Sanford Health is hiring a Lead Reimbursement Analyst to provide critical analytical direction and support across our enterprise. You will strategically lead our reimbursement team in analyzing and implementing new payment methodologies to establish optimal reimbursement levels for our health system.
What You'll Do
- Strategically lead the reimbursement team in analyzing and implementing new payment methodologies.
- Create policies and procedures for reimbursement functions including estimating, modeling and reporting provider reimbursement levels.
- Coach others in the organization regarding reimbursement functions.
- Direct the implementation and monitoring of reimbursement functions, which includes Medicare, Medicaid or other third party cost reports, related audits, appeals, disproportionate share hospital (DSH) programs, drug discount programs (340B) and CPT/HCPS code changes.
- Lead the review and impact analysis of payor proposed and final Medicare and Medicaid regulation changes.
- Review and provide expertise in the impact analysis of payor contract changes during negotiations and finalizations of contracts.
- Consult and review third party payor contracts in Experian and Contract Maintenance (hospital and clinic payment integrity tools).
- Act as a resource and coach others regarding third party payor issues.
- Direct reports for the annual pricing and fee schedule updates including impacts on physician compensation.
- Consult in the annual budgeting and audit process such as monthly discounts, year-end discounts and third party reserves.
- Contribute and monitor on-going support of operations and CDM team in maintaining and charging masters particularly as it relates to setting up new codes and establishing prices.
- Assist in on-going pricing initiatives across the enterprise.
- Review and produce reports, analyze and integrate data alongside completing other projects accurately and efficiently.
- Promote integrity and confidentiality of data when sharing with others.
- Develop, summarize, present and explain data in useful and understandable formats.
- Accept and respond to questions and challenges regarding information provided.
- Develop and maintain relationships with finance and accounting staff across the enterprise.
- Coach individuals and provide reimbursement and accounting support.
- Develop, review and update policies and procedures when directed.
What We're Looking For
- Bachelor's degree in Accounting, Business, or a healthcare related field with a strong financial focus.
- Minimum of seven years experience related to reimbursement with Medicare and other third party payers.
Technical Stack
- Experian
- Contract Maintenance (hospital and clinic payment integrity tools)
Team & Environment
You will lead the reimbursement team, providing direction, guidance, and support.
Benefits & Compensation
- Compensation Range: $31.00 - $49.50 per hour.
- We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family.
Work Mode
This is a hybrid position open to candidates in Remote, Fargo, Sioux Falls, and Marshfield locations.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
