Reimbursement Manager

Job Requisition #: JR55514

End Date: 9/25/2021

Location: Wilmington, Delaware

Position Type: Management/Executive

Shift: Day Shift, No Rotation

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Under the direction of the Director, Decision Support and Reimbursement, this position leads the reimbursement and cost reporting functions of ChristianaCare. Oversite of these functions, and the management of the departmental staff supporting these functions, will ensure that reimbursement systems are maintained in a manner to comply with regulatory standards and evaluated to preserve the organizational vitality goals of ChristianaCare.

Highlights:

When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as

Primary duties and responsibilities:

  • Manages the staff, processes, and procedures necessary to evaluate, maintain and submit Medicare cost reports, third-party reimbursements, and other reports and questionnaires that are consistent with organizational goals and expectations.
  • Manages the staff, processes, and procedures necessary to evaluate, maintain, and submit HSCRC reporting on a month, quarterly, and annual basis.
  • Manages the staff, processes, and procedures to ensure HSCRC rates are properly evaluated and set in a manner to comply with HSCRC regulations.
  • Responsible for the positive resolution of third-party audits and inquiries through management of reimbursement staff, direct communication with third-party representatives, and keeping Finance Leadership informed on a timely basis.
  • Manages the analysis of regulatory changes and communicates the impact to Finance Leadership.
  • Collaborates with internal and external department staff to address regulatory impacts.
  • Provides education to system leadership and staff on regulatory changes and reimbursement impacts from all third-party payors.
  • Responsible for the compliance of 340B regulations and keeping Finance Leadership informed on a timely basis.
  • Provides for the calculation and the report of reimbursement rates to be utilized in third-party reserves, financial forecasts, and annual budgets.
  • Responsible for the timely and accurate maintenance of third-party contract modeling.
  • Collaborates with Managed Care Contracting staff to ensure third-party reimbursement model assumptions are updated timely and accurately to support the evaluation of payment options.
  • Collaborates with Managed Care Contracting staff and external vendors to maintain contract modeling software.
  • Collaborates with Departmental Leadership and staff to support the development and evaluate the impact of alternative payment models.

Education and experience requirements:

BS/BA in Accounting or Finance required; MS/MBA preferred.

Active professional certification of financial relevance desirable.

At least six years of experience in a major acute care teaching hospital setting or equivalent.

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.


UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.

Why do WE offer careers full of possibilities?

For the Love of Health.

Inclusion & Diversity

At ChristianaCare, we’re committed to treating everyone with dignity and respect. We believe in a safe, inclusive work environment that fosters collaboration between caregivers from all walks of life. We know that each unique viewpoint is vital in delivering high-quality, safe patient care to everyone who walks through our doors. Our policies, benefits, hiring practices, employee resource groups, and corporate citizenship demonstrate our commitment to inclusion and diversity throughout our system.

Why do we embrace inclusion and diversity? For the Love of Health.

Our Values

We serve together in Love and Excellence. Our unique values, Love and Excellence are bold and powerful, and they are the reason why working for ChristianaCare is special. The behaviors associated with our values guide how caregivers interact with everyone they work with and make for an exceptional work experience. We believe that when you lead with Love, Excellence is inevitable.

Benefits

ChristianaCare’s comprehensive total rewards package is one of the most competitive in the region. We are proud to offer excellent benefits that reflect the organization’s commitment to being exceptional today and even better tomorrow.

At ChristianaCare, we provide access to high-quality and affordable benefits designed to meet our caregivers where they are. You can tailor your benefits to meet your needs now and adjust them as your priorities change.

Take advantage of ChristianaCare’s wide-ranging benefit offerings from supporting optimal health through medical, prescription, dental and vision coverage to valuable wellness and work/life programs, which include paid parental leave, coverage for infertility and assisted reproductive technologies, an employer-funded short-term disability program, and more.

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Our Region

A Great Place To Live

Our region offers a diversity of cultures, lifestyles, sports and entertainment events, housing options and educational opportunities. Located between Philadelphia and Washington, D.C., our locations provide easy access to two international airports, employment opportunities in a tri-state area, and proximity to some of the nation's top universities and colleges, as well as beaches in MD, DE and NJ!

Why Delaware? Why Maryland?
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We Serve Together

For the Love of Health

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