Job Summary:

The Senior Reimbursement Analyst assumes a lead role within the reimbursement function for assigned entities/service lines and participates in overall reimbursement function for Care New England. Implements hospital and system-wide priorities to ensure achievement of established goals and objectives. Assumes a lead role in gross and net revenue reporting functions and cost reporting function for primary entity/service line.

Duties and Responsibilities:

Assumes a lead role within the reimbursement function for the entity/service line.

Researches, analyzes, and reviews issues related to reimbursement, develops methods and rationales to estimate financial and operational impact on the entity/service line.

Maintains knowledge of current federal, state, and legislative regulations and contract specifics affecting reimbursement.

Assumes a lead role in preparing all filings and providing audit defenses.

Prepares monthly presentation for Senior Management which reports results accurately, compares results with prior periods, reports on trends, analyzes variances from expected results, highlights significant changes in drivers and potential risks. Makes recommendations for improvements in processes as required.

Assumes a lead role in preparing filings for Medicare, State filings for Disproportionate share and other supplemental payments, Workers Compensation, and state filings as required.

Leads multidisciplinary teams to ensure compliance with other regulatory requirements, such as the Promoting Interoperability program, and provider time studies.

Prepares and negotiates facilities & administrative (F&A) rates for grants with the U.S. Department of Human Services.

Interacts with independent financial statement auditors, as well as auditors for Medicare, Medicaid, and the U.S. Department of Human Services for federal funding.

Understands CNE’s financial process and is an active participant in the management of financial information.

Understands and demonstrates complex concepts in ways that lead to understanding by a wide audience.

Assumes a lead role in preparing patient revenue related month-end and quarter-end financial reports, as well as the year-end audit process, in accordance with generally accepted accounting principles.

Assumes a lead role in preparing entity/service line operating annual financial plans, particularly in regard to gross and net revenue, charge amounts, volumes, proper coding and system interfaces

Oversees the preparation of statistical reports monthly and as needed.

Manages human resources effectively

Assumes a lead role in selected areas of expertise for Care New England.

Performs other related duties as assigned.

Requirements:

BA/BS degree in Accounting, Business or Finance.

MBA or Master’s Degree in related field preferred.

Experience in Healthcare and reimbursement required.

Minimum of five years experience in hospital finance required.

Proficiency in the English language.

Care New England Health System (CNE) and its member institutions;Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.