MedStar Health
Manager Maryland Regulatory and Revenue Management
MedStar Health, Baltimore, Maryland, United States
Overview
Manager Maryland Regulatory and Revenue Management at MedStar Health. This role performs regulatory functions to maintain compliance with the Health Services Cost Review Commission (HSCRC) requirements. The position manages HSCRC revenue and reimbursement reporting for up to three Maryland hospitals, which may vary throughout the year, and handles the compilation, reconciliation and submission of HSCRC all-payor tape data. The role also implements HSCRC methodology mandates for Maryland hospitals. Salary range: $111,779 - $212,513.
Responsibilities
Reviews, implements and is responsible for all HSCRC compliance methodologies including corridor compliance.
Develops reimbursement, revenue, case-mix and budget models, working with IT and others, that incorporate all changes and new HSCRC policies and HSCRC reimbursement regulations.
Validates and submits HSCRC tapes including working with IT, HSCRC and others to implement any changes to reporting criteria, resolve errors and implement new procedures.
Develops and maintains HSCRC reports, working with IT and others that incorporate all revised and new HSCRC regulatory methodologies to include but not limited to Denials, Uncompensated Care, Statistical and Financial monthly, quarterly and annual reporting
Acts as liaison for hospital issues with the HSCRC staff, maintaining a good working relationship
Provides a review of the HSCRC Annual Filings and assists in completion as deemed necessary.
Provides a review of the Medicare Cost Reports and assists in completion as deemed necessary.
Completes HSCRC and Medicare audits
Participates in MHA (Maryland Hospital Association) and HSCRC Task Forces as deemed necessary.
Reviews monthly case-mix and volume reporting and identifies significant fluctuations to budget and monthly trend.
Communicates with hospitals, accounting, management and other departments concerning any reimbursement related issues or changes and quantifies expected impact on reimbursement.
Reviews and assists, as needed, on regulatory surveys and annual community benefit reporting.
Selects, trains, orients, and assigns department regulatory staff. Develops standards of performance, evaluates performance, and conducts performance management planning. Initiates or makes recommendations for personnel actions and maintains ongoing communication with direct reports to review programs, provide feedback, discuss new developments, and exchange information.
Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
Responsible for providing information for Hospitals to complete Community Benefit Report and review of HSCRC Community Benefit Report to provide feedback to Corporate. Provide information as deemed necessary to Corporate related to the MedStar and IRS Community Benefit Report.
Qualifications
Education: Bachelor's degree in Accounting, Finance or other related field required
Experience: 2 years regulatory/reimbursement experience plus 2 years public accounting experience required, or 4 years of regulatory/reimbursement experience required
Knowledge, Skills, and Abilities: Verbal and written communication skills are necessary. Microsoft Excel, Access and Power BI proficiency; SQL and significant database proficiency may be required
Job Details
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Legal
Industries: Hospitals and Health Care
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Responsibilities
Reviews, implements and is responsible for all HSCRC compliance methodologies including corridor compliance.
Develops reimbursement, revenue, case-mix and budget models, working with IT and others, that incorporate all changes and new HSCRC policies and HSCRC reimbursement regulations.
Validates and submits HSCRC tapes including working with IT, HSCRC and others to implement any changes to reporting criteria, resolve errors and implement new procedures.
Develops and maintains HSCRC reports, working with IT and others that incorporate all revised and new HSCRC regulatory methodologies to include but not limited to Denials, Uncompensated Care, Statistical and Financial monthly, quarterly and annual reporting
Acts as liaison for hospital issues with the HSCRC staff, maintaining a good working relationship
Provides a review of the HSCRC Annual Filings and assists in completion as deemed necessary.
Provides a review of the Medicare Cost Reports and assists in completion as deemed necessary.
Completes HSCRC and Medicare audits
Participates in MHA (Maryland Hospital Association) and HSCRC Task Forces as deemed necessary.
Reviews monthly case-mix and volume reporting and identifies significant fluctuations to budget and monthly trend.
Communicates with hospitals, accounting, management and other departments concerning any reimbursement related issues or changes and quantifies expected impact on reimbursement.
Reviews and assists, as needed, on regulatory surveys and annual community benefit reporting.
Selects, trains, orients, and assigns department regulatory staff. Develops standards of performance, evaluates performance, and conducts performance management planning. Initiates or makes recommendations for personnel actions and maintains ongoing communication with direct reports to review programs, provide feedback, discuss new developments, and exchange information.
Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
Responsible for providing information for Hospitals to complete Community Benefit Report and review of HSCRC Community Benefit Report to provide feedback to Corporate. Provide information as deemed necessary to Corporate related to the MedStar and IRS Community Benefit Report.
Qualifications
Education: Bachelor's degree in Accounting, Finance or other related field required
Experience: 2 years regulatory/reimbursement experience plus 2 years public accounting experience required, or 4 years of regulatory/reimbursement experience required
Knowledge, Skills, and Abilities: Verbal and written communication skills are necessary. Microsoft Excel, Access and Power BI proficiency; SQL and significant database proficiency may be required
Job Details
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Legal
Industries: Hospitals and Health Care
#J-18808-Ljbffr