At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

VP OF REIMBURSEMENT | REMOTE

The Vice President of Reimbursement is responsible for governmental reimbursement cost reporting across Bon Secours Mercy Health. This includes cost reports for acute, rural health clinics, skilled nursing, hospice, and HHA comprised of $11 b of net patient revenue for the ministry.

Essential Functions

• Responsible for all governmental reimbursement related cost and regulatory reporting monitoring and compliance, including the strategy for audits, appeals and exception requests related to these payers.
• Collaborate and coordinate with other departments and personnel at all levels across the ministry to influence the best possible outcomes regarding reimbursement by shaping regulatory changes, responding to regulatory changes influencing reimbursement, and assuring appropriate collections.
• Monitor and evaluate existing and proposed regulations related to Medicare, Medicaid and other government payers. Proactively analyze and synthesize the reimbursement impact and compliance considerations of proposed and revised regulations on reimbursement across the ministry, provide effective communication, education, and recommended strategies to various leadership and stakeholders.
• Analyze the revenue impact of proposed new programs, payment models, services, and operating strategies. Provide reports and recommendations for achieving proposed financial objectives.
• Develop, communicate, and lead the coordination of strategies to maximize reimbursement in accordance with legal and regulatory guidelines to ensure unit cost controls meet or exceed corporate objectives for medical cost containment. Analyzes claims, utilization, and medical cost data.
• Develop and maintain a ministry-wide approach to processing Medicare, Medicaid and other third party agency enrollment applications and coordinate the enrollment update process for the ministry.
• Proactively identify and lead the development and implementation of standard policies and procedures for the reimbursement functions across Bon Secours Mercy Health. Work closely with the groups to interpret and implement the approved policies and procedures in their areas.
• Drive consistency across the organization; review policy application and identify areas of risk to the organization; establish mitigation plans and action strategies where compliance issues are raised.
• Establishes and maintains strong relationships with external agencies including Medicare, Medicaid, or other government agencies.
• Develop, implement and maintain a staff mentorship and development program.
• Communicating critical or non-compliance issues;
• Facilitating standard processes to ensure that reimbursements are adequate for and appropriate to services provided.
• Provide guidance and recommendations to ELC and stakeholders on trends and issues; conduct research, prepare analyses and draft recommended position papers on priority regulatory issues
• Evaluate reimbursement effectiveness and efficiency on an ongoing basis. Identify and implement key operating metrics to objectively measure performance against benchmarks. Identify and implement policy, process, and structural changes as needed to maximize the benefit to the system.
• Leading special projects.
• Develop strategic, cost effective programs, and make recommendations for system or network changes to enhance revenue position.

REQUIRED:

• Bachelor Degree in Accounting, Business, or Finance
• Minimum of 10 years executive level leadership experience in healthcare finance, reimbursement, and finance operations
• Experience with monitoring government reimbursement regulations, evaluating impact, and developing strategies to either achieve full reimbursement available or minimize risks of payment reductions

PREFERRED:

• Masters Degree in Accounting, Business, or Finance
• CPA, FHFMA, or CRCR

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more

• Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com