Fairview Health Services Manager, Government Reimbursement in Minneapolis, Minnesota

Overview

The Reimbursement Manager will provide their government regulatory and reporting requirement expertise with the government reimbursement team, senior leadership and other as requested. They will monitor, provide guidance as needed, conduct reviews and be a key player in compiling Fairview’s final regulatory reports. They will ensure Fairview is optimizing our revenue opportunities within the boundaries of government regulations. The Manager will also provide expertise on providing impact analysis on proposed and final regulations or other projects that pop up. Must understand the many reimbursement methodologies the government utilizes for problem resolving and develop strategic thinking on future outcome. Key attributes needed are mentoring skills, multitasking, detail oriented, meets deadlines, good people skills and organizational skills.

Responsibilities/Job Description

  • Assist in building an effective team within Revenue Management for government reimbursement reporting and analysis

  • Maintain, monitor and disseminate knowledge of trends within Fairview. Recommend and develop strategies to optimize reimbursement related to government payers

  • Assist with developing assumptions and guidelines relating to revenue accounting and budgeting for governmental payers ensuring accuracy, consistency and timely outcomes

  • Monitor federal and state legislative and policy proposals and developments affecting healthcare finance. Assist with developing recommendations and analysis on proposals as mandated by governmental reimbursement agencies. Represent Fairview Revenue Management on internal and/or external committees as assigned.

  • Manage the preparation, filing, audits and appeals of annual regulatory reports required by Medicare and Medicaid for Fairview (hospitals, home office and home health) Ensures reports are completed accurately, on time, adequate supporting documentation is maintained, follows regulatory citations and proper reimbursement is received. Regulatory reports include Medicare cost reports, Medicaid cost reports, Medicaid DSH Reports, Hospital Annual Reports, MERC, NIH, Diagnostic Imaging Report, Freestanding Ambulatory Surgical Centers and Tricare.

  • Assist in assuring Fairview is compliant with appropriate laws, regulations and policies. Adequately instructs and communicates with employees regarding compliance and actively conducts reasonable diligence to detect noncompliance. Promotes and integrates compliance into operations for applicable areas. Understands regulatory requirements and changes thereto. Develops and implements necessary compliance policies and procedures, process improvement, training and monitoring activities.

  • Collaborate with ACO Analytics, Corporate Accounting, Revenue Analysis and Decision Support and other areas as needed to optimize outcomes and efficiencies for Fairview system regarding federal and state regulations and requirements.

Qualifications

Education

Minimum:

  • BA in Accounting or Finance

Preferred Education:

  • MBA strongly preferred

Preferred License/Certification/Registration:

  • CPA, CMA

Experience

Minimum:

  • 10 year health care reimbursement experience, including 3 years Intermediary experience and substantial experience with large teaching institutions or equivalent cost report preparation and auditing experience

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Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Joined by HealthEast in June 2017, Fairview is one of the most comprehensive and geographically accessible systems in the state, with 12 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area and north-central Minnesota.

Its broad continuum also includes 56 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.

EEO/AA Employer/Vet/DisabledAll qualified applicants will receive consideration without regard to any lawfully protected status.

Requisition ID 2018-22516

Profession Non-Clinical Professional

Speciality Leadership/Management/Executive

Location Fairview offices at 400 Stinson

Shift day

Hours per 2 weeks 80

Department Government Reimbursement