Diverse Lynx
Senior Program Manager - Reimbursement - Acute
Diverse Lynx, King Of Prussia, Pennsylvania, United States, 19406
Title: Senior Program Manager - Reimbursement - Acute
Location: 367 S Gulph Road, King of Prussia, PA 19406
Client: UHS of Delaware, Inc
Duration: 13 Weeks
Shift: Days
Timing: 8am - 4:30pm
Bill Rate: $95
Responsibilities
Join a dynamic organization driven by our passion for healthcare. UHS is seeking talented individuals who are eager to contribute their expertise and pursue rewarding careers. As a leader in acute care and behavioral health, UHS provides high-quality care to over 3 million patients annually, across our national network of facilities.
The
UHS Corporate Reimbursement Department
is hiring a
Senior Program Manager - Reimbursement - Acute
to manage the Medicare and Medicaid fee-for-service reimbursement functions for multiple assigned hospitals or other UHS entities with complex reimbursement environments and that have a significant level of UHS financial statement impact. This role will also ensure compliance with applicable federal and state reimbursement rules and regulations and optimizes Medicare and Medicaid reimbursement through development of strategic planning and on-going financial analysis.
Key Responsibilities include: Complete Medicare and Medicaid cost report submissions for assigned hospitals or other UHS entities and related desk review and audit activity (including wage index reviews or other Medicare/Medicaid reimbursement activity) for multiple facilities with complex reimbursement environments Provide independent on-going hospital reimbursement consulting services (e.g. compliance, billing, financial pro forma analysis) to UHS corporate business office, regional finance and to hospital executive staff and other UHS entities. Independently handle complex reimbursement projects and assignments Oversee, coordinate and develop the reimbursement aspects of all UHS acute care hospital Medicare alternate payment methodology activity with a focus on bundled payments, as applicable Oversee, coordinate and develop the reimbursement aspects of all UHS acute care hospital Medicare quality based payment methodology activity including but not limited to Value-Based Purchasing, Hospital Acquired Conditions, Excess Readmissions, etc., as applicable Provide applicable Medicare and Medicaid contractual models, related reimbursement factors and other necessary data. Review these models for compliance and accuracy Participate in the oversight, development and maintenance of Medicaid supplemental payment (UPL) and state Medicaid DSH programs for assigned facilities Qualifications
Bachelor's degree with 10+ years' experience of Medicare cost reporting and concepts.
Comprehensive knowledge of Medicare prospective payment systems including
Inpatient Acute DRGs, Outpatient APCs, Rehabilitation CMGs and Psychiatric DRG's Thorough understanding of
Medicare statutes, regulations and administrative rules
and their related legislative and regulatory processes. Specific
knowledge of Graduate Medicare Education (GME) and Indirect Medical Education (IME) reimbursement Thorough understanding of
Medicaid supplemental payment
concepts including state directed payments and related provider tax assessments Thorough understanding Medicare alternate payment concepts with a particular focus on Bundled Payments Thorough understanding of Quality based Medicare reimbursement concepts (i.e. Value-Based Purchasing, Hospital Acquired Conditions, Excess Readmissions, etc.) Intermediate-to-Advanced level knowledge of Microsoft Excel Familiarity with Mckesson G/L and Siemens Invision Proficiency in HFS cost report software (or its equivalent)
Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.
Location: 367 S Gulph Road, King of Prussia, PA 19406
Client: UHS of Delaware, Inc
Duration: 13 Weeks
Shift: Days
Timing: 8am - 4:30pm
Bill Rate: $95
Responsibilities
Join a dynamic organization driven by our passion for healthcare. UHS is seeking talented individuals who are eager to contribute their expertise and pursue rewarding careers. As a leader in acute care and behavioral health, UHS provides high-quality care to over 3 million patients annually, across our national network of facilities.
The
UHS Corporate Reimbursement Department
is hiring a
Senior Program Manager - Reimbursement - Acute
to manage the Medicare and Medicaid fee-for-service reimbursement functions for multiple assigned hospitals or other UHS entities with complex reimbursement environments and that have a significant level of UHS financial statement impact. This role will also ensure compliance with applicable federal and state reimbursement rules and regulations and optimizes Medicare and Medicaid reimbursement through development of strategic planning and on-going financial analysis.
Key Responsibilities include: Complete Medicare and Medicaid cost report submissions for assigned hospitals or other UHS entities and related desk review and audit activity (including wage index reviews or other Medicare/Medicaid reimbursement activity) for multiple facilities with complex reimbursement environments Provide independent on-going hospital reimbursement consulting services (e.g. compliance, billing, financial pro forma analysis) to UHS corporate business office, regional finance and to hospital executive staff and other UHS entities. Independently handle complex reimbursement projects and assignments Oversee, coordinate and develop the reimbursement aspects of all UHS acute care hospital Medicare alternate payment methodology activity with a focus on bundled payments, as applicable Oversee, coordinate and develop the reimbursement aspects of all UHS acute care hospital Medicare quality based payment methodology activity including but not limited to Value-Based Purchasing, Hospital Acquired Conditions, Excess Readmissions, etc., as applicable Provide applicable Medicare and Medicaid contractual models, related reimbursement factors and other necessary data. Review these models for compliance and accuracy Participate in the oversight, development and maintenance of Medicaid supplemental payment (UPL) and state Medicaid DSH programs for assigned facilities Qualifications
Bachelor's degree with 10+ years' experience of Medicare cost reporting and concepts.
Comprehensive knowledge of Medicare prospective payment systems including
Inpatient Acute DRGs, Outpatient APCs, Rehabilitation CMGs and Psychiatric DRG's Thorough understanding of
Medicare statutes, regulations and administrative rules
and their related legislative and regulatory processes. Specific
knowledge of Graduate Medicare Education (GME) and Indirect Medical Education (IME) reimbursement Thorough understanding of
Medicaid supplemental payment
concepts including state directed payments and related provider tax assessments Thorough understanding Medicare alternate payment concepts with a particular focus on Bundled Payments Thorough understanding of Quality based Medicare reimbursement concepts (i.e. Value-Based Purchasing, Hospital Acquired Conditions, Excess Readmissions, etc.) Intermediate-to-Advanced level knowledge of Microsoft Excel Familiarity with Mckesson G/L and Siemens Invision Proficiency in HFS cost report software (or its equivalent)
Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.