Director, Reimbursement, Southbank Plaza II

Job Summary

Director, Reimbursement, Southbank Plaza

The Director of Reimbursement is responsible for leading the reimbursement function for Baptist Health, including oversight of government reimbursement, net revenue budgeting, cost reporting, charge master maintenance, regulatory compliance, and reimbursement-related financial analysis. This leader provides strategic direction and operational oversight to ensure accurate reimbursement, compliance with government regulations, and timely communication of reimbursement issues impacting the Health System.

The Director partners closely with Finance, Revenue Cycle, Operations, Compliance, and senior leadership to evaluate reimbursement performance, monitor regulatory changes, support financial planning, and provide analysis and recommendations related to reimbursement opportunities, risks, and trends.

Key Responsibilities:

• Provides leadership, staffing oversight, and departmental supervision for the Reimbursement function.

• Ensures compliance with applicable government reimbursement regulations, reporting requirements, and industry standards.

• Monitors reimbursement rules, regulatory updates, and payer changes, and communicates potential financial or operational impacts to Health System leadership.

• Directs the preparation of annual net revenue budgets, including analysis of reimbursement assumptions, payer trends, and projected revenue performance.

• Oversees the preparation, review, and submission of government cost reports and related reimbursement filings.

• Leads and supports home office cost report preparation, review, analysis, and related reimbursement activities.

• Monitors monthly net revenue performance and provides leadership with analysis of variances, trends, and reimbursement-related impacts.

• Leads financial analysis related to reimbursement issues, regulatory changes, governmental payer programs, and other revenue-related matters.

• Pulls, reviews, and analyzes government reimbursement reports and related data to support financial reporting, compliance, and decision-making.

• Directs the maintenance and compliance of the Health System charge master, ensuring charges are accurate, current, and aligned with applicable regulatory requirements.

• Partners with internal stakeholders to support reimbursement strategy, financial forecasting, revenue optimization, and operational decision-making.

• Provides guidance and education to Health System leaders regarding reimbursement issues, regulatory updates, and financial implications.

• Supports audit readiness and responds to reimbursement-related inquiries, reviews, or requests as needed.

• Develops and maintains policies, procedures, and internal controls related to reimbursement operations and compliance.

Required Education and Qualifications:

• Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field required.

• 5+ years of healthcare finance experience required.

• Home office cost report experience required.

• Significant experience in healthcare reimbursement, net revenue, cost reporting, finance, revenue cycle, or related financial operations required.

• Strong knowledge of Medicare, Medicaid, and government reimbursement regulations.

• Experience preparing or overseeing government cost reports and reimbursement-related financial analysis.

• Prior leadership or supervisory experience required.

• Strong analytical, communication, problem-solving, and organizational skills.

• Ability to interpret complex regulatory guidance and communicate impact to leadership and operational stakeholders.

• #LI-BHS

Preferred Qualifications:

• Master’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field preferred.

• Experience in a hospital or health system environment preferred.

• AHCA reporting experience preferred.

• Experience pulling government reports and analyzing government reimbursement data preferred.

• Experience with charge master oversight, net revenue budgeting, and reimbursement compliance preferred.

• CPA, HFMA certification, or other relevant healthcare finance certification preferred.

Knowledge, Skills & Abilities

• Strong understanding of healthcare reimbursement methodologies and government payer regulations.

• Knowledge of home office cost reporting, government reporting requirements, and reimbursement-related financial reporting.

• Ability to lead teams, manage priorities, and meet reporting deadlines.

• Strong financial analysis and budgeting skills.

• Ability to collaborate effectively with Finance, Revenue Cycle, Compliance, Operations, and executive leadership.

• Excellent written and verbal communication skills.

• High attention to detail and commitment to accuracy and compliance.

• Ability to identify reimbursement risks, opportunities, and operational impacts.

Education Required

BS

Experience

• Healthcare Finance Experience

License and Certification

• Driver's License - DMV

Location