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Stanford Health Care · 2 months ago

Director - Reimbursement (Remote)

United States

Full-time

Remote

Director/Executive

$89.01/hr - $117.94/hr

10+ years exp

Stanford Health Care is a leading healthcare organization committed to innovation and excellence. They are seeking a Director of Reimbursement who will oversee compliance reporting and non-patient services reimbursement activities, ensuring accurate financial reporting and regulatory compliance. This leadership role involves mentoring staff, managing audits, and driving process improvements in reimbursement practices.

Health CareHealth DiagnosticsHospitalMedicalPrimary and Urgent Care

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

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 to address complex reimbursement and compliance matters

Communicate complex, variable reimbursement and regulatory issues in clear, concise narratives to support strategic decision-making

Provide analytical and subject matter support to broader strategic and financial initiatives as needed

Qualification

CMS reimbursement principlesMedicareMedicaid regulationsERP system managementFinancial reportingGovernment compliance reportingAudit processesContract complianceAnalytical skillsTeam developmentProactive cultureHigh quality analysisWorkday expertiseSuccession planningLeadershipCollaborationCommunication skillsProblem-solvingTime managementPresentation skillsMentoringCross-functional collaboration

Required

Bachelor's Degree in business, finance, health or public administration or a related field

Minimum ten (10) years of progressively responsible and directly related work experience required

Advanced knowledge of CMS and state Medicaid reimbursement principles and practices

Multi-year skill and experience managing business processes for organizations using a major ERP system

Ability to communicate complex concepts in simple form to non-finance users to understand the appropriate use and limits of the information provided

Ability to communicate and present complex issue with government agencies to resolve audit issues

Ability to manage, organize, prioritize, multi-task and adapt to changing priorities

Ability to foster effective working relationships and build consensus

Ability to partner in the development and achievement of goals, vision, and overall direction of the Controller's Office at Stanford Health Care

Ability to provide clear and concise information/presentations to Senior Executive Team

Ability to develop strong team culture and working relationship with colleagues across the health system

Ability to drive a culture of proactive, integrated, responsive, high quality financial analysis

Ability to effectively manage deliverables and timelines

Preferred

Master's Degree in business, health or public administration, management, or related field strongly preferred

10+ years of performing duties similar to those described in essential functions of the description. Preferred experience as an auditor working with CMS or a CMS Medicare Auditor Contractor and strong familiarity with Medicare and Medicaid regulations

Ability to develop strong team culture and working relationship with colleagues across the health system

Ability to drive a culture of proactive, integrated, responsive, high quality financial analysis

Ability to effectively manage deliverables and timelines

CPA - Certified Public Accountant preferred

HFMA - Certified Rev Cycle Rep (CRCR) preferred

Company

Stanford Health Care

Glassdoor4.0

Stanford Health Care is a healthcare center that treats cancer, heart disease, brain disorders, and primary care issues.

Founded in 1885

Palo Alto, California, USA

10001+ employees

https://stanfordhealthcare.org

H1B Sponsorship

Stanford Health Care has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (102)

2024 (74)

2023 (82)

2022 (55)

2021 (54)

2020 (67)