Director, Reimbursement - Health System Reimbursement - Hospital in CA

Job Description

The Director of Reimbursement provides leadership, management, and coordination of government reimbursement for multiple hospitals within the health system. This role ensures timely and accurate financial and governmental reporting by managing the reimbursement team consistent with regulatory guidelines. The Director is responsible for identifying, developing, and implementing comprehensive strategies, policies, and procedures that optimize all aspects of reimbursement management. The role requires vigilant monitoring of state and federal regulatory proposals related to healthcare payment policies, with the ability to perform impact assessments and effectively communicate findings to executive leadership.

Additionally, the Director is dedicated to fostering staff development, enhancing productivity, and driving performance improvements while adhering to department budgets.

Key Responsibilities include:

• Providing strategic leadership, management, and coordination for government reimbursement across multiple hospitals within the health system.
• Ensuring timely and accurate completion of financial reporting by effectively managing the reimbursement team in accordance with relevant regulatory and policy guidelines, including state, federal, and private industry reporting (Medicare, Medi‑Cal, HCAI, NIH, AHA, etc.).
• Monitoring and communicating federal and state regulatory proposals regarding healthcare reimbursement and providing effective briefings and impact assessments to executive management.
• Coordinating with consultants, internal and external counsel concerning regulatory appeals, special projects, and other reporting matters at the health system level.
• Managing audit responses and providing guidance for all relevant external and internal audit reviews, including those conducted by Medicare, Medi‑Cal, NIH, OIG, and other agencies, as well as the health system’s annual financial audit.
• Preparing annual reporting for the National Institutes of Health regarding research funding for indirect rate and fringe benefit reimbursement.
• Identifying and implementing strategies, policies, and procedures related to all aspects of reimbursement management.
• Ensuring compliance with all applicable state and federal regulatory guidelines related to financial reporting.
• Managing the productivity, development, and performance of the reimbursement team, ensuring adherence to budget targets and maintaining compliance with all applicable internal policies and procedures.

• Bachelor's degree in Finance, accounting, or a related field (minimum). Combination of education and experience acceptable.
• Minimum 3 years of leadership experience with Medicare and Medicaid (Medi‑Cal) reimbursement, demonstrating leadership progression within a relevant organization.
• Preferred 5 years of leadership experience with Medicare and Medicaid (Medi‑Cal) reimbursement in a large academic medical center or health system environment.
• Hybrid role requires minimum two days per week in the office.

Cedars‑Sinai is a leader in providing high‑quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars‑Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars‑Sinai is known for its national leadership in transforming healthcare for the benefit of patients.

Cedars‑Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars‑Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.

Cedars‑Sinai is one of the largest nonprofit academic medical centers in the U.S., with 886 licensed beds, 2,100 physicians, 2,800 nurses and thousands of other healthcare professionals and staff. Choose this if you want to work in a fast‑paced environment that offers the highest level of care to people in the Los Angeles area that need our care the most.