Senior Director Reimbursement - DUHS

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General Description

This position leads all governmental reimbursement functions at Duke University Health System and is therefore responsible for compliance, analysis, revenue optimization, advocacy and communication on all related matters. Given the position of DUHS as a leader in state, regional and national care delivery, this position will be expected to lead in the development of regulations, policies and practices at all levels.

In addition, the position :

• has overall responsibility for compliant compilation, submission and defense through final settlement of annual Medicare, Medicaid, Tricare and other external Cost Reports for Duke University Health System, Inc. (Home Office), Hospitals, and related entities.
• is responsible for appropriate completion of all audit / desk review analysis and required responses to auditor inquiries as well as complete and compliant Cost Report re-openings and appeals.
• assesses Health System participation in Cost Report-related litigation and, as applicable, ensures the Health System participates in appeal matters necessary to appropriately protect the Health System's position to secure future reimbursement.
• maintains direct contact with various Duke University Health System and Hospital entities to optimize governmental reimbursements in compliance with the governmental guidelines.
• Develops and leads a team of professionals experienced in this highly-specialized and regulated work environment, with a focus on team culture as well as each individual's development and work satisfaction.
• represents DUHS in consultations with the NC Medicaid program around reimbursement programs, including supplemental or direct payment programs; coordinates with CFOs of other major North Carolina health systems, North Carolina Healthcare Association and outside counsel to ensure proposals support the interests of Duke Health and academic medicine.

Duties and Responsibilities of this Level

Responsible for the timely submission of compliant governmental reporting including :

Ensures the Cost Report compilation process is consistent with Health System strategies, policies and procedures including :

General :

Position Communication

This position will communicate directly with the Vice-President - Finance, Health System CFO, Health System Controller, Hospital CFOs, entity / departmental operational leadership and PRMO Senior Management and Revenue Managers.

Education

Work requires a Bachelor's degree in Accounting or Business. Advanced degrees or credentials are desirable.

Experience

Work requires 8 years of relevant accounting experience in reimbursement and revenue accounting. Management-level reimbursement experience at an academic medical center is preferred.

Degrees, Licensures, Certifications

N / A

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions :

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and / or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.