Director, Reimbursement Job at Baptist Health (Florida) (Jacksonville)

Job Description

The Director of Reimbursement is responsible for leading the reimbursement function for Baptist Health, including oversight of government reimbursement, net revenue budgeting, cost reporting, charge master maintenance, regulatory compliance, and reimbursement-related financial analysis. This leader provides strategic direction and operational oversight to ensure accurate reimbursement, compliance with government regulations, and timely communication of reimbursement issues impacting the Health System. The Director partners closely with Finance, Revenue Cycle, Operations, Compliance, and senior leadership to evaluate reimbursement performance, monitor regulatory changes, support financial planning, and provide analysis and recommendations related to reimbursement opportunities, risks, and trends.

Job Responsibility

Provides leadership, staffing oversight, and departmental supervision for the Reimbursement function
Ensures compliance with applicable government reimbursement regulations, reporting requirements, and industry standards
Monitors reimbursement rules, regulatory updates, and payer changes, and communicates potential financial or operational impacts to Health System leadership
Directs the preparation of annual net revenue budgets, including analysis of reimbursement assumptions, payer trends, and projected revenue performance
Oversees the preparation, review, and submission of government cost reports and related reimbursement filings
Leads and supports home office cost report preparation, review, analysis, and related reimbursement activities
Monitors monthly net revenue performance and provides leadership with analysis of variances, trends, and reimbursement-related impacts
Leads financial analysis related to reimbursement issues, regulatory changes, governmental payer programs, and other revenue-related matters
Pulls, reviews, and analyzes government reimbursement reports and related data to support financial reporting, compliance, and decision-making
Directs the maintenance and compliance of the Health System charge master, ensuring charges are accurate, current, and aligned with applicable regulatory requirements
Partners with internal stakeholders to support reimbursement strategy, financial forecasting, revenue optimization, and operational decision-making
Provides guidance and education to Health System leaders regarding reimbursement issues, regulatory updates, and financial implications
Supports audit readiness and responds to reimbursement-related inquiries, reviews, or requests as needed
Develops and maintains policies, procedures, and internal controls related to reimbursement operations and compliance

Requirements

Bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field required
5+ years of healthcare finance experience required
Home office cost report experience required
Significant experience in healthcare reimbursement, net revenue, cost reporting, finance, revenue cycle, or related financial operations required
Strong knowledge of Medicare, Medicaid, and government reimbursement regulations
Experience preparing or overseeing government cost reports and reimbursement-related financial analysis
Prior leadership or supervisory experience required
Strong analytical, communication, problem-solving, and organizational skills
Ability to interpret complex regulatory guidance and communicate impact to leadership and operational stakeholders

Nice to have

Master's degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field preferred
Experience in a hospital or health system environment preferred
AHCA reporting experience preferred
Experience pulling government reports and analyzing government reimbursement data preferred
Experience with charge master oversight, net revenue budgeting, and reimbursement compliance preferred
CPA, HFMA certification, or other relevant healthcare finance certification preferred

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Director, Reimbursement

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