Dir. Reimbursement Strategy-Patient Accounting

Job Summary

The Director of Reimbursement Strategy leads the development and execution of enterprise-wide reimbursement strategies that optimize financial performance, ensure regulatory compliance, and strengthen the long‑term sustainability of the organization. As the health system’s subject matter expert in governmental and commercial reimbursement, this role evaluates payment methodologies, monitors regulatory and payer changes, and drives initiatives that improve reimbursement outcomes across all care settings. The Director works collaboratively across a highly matrixed environment, including Revenue Cycle, Managed Care, Finance, HIM, CDI, Care Management, Compliance, IT, Operations, and Executive Leadership—to identify opportunities, resolve reimbursement challenges, and implement sustainable improvements. The position oversees reimbursement analytics, performance monitoring, and reporting tools that support proactive payer management and accountability. Ultimately, the Director ensures the organization captures all entitled reimbursement, maintains compliance with federal, state, and payer requirements, and advances strategies that enhance financial stability and operational effectiveness.

Minimum Job Requirements:

Work Experience:

Seven years of progressively responsible experience in healthcare reimbursement, healthcare finance, revenue cycle, managed care, or reimbursement compliance, including a minimum of five years in a leadership role within a hospital, health system, academic medical center, payer organization, healthcare consulting firm, or related healthcare environment. Demonstrated expertise in Medicare and Medicaid reimbursement methodologies, healthcare payment systems, and reimbursement regulations, with a proven ability to lead complex, cross‑functional initiatives involving multiple stakeholders. Experience within a large integrated health system, academic medical center, public hospital, or safety‑net organization is strongly preferred.

Experience with governmental reimbursement programs including DSH, UPL, Directed Payment Programs, Uncompensated Care Programs, and Graduate Medical Education reimbursement.  Experience supporting payer contract analysis and reimbursement optimization initiatives.  Experience utilizing healthcare analytics, reimbursement modeling, and performance reporting tools.

License/Registration/Certification:

None

Education and Training:

Bachelor's Degree in Healthcare Administration, Finance, Accounting, Business Administration, Economics, or a related field required.

Master's Degree in Healthcare Administration (MHA), Business Administration (MBA), Finance, Accounting, Public Health, or related field preferred.

Skills:

1. Expert knowledge of governmental and commercial reimbursement methodologies
2. Strong understanding of healthcare finance, reimbursement regulations, and payer payment practices
3. Knowledge of hospital and professional billing, coding, documentation, and patient status regulations
4. Advanced analytical and financial modeling skills
5. Ability to interpret complex regulatory requirements and translate them into operational strategies
6. Exceptional problem‑solving and critical‑thinking skills
7. Collaboration and influence skills across highly matrixed environments
8. Negotiation skills, particularly with payers and cross‑functional stakeholders
9. Executive‑level verbal, written, and presentation communication skills
10. Leadership of large‑scale, cross‑functional initiatives
11. Proficiency with healthcare financial systems, reimbursement analytics tools, and reporting platforms
12. Advanced Microsoft Office proficiency, especially Excel and Power BI‑style analytics
13. Strategic planning and execution, including enterprise reimbursement strategy development
14. Project management and organizational leadership
15. Ability to evaluate reimbursement implications of service line, facility, and operational changes
16. Payer performance evaluation, including contract compliance and payment accuracy
17. Regulatory monitoring and policy interpretation, with proactive risk mitigation
18. Ability to develop dashboards, scorecards, and reimbursement monitoring tools
19. Cross‑departmental coordination, including Finance, Managed Care, Revenue Cycle, HIM, CDI, Compliance, and IT
20. Team leadership and staff development, including coaching, performance management, and conflict resolution