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Director, Enterprise Reimbursement at WVU Medicine

Posted on 7/15/2019

Contact Info

Name Caitlin Tozzie
Address 1 Medical Center Drive
Morgantown, WV 26506
Phone 412-926-7301

https://re12.ultipro.com/WES1019WVUH/jobboard/NewCandidateExt.aspx?__JobID=40554

POSITION DESCRIPTION



JOB TITLE & CODE:


Enterprise Director Reimbursement (88055)

DEPARTMENT:


Enterprise Finance & Reimbursement

REPORTS TO:


Senior Enterprise Director Finance & Reimbursement

FLSA STATUS:


Exempt







POSITION SUMMARY: Responsible for ensuring that all WVU Medicine hospital facilities are in compliance with all state and federal regulatory reporting requirement relating to finance & reimbursement. This position is also responsible for directing all aspects of net revenue reporting, from development of the budget, ongoing monitoring of actual performance, reserve analyses and identifying and implementing revenue enhancement opportunities. The Director will have leadership oversite of a team of reimbursement staff. The Director is responsible for all strategic and operational planning, day-to-day operations, internal/external relationship management, fiscal and personnel matters for the reimbursement function.

























MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1.


Bachelor’s degree in business administration with major in Accounting or Finance.

EXPERIENCE:

1.


Seven (7) year of experience in healthcare finance, in particular third party reimbursement and Medicare Cost

Reporting.

2.


Five (5) years of management experience.





PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1.


Master’s of Business Administration (MBA) or Certified Public Accountant (CPA).





CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1.


Oversees the preparation and analytical review of all external cost reports, HCA filings and all other state or federal reimbursement filings.

2.


Oversees the review and analysis of all state and federal reimbursement regulations to ensure compliance and presents the impact of all changes in regulations to senior management.

3.


Provides oversight of all state and federal audits in regard to reimbursement matters. Communicates directly with external auditors.

4.


Directs the development of the net revenue budget for all hospital entities. Coordinates with system CFO’s.

5.


Provides oversight for all monthly and annual net revenue reporting. Establishes a process for ongoing monitoring of gross and net revenue, including an analysis of reserves for contractuals and bad debt. Responsible for monitoring budget performance including variance analysis.

6.


Directs the analysis of opportunities for the optimization of reimbursement, including oversight and resolution of outstanding Medicare appeals.

7.


Provides leadership and direction to professional staff, including development and performance assessment.

8.


Provides leadership and support in performance improvement activities for both the department and all system hospitals.

9.


Provide oversight for EPIC system implementation and upgrades for all existing and new system hospitals.



10.


Coordinates departmental operations and communicates effectively with all system CFO’s

11.


Keeps informed of all financial and reimbursement changes. Oversees changes or recommends alternatives to enhance the hospital’s financial position and/or to support the hospital’s fiduciary responsibility.

12.


Provides direction, expertise, and leadership for reimbursement staff. Selects qualified personnel and provides for their on-going training and development. Assures that duties, responsibilities, and authority of each job are clearly defined and communicated.



PHYSICAL REQUIREMENT

S: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.


May need to sit during extended periods of time. Must have the ability to travel to all system hospitals. Must be able to present information both via phone and in person.



WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.


Standard office environment.



SKILLS AND ABILITIES:

1.


Ability to multi-task and work in a challenging fast paced environment

2.


Strong organizational skills and attention to detail

3.


Independent worker and analytical thinker with ability to conduct research, data analysis and resolve complex problems

4.


Excellent written and verbal communication skills





Date Reviewed/Revised: February 2019