Director - Reimbursement; Remote

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1.0 FTE Full time Day - 08 Hour R2550884 Remote USA  Finance Reimbursement Finance & Revenue Cycle

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Day - 08 Hour (United States of America)

The Director of Reimbursement is a key leadership role within the Controller's Office, responsible for overseeing the organization's compliance reporting and non-patient services reimbursement activities. This role ensures the timely and accurate preparation and submission of financial and regulatory reports to government agencies, including but not limited to:

• Medicare and Medi-Cal cost reports
• Financial disclosures to the Department of Health Care Access and Information (HCAI)

In addition, the Director of Reimbursement oversees the organization's responses to government audits and inquiries, ensuring full compliance and clear communication with regulatory agencies. The role also ensures the accuracy of invoicing for non-patient related services provided to external customers. The Director of Reimbursement plays a critical role in shaping the financial integrity of the organization. As a senior member of the team, this individual actively contributes to process improvement initiatives, drives innovation in financial systems, and fosters a culture of change, accountability, and continuous improvement.

Stanford Health Care

• Government Payor Reporting & Reimbursement
• Ensure timely and accurate filing of annual government cost reports, including Medicare, Medi-Cal, and HCAI submissions.
• Maintain comprehensive knowledge of federal and state reimbursement laws and regulations to maximize reimbursement.
• Develop, implement, and maintain internal policies and procedures to ensure complete and accurate capture of all legitimate reimbursement opportunities.
• Oversee Medicare and Medi-Cal audit processes, addressing inquiries and pursuing appeals or litigation when necessary (e.g., CMS disputes).
• Review third-party contractual allowances, settlements, and variances (actual vs. budget) to support accurate financial reporting.
• Participate in the annual budget development process by providing detailed analysis and projections related to government payor net income.
• Prepare and respond to year-end financial audits, specifically related to third-party liabilities and balance sheet reserves.
• Serve as the subject matter expert on regulatory compliance reporting, including Medicare and Medi-Cal cost reports.
• Lead alignment of compliance reporting processes across SHC-related entities and partner organizations.
• Continuously assess and improve reimbursement and reporting processes to increase efficiency, accuracy, and scalability.
• Non-Patient Care Services Receivable
• Oversee invoicing, contract compliance, and financial administration for non-patient care service agreements, such as:
• Graduate Medical Education (GME) affiliation agreements
• Physician outreach and other academic/clinical support contracts
• Coordinate with internal department, affiliated entities, and external partners to ensure contract terms are accurately maintained and executed.
• Ensure obligations are properly managed and tracked within the Workday customer management model.
• Serve as the subject matter expert for the Workday customer management model, assisting in the development and enhancement of business process workflows.
• Participate in system testing and user acceptance activities related to workflow improvements and updates within Workday.
• Leadership, Collaboration & Strategic Support
• Promote a culture of learning, continuous improvement, and compliance across the reimbursement function.
• Mentor and develop staff to deepen their knowledge of reimbursement regulations, reporting, and methodologies.
• Support talent development and succession planning by identifying growth opportunities and preparing high-potential staff for future leadership roles.
• Work cross-functionally with leaders and staff from various departments and backgrounds…