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Ensemble Health Partners · 6 days ago

Director, Government Reimbursement

United States

Full-time

Remote

Director/Executive

$134K/yr - $200K/yr

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems. This role involves advising large health systems on managing and optimizing healthcare reimbursement processes, focusing on various governmental programs and ensuring compliance with federal regulations.

Health CareHospitality

Responsibilities

Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations

Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results

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

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

Serve as a trusted advisor to clients, offering strategic insights and recommendations on reimbursement-related matters

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

Assist healthcare providers in navigating reimbursement complexities, including audits, appeals, and compliance inquiries

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

Provide guidance and training to client staff on reimbursement regulations and best practices

Qualification

Healthcare reimbursement expertiseMedicare cost report analysis340B program complianceCPA LicensedAnalytical skillsLeadershipCommunication skillsNegotiation skillsProject management

Required

Expert advice on reimbursement strategies for governmental lines of business, including Medicaid and Tricare