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Project Manager, Government Reimbursement

Emory Healthcare/Emory University

Atlanta, GA

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JOB DETAILS
SALARY
SKILLS
Accounting, Alliance/Partner Management, Analysis Skills, Blood-Borne Pathogens, Budget Management, Business Analysis, Business Operations, Business Services, Business impact analysis (BIA), Channel Strategies, Cross-Functional, Data Collection, Decision Support, Documentation Models, Environmental Work, Epic Systems, Finance, Financial Analysis, Financial Management, Financial Modeling, Financial Operations, Financial Regulations, Funding, Genetics, Government, Health Informatics, Healthcare, Healthcare Reimbursement, Hospital, Infectious Diseases, LaTeX Typesetting, Leadership, Legal, Lift/Move 25 Pounds, Lift/Move 35 Pounds, Managed Care, Material Moving, Medicaid, Medical Waste, Operational Support, Operations Management, Outsourcing, Patient Care, Physical Demands, Policy Implementation, Prepare Correspondence, Presentation/Verbal Skills, Project/Program Management, Regulations, Reimbursement, Revenue Management, Risk, Risk Management, Tax Reporting, Time Management, Typing, Willing to Travel
LOCATION
Atlanta, GA
POSTED
11 days ago


Overview



Be inspired. Be rewarded. Belong. At Emory Healthcare.

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: + Comprehensive health benefits that start day1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives + Ongoing mentorship, _development,_ and leadership programs + And more

Work Location:

Atlanta, GA

Description



Overview:

+ Partners directly with the Corporate Director of Government Reimbursement as a strategic operator and project leader, driving complex Federal and State reimbursement initiatives across the enterprise. + Works horizontally across reimbursement managers, finance leadership, operational departments, and external stakeholders to advance high-priority programs from strategy through implementation. + Leads transformational initiatives spanning supplemental payment programs, reimbursement optimization, regulatory change, audit strategy, and the transition of outsourced functions to in-house operations. + Splits time between director-led enterprise projects and manager-supported operational work, deploying subject matter expertise where complexity, risk, or financial impact is highest.

Primary duties and responsibilities:

+ Strategic Partnership & Enterprise Leadership + 1. Serve as strategic partner to the Corporate Director, providing surge capacity and subject matter expertise on high-priority enterprise reimbursement initiatives. + 2. Lead cross-functional workgroups spanning finance leadership, operational departments, and external stakeholders to drive complex Federal and State reimbursement projects from strategy through implementation. + 3. Develop executive-level summaries, briefing materials, strategic recommendations, and implementation roadmaps to support leadership decision-making. + 4. Assist in transition planning for reimbursement functions currently supported by external vendors, managing migration to in-house operations. + Supplemental Payment Programs & State Reimbursement + 1. Provide subject matter expertise on State Medicaid financing mechanisms, waiver programs, directed payment models, and supplemental funding structures, with emphasis on Georgia Medicaid/DCH policies. + 2. Oversee cross-functional workgroups for Disproportionate Share Hospital (DSH) programs, Upper Payment Limit (UPL) reporting, provider tax programs, Graduate Medical Education (GME) funding, and uncompensated care pools. + 3. Coordinate data collection, financial modeling, regulatory documentation, and executive reporting tied to state and federally funded reimbursement streams. + 4. Support regulatory change implementation and monitor evolving DCH policies and state-specific settlement programs. + Financial Analysis & Reimbursement Modeling + 1. Conduct financial impact analyses related to new business ventures, service line expansions, provider-based arrangements, and organizational integrations to quantify governmental reimbursement implications. + 2. Develop advanced reimbursement models to evaluate the financial impact of regulatory changes, program participation decisions, and optimization opportunities. + 3. Support budget development, audit strategy, appeals preparation, and regulatory correspondence. + Operational Support & Project Management + 1. Split time supporting Government Reimbursement Managers on high-complexity initiatives, operational escalations, and projects with elevated risk or financial impact. + 2. Manage multiple complex initiatives simultaneously with a high degree of autonomy, aligning stakeholders, mitigating regulatory risk, and ensuring timely execution. + 3. Perform reimbursement impact analysis for new business initiatives and operational changes to inform leadership decisions. +

Additional Duties as Assigned.

+

Travel: Less than 10% of the time may be required. Work Type: Remote employee



Minimum Required Qualifications:

+ Education - Bachelor's degree in Accounting, Finance, or related field required. + Experience - Minimum 6 years of governmental reimbursement experience. Knowledge, skills, and abilities (required): + Strong experience with State Medicaid reimbursement programs required. + Demonstrated project leadership and cross-functional coordination experience. + Advanced analytical and reimbursement modeling skills Preferred Qualifications: + Experience in complex academic healthcare systems preferred. + Experience with EPIC and Strata preferred. Knowledge, skills, and ability requirements (preferred): + Georgia Medicaid/DCH experience strongly preferred.PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs., 0-33% of the work day (occasionally) Lifting 25 lbs. max; Carrying of objects up to 25 lbs.; Occasional to frequent standing & walking, Frequent sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste chemicals/gases/fumes/vapors, Communicable diseases, Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Additional Details

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

ACCOMMODATIONS:

EHC will provide reasonable accommodation to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Leave and Accommodations.

PHYSICAL REQUIREMENTS:

(Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS:

Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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Division

_Emory Healthcare Inc._

Campus Location

_Atlanta, GA, 30345_

Campus Location

_US-GA-Atlanta_

Department

_EHI RCM Govt Reimbursement_

Job Type

_Regular Full-Time_

Job Number

_166350_

Job Category

_Revenue Cycle & Managed Care_

Schedule

_8a-5p_

Standard Hours

_40 Hours_

Hourly Minimum

_USD $55.32/Hr._

Hourly Midpoint

_USD $67.40/Hr._ Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

About the Company

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Emory Healthcare/Emory University