State Licensed Reimbursement Director

Job Summary

Leading an assigned state portfolio, the full-time remote State Licensed Reimbursement Director will manage reimbursement workstreams, including cost reporting, Medicare and Medicaid payment integrity, and regulatory analysis while collaborating with various operational partners to ensure defensible reimbursement outcomes.

Key responsibilities

• Lead the reimbursement operating model for the assigned state portfolio, ensuring accountability for cost reporting and payment integrity
• Monitor and analyze the impact of regulatory changes on reimbursement, providing proactive financial impact assessments to leadership
• Oversee the cost report lifecycle and ensure compliance with Medicare and Medicaid regulations, including audit response and settlement processes

Required qualifications

• Bachelor's degree in accounting, finance, business administration, health care administration, or a related field, or equivalent experience
• Extensive experience in hospital reimbursement, including Medicare and Medicaid cost reporting and regulatory analysis
• Demonstrated ability to lead teams and manage complex reimbursement portfolios with competing deadlines
• Foundational digital literacy, including familiarity with AI and GenAI tools for reimbursement analytics
• Experience advising senior executives and synthesizing complex reimbursement issues into clear recommendations