbursement strategies for governmental lines of business, including Medicaid and Tricare Support 340B program compliance, eligibility, and ensure correct billing processes.
This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require. This position pays between $134,000- $200,000 based on relevant years of experience.