Reimbursement Program Manager (Supplemental Funding and Medicaid)
Johns Hopkins Medicine
- Saint Petersburg, FL
- Permanent
- Full-time
- Bachelor's degree in Accounting or Finance or related field
- 5+ years of experience in Medicare and Medicaid reimbursement and cost reporting preparation
- Demonstrated knowledge of experience in Florida Medicaid and the supplemental funding pools (dollars outside of Fee for Service), strongly preferred
- Familiarity with 340B programs, managed care relationships, and standard revenue cycle practices strongly preferred
- 2 years of experience in a leadership role preferred
- Basic understanding of Generally Accepted Accounting Principles (GAAP) and their application
- Experience with healthcare and non-for-profit accounting principles and procedures
- Ability to interpret an analyze regulations issued by Centers for Medicare and Medicaid Services (CMS)
- Proficient in the use of a personal computer and software applications (e.g. Microsoft, Word, Excel, PowerPoint, etc.) to include cost reporting and graduate medical education software
- Manages the process for the collection of data and creation of supporting documentation for the preparation and submission of the Medicare and Medicaid cost reports for submission to the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Administration (AHCA) for government reimbursement of costs. Works in conjunction with members of the JH Revenue & Reimbursement department.
- Works with appropriate parties to coordinate the completion and submission of the initial application, performance report, and reconciliation application for the Children's Hospitals Graduate Medical Education (CHGME) program for government reimbursement of graduate medical education costs.
- Serves as a liaison to contracted government auditors in the audit of submitted cost reports to provide data requests, supporting documentation, and guidance.
- Organizes the completion and submission of annual surveys and State agency reports such as Disproportionate Share (DSH), Low-Income Pool (LIP) and Florida Hospital Uniform Reporting System (FHURS).
- Analyzes impact of federal regulation changes to Medicare and Medicaid, as well as State of Florida legislature policy changes and communicates those impacts to leadership.
- Assists finance and accounting staff to record accounting entries related to DSH, LIP, Education Revenues, and cost report settlements.
- Provides training and coaching to leaders and stakeholders to develop internal expertise. Keeps executive leadership informed of potential/pending changes and models the impact to JHACH.
- Actively broadens knowledge and develops relationships with industry peers and local colleagues to stay informed of best practices.
- Works closely with the JHACH Financial Planning & Analysis team on the annual operational budget, prospectively modeling reimbursement for the forthcoming year. Assists in the tracking and reporting of variances from plan throughout the year.
- Manages relationship and directs relevant JHACH third-party consultants/advisors. Regularly evaluates the scope of external relationships for improvements required or expense reduction opportunities.
- Serves as a liaison with Johns Hopkins Health System office of Revenue Management and Reimbursement and team to coordinate ownership of various tasks.
- Responsible for the coordination of activities and ensures continual compliance with local and national regulatory standards (i.e. TJC, CMS, AHCA, etc.).