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NYC Health + Hospitals · 3 days ago

Director of Supplemental Medicaid Revenue Collections (Director of Finance)

New York, NY

Full-time

Onsite

Lead/Staff, Director/Executive

$140K/yr - $175K/yr

4+ years exp

NYC Health + Hospitals is the largest public health care system in the United States, providing essential services to over a million New Yorkers annually. The Director of Supplemental Medicaid Revenue Collections will oversee the tracking and management of Medicaid managed care claims to ensure the collection of state-directed payment revenue, contributing significantly to the system’s $12B revenue budget.

Health CareHome Health CareHospitalMedicalNursing and Residential Care

Responsibilities

Enhance and maintain internal reporting to track whether claims paid by Medicaid Managed Care plans include add-on rates within the revenue collected for our inpatient and outpatient encounters

Analyze and organize massive data files to categorize claims that require follow up with each Medicaid Managed Care plan when add-on payments are not processed

Routinely prepare, transmit and manage resolution of claims project files with contracted Medicaid Managed Care plans to hold payers accountable for paying each claim warranting an add-on payment

Strategically evaluate payers’ claims processing trends to discern risks that NYC Health + Hospitals might not collect as much of the state-direct payment dollars as budgeted and synthesize into talking points for NYC Health + Hospitals leadership

Leverage internal reports to disseminate monthly updates on collections stats (by payer and by site) with colleagues in Finance and Managed Care

Develop tight collaboration with colleagues in Revenue Cycle Services to better monitor appeal status of denied claims that are temporarily ineligible for add-on payments

Perform other job-related duties as required

Qualification

Fiscal managementFinancial systemsManaged Care knowledgeEpic proficiencyExcel proficiencyMicrosoft Access proficiencyClaims interpretationAnalytical skillsCommunication skillsPresentation skills

Required

Master's degree from an accredited college or university in Accounting, Finance, Business Administration or a related discipline with an emphasis on accounting and financial systems; and four (4) years of responsible-level experience in fiscal management or administration with an emphasis on financial systems, management information and controls, three (3) years of which must have been in responsible administrative or managerial capacity

Bachelor's degree from an accredited college or university in disciplines, as listed in '1' above; and five (5) years of experience, as described in '1' above, three (3) years of which must have been in a responsible administrative or managerial capacity

Knowledge of Managed Care market in NYC

Ability to interpret claims and remittances

Proficiency in Epic, Microsoft Access, Excel, and Word

Strong analytical, communication and presentation skills required

Must be able to read and comprehend large Excel data files