Manager of Reimbursement Strategy, Analysis and Forecasting

Manager of Reimbursement Strategy, Analysis, and Forecasting Salary Range: $89,648 - $107,578 based on relevant experience Location: Larimer County, Colorado Status: Full-time, 40 hours per week Hours: Monday - Friday Role Overview: The Manager of Reimbursement Strategy, Analysis, and Forecasting is a strategic leadership role responsible for providing data-driven insights, aligning operational oversight related to payer reimbursement, revenue modeling, and financial performance. This role is essential for maximizing understanding of and responsiveness to evolving reimbursement models, including Medicaid, commercial, grant-funded, and value-based arrangements, ensuring effective participation in risk-based and prospective payment systems. The position involves analyzing payment methodologies, forecasting revenue, and developing financial strategies to ensure sustainability and support high-quality behavioral health services. The role collaborates closely with Finance, Clinical Operations, Revenue Cycle, and Executive Leadership to integrate reimbursement intelligence into budgeting, forecasting, and decision-making processes. Essential Duties: Reimbursement Strategy and Analysis: Serve as the organization’s lead expert on payer reimbursement, including prospective payment systems (PPS), capitation, fee-for-service, and value-based care models. Monitor regulatory and legislative activity affecting Medicaid policy; analyze the financial impact of current and proposed payment methodologies; recommend organizational responses. Support contract negotiation and program development with reimbursement modeling and revenue projections. Financial Planning and Forecasting: Lead multi-year revenue forecasting and financial planning processes, incorporating reimbursement trends and payer dynamics. Integrate cost, volume, and payment data into comprehensive program financial plans. Decision Support and Revenue Modeling: Design and maintain financial models and dashboards to inform leadership on the financial impact of reimbursement policies, service mix, and operational performance. Provide scenario planning for new payer models, rate changes, or policy shifts. Evaluate financial risk and return associated with entering into new reimbursement arrangements, pilots, or strategic partnerships. Cross-Functional Collaboration and Leadership: Work closely with the CFO, Executive, and Senior Leadership Teams to align financial planning with organizational goals and funding environment. Communicate complex financial information and reimbursement issues clearly to non-financial stakeholders. Stakeholder Engagement and Advocacy: Liaise with state Medicaid agencies, managed care organizations, associations (e.g., CBHC), and external consultants on payment model developments. Monitor regulatory and legislative activity affecting behavioral health reimbursement; recommend organizational responses. Minimum Requirements: Bachelor’s degree in Accounting, Finance, Analytics, Economics, or a related field (or equivalent experience); master’s degree or CHFP certification preferred. Minimum 7 years of progressive experience in healthcare finance, reimbursement analysis, or payer contracting; behavioral health or Medicaid focus preferred. Strong knowledge of healthcare reimbursement models, financial forecasting, and planning tools. Proficient in financial modeling, Excel, and business intelligence platforms (e.g., Power BI). Exceptional analytical, communication, and leadership skills. Preferred Qualifications: Experience in community mental health, FQHCs, or safety-net healthcare systems; familiarity with Colorado Medicaid and behavioral health integration strongly preferred. Proven ability to communicate complex financial concepts to executives and external stakeholders. Demonstrated success in strategic planning, project management, and cross-functional collaboration. Skilled in proactive problem-solving, service-oriented communication, and driving continuous improvement. Experience in fast-paced, policy-driven environments; consulting or multi-site healthcare systems experience a plus. Bilingual / bi-cultural preferred Total Rewards: At SummitStone Health Partners, we offer a competitive benefits package to support our teams’ wellbeing. Visit our website for more information about Total Rewards. Reach Out: SummitStone provides reasonable accommodations for persons with disabilities. If needed to participate in the application or selection process, please inform your recruiter. Questions? Email us at hiring@summitstonehealth.org. This position remains open for a minimum of three days or until a top candidate is selected.

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