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Kavaliro · 1 day ago

Reimbursement Analyst III

Sacramento, CA

Contract

Hybrid

Mid Level

Kavalio is seeking an experienced Reimbursement Analyst III for a long-term contract opportunity. This role involves preparing, reviewing, and analyzing complex regulatory reports and cost filings required by Medicare and Medicaid, supporting the organization’s largest affiliates, and requiring hands-on experience with HCAI reporting and Medicare Cost Report preparation.

B2BConsultingDeliveryHuman ResourcesInformation Technology

Culture & Values

Responsibilities

Preparing, analyzing, and validating cost reports, supplemental filings, and regulatory disclosures in accordance with CMS, Medicare, Medicaid/Medi-Cal, and state agency requirements

Performing detailed review of Medicare and Medicaid/Medi-Cal audit adjustments; managing the appeals process including preparation of supporting documentation and coordination with CMS/HCFA, HCAI, and the Department of Health Services

Serving as a subject matter expert on HCAI annual reporting, Medicare/Medicaid reimbursement methodologies, program regulations, and cost report implications

Providing financial impact analyses on regulatory changes, newly enacted or proposed legislation, and reimbursement updates; producing multi-year projections for system and affiliate leaders

Supporting Managed Care negotiations by supplying reimbursement modeling, trending analyses, and regulatory insights that influence payer strategy

Collaborating with affiliate finance teams during contractual reviews and audits, and with external auditors or third-party consultants on reimbursement-related evaluations

Contributing to annual budget development and forecast cycles by supplying government-payer revenue projections grounded in cost report and HCAI data

Ensuring accuracy, timeliness, and compliance across all submissions, internal workpapers, and supporting documentation

Qualification

HCAI reportingMedicare Cost Report preparationCMS reimbursement principlesMedi-Cal reimbursement methodologiesAdvanced analytical skills

Required

Direct, recent experience preparing and filing HCAI (OSHPD) reports for large or multi-facility healthcare organizations

Demonstrated experience preparing Medicare Cost Reports (e.g., Form CMS-2552-10) including worksheets, supporting schedules, audit follow-up, and appeals

Strong knowledge of CMS reimbursement principles, Medi-Cal reimbursement methodologies, and regulatory reporting standards

Advanced analytical skills with the ability to interpret complex regulatory guidance and translate it into financial impact models