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Director of Finance-Cost Reimbursement in Chicago, Illinois, US at Keystone Advisors

Date Posted: 8/10/2018

Job Snapshot

Job Description

Keystone Advisors is an independent certified public accounting firm licensed in the State of Illinois.

Keystone provides Audit, Accounting, and Advisory Services in the areas of financial and administrative management, organizational and business improvement, program management support, budget support, financial analytical services and reconciliation, technology management and staff augmentation.

Keystone is looking for a Director of Finance-Cost Reimbursement for one of our clients, a Non-For-Profit Health Care Provider in the Illinois Medical District. The organization is a teaching hospital that provides primary, specialty and tertiary healthcare services. The hospital has a staff of more than 300 attending physicians along with more than 400 medical residents and fellows.

Job Summary

The Director of Finance-Cost Reimbursement is responsible for overseeing all strategic and management initiatives related to governmental reimbursement including various supplemental revenue programs from various third-party payers. The Director of Finance-Cost Reimbursement will work with State and Federal representatives to establish new programs and help determine the rates paid for these new programs. The Director of Finance-Cost Reimbursement is expected to function independently as well as collaborate with other finance team members of the Health System in seeking reimbursement through these complex governmental financing initiatives.

The Director is expected to propose new models of reimbursement to address opportunities under the Affordable Care Act. The Director of Finance-Cost Reimbursement is also responsible for reimbursement to the Health System from non-governmental payers. The position is also responsible for managing the day to day functions of the Health System Cost & Reimbursement department

The Director of Finance-Cost Reimbursement reports to the Chief Financial Officer.

Job Duties

General Administrative Responsibilities

Management

  • Contributes to the management of Health System staff and systemic development and success
  • Discusses and develops Health System policies and procedures
  • Consistently uses independent judgment to identify operational staffing issues and needs and performs the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements
  • Works with Labor Relations to discern past practice when necessary

Supervision

  • Directs and effectuates Health System management policies practices
  • Accesses and proficiently navigates the Health System records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements

Collective Bargaining

  • Reviews applicable Collective Bargaining Agreements and consults with Labor Relations to generate management proposals
  • Participates in collective bargaining negotiations, caucus discussions and working meetings

  Discipline

  • Documents, recommends and effectuates discipline at all levels
  • Works closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements
  • Initiates, authorizes and completes disciplinary action pursuant to Health System rules, policies, procedures and provision of applicable Collective Bargaining Agreements

Other Responsibilities

  • Advocates and serves as a liaison in negotiations with HFS (Medicaid) and CMS (Medicare) in all Health System reimbursement issues with the emphasis of optimizing rates and revenues
  • Responsible for the accurate and timely filing of all Health System Medicare, Medicaid, Blue Cross, Encounter Clinic, and CountyCare Cost Reports
  • Reviews notices of program reimbursement and determines if issues should be appealed and files the appropriate appeal with the proper support
  • Determines and recommends to management whether the Health System should join with MCHC, IHA, or other organizations to participate in group appeals
  • Implements policies and procedures to oversee adherence to governmental regulations to assure compliance to all appropriate reimbursement regulations
  • Manages all relationships with auditors including Medicare, Medicaid, Blue Cross, DSH and Independent Financial Auditors
  • Makes recommendations and develops new processes to optimize reimbursement for Health System hospitals and its affiliated clinics
  • Prepares reports to match all costs under the 1115 wavier to reimbursement received through the program
  • Participates in negotiations with State and Federal governments on future reimbursement issues due to the Affordable Care Act
  • Troubleshoots for the revenue cycle team gaps or problems with the emphasis on maximizing reimbursement while adhering to all proper regulations
  • Responsible for negotiating, compiling and reporting Health System inpatient and outpatient revenue, physician revenue and supplemental revenues including DSH & BIPA payments
  • Maintains a comprehensive knowledge of new developments in the industry as well as changing regulatory requirements for Medicare, Medicaid, Blue Cross and other Third-Party Payers
  • Manages and works with consultants to maximize reimbursement to Health System
  • Responsible for managing all employees in the Health System Cost & Reimbursement Department
  • Works directly with the CFO on all Health System reports to satisfy all State or Federal governmental requirements
  • Ability to communicate effectively with third party payers, hospital organizations,and outside independent auditors
  • Maintains a thorough knowledge of Health System’s financial operations and budgeting as well as GAAP and GASB accounting policies and procedures
  • Works with the Health System physician program director of resident education to insure The Health System receives the maximum reimbursement for its educational programs.
  • Performs other duties, as requested

Job Requirements

Required Minimum Qualifications

  • Bachelor's (or higher level) Degree in Accountancy or Finance from an accredited college or university
  • Five (5) years of experience in Hospital Cost and Reimbursement at a teaching facility
  • Three (3) years of related supervisory experience

Required Knowledge Skills & Abilities

  • Highly proficient in the use of Excel, Access, Word, and Power Point
  • Ability to organize and manage personnel
  • Ability to communicate and negotiate effectively with a wide variety of individuals
  • Ability to present and operate at Board level
  • Strong people management and leadership skills: ability to communicate and work well with people at all levels
  • High level presentation skills: able to confidently present information publicly using a variety of media in different settings in both 1:1 settings and to large gatherings of clinical professionals (conferences, workshops, town halls, etc.)
  • An extremely organized, disciplined, hands-on and process-oriented leader who is not afraid of digging into details when necessary
  • Open leadership style: actively seeks out and supports collaborative thinking and problem solving with others in the organization
  • Problem-solver and approaches work from a "return on investment" perspective 
  • Knowledgeable of how decisions impact all aspects of the business
  • Approaches his/her work as an interconnected system.
  • Ability to understand major objectives and break them down into meaningful action steps
  • Demonstrates respect and sensitivity for cultural diversity and working with employees, co-workers, patients, clients of diverse backgrounds
  • Strong interpersonal skills necessary for interfacing with management at all levels of the organization, building relationships within the Health System and with external agencies
  • Excellent communication skills
  • Strong writing skills with a demonstrated ability to prepare written material for internal or external use
  • Analytical skills; problem-solving skills
  • Strong decision-making skills; ability to discern and selectively communicate critical information
  • Attention to detail
  • Work to deadlines
  • Flexibility and adaptability in performing work duties
  • Strong project management skills
  • Ability work well under pressure
  • Conflict management skills
  • Ability to analyze data and provide recommendations
  • Ability to work independently through the completion of projects and assignments
  • Strong organizational skills

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