Hours:

Shift Start Time:

Not Specified

Shift End Time:

Not Specified

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

8 hr/day shifts, M-F, flexible start/end times

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$49.700 - $64.130 - $71.820

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do
To provide leadership in the coordination and accumulation of documentation relating to reimbursement issues (analysis, cost report preparation, review and recommendation, governmental physician reimbursement analysis, preparation and review of Medicare/Medi-Cal and OSHPD reports, analysis and recommended action on proposed regulations, and coordinating the appeals process) to enable Sharp HealthCare entities to obtain the highest possible reimbursement on governmental programs. To act as a liaison to fiscal intermediaries and coordinate the audit process. To assist in standardizing the financial reporting of third party reimbursement.

Required Qualifications

• 2 Years reimbursement experience with a Fiscal Intermediary or in an acute care setting.

Preferred Qualifications

• Bachelor's Degree in Business Administration with major in finance or accounting.
• Additional experience in financial analysis.
• Affiliation with HealthCare Financial Management (HFMA).

Essential Functions

• Customer service
  Customer Service - Demonstrates effective customer relations by:
  Consistently communicating with Executives, Operations Senior Management, department members and other Sharp employees in a pleasant, professional and effective manner;
  Responding appropriately to need, preferences and dissatisfactions expressed by customers within a time period appropriate to the request;
  Maintaining confidentiality;
  Ensuring effective, customer-focused operations of responsible areas;
  Providing effective consultation and support services to Executives, Operations Senior Management, to assist in strategic and operational planning and facilitate achievement of organizational and departmental goals;
  Developing and coordinating the development of the System net revenue/third party reimbursement budgets;
  Assisting Senior Management with financial feasibility and other financial analyses for special projects, joint venture proposals, affiliations, operations, etc;
  Analyzing and interpreting trends and variances requiring Senior Management's attention;
  Providing effective financial consultation and training to Senior Management and other Sharp management personnel to assist in strategic and operational decision making for the System;
  Assisting Senior Management with other financial requests and analyses.
• Leadership
  Assessment Rating by Manager of Reimbursement and/or Director of Reimbursement/Peers Overall Score Meets/Exceeds.
  Provides effective leadership of the Reimbursement Department, including properly motivating staff, ensuring optimum levels of productivity, re-engineering workloads, etc.
  Assessment Rating by Vice President, Finance Overall Score Meets/Exceeds.
  Assessment Rating by Selected Customers Overall Score Meets/Exceeds.
• Quality
  Effectiveness - Ensures optimum performance of the Senior Reimbursement Analyst function by:
  Recommending and implementing/assisting in the implementation of techniques to improve productivity, increase efficiencies, reduce costs, take advantage of opportunities and maintain state-of-the-art practices;
  Ensuring compliance with corporate policies, HCFA, DHS and other regulatory agencies;
  Ensuring that audit adjustments proposed by the external auditors have no net effect on net income for items within the responsibility of the Senior Reimbursement Analyst excluding items based on estimation and judgment when such items were discussed with and agreed by the Manager of Reimbursement and Director of Reimbursement;
  Coordinating with the Manager of Reimbursement external third party audit functions;
  Reviewing and coordinating with the Manager of Reimbursement external third party re-openings and appeals;
  Keeping abreast of current trends and practices in healthcare financial reporting, accounting regulations and management practices;
  Demonstrating ability to effectively manage third party reimbursement functions of the Systems by insuring that no "surprises" occur (i.e. determination of a significant error in an audit, reopening or appeal item, etc.);
  Assisting in coordinating the activities of Healthcare Management Solutions, Inc. (HMSI) to ensure optimal third-party reporting and maximization of reimbursement to the extent allowable by government regulations.
  Sharing available resources and information with others;
  Accepting interpersonal differences, respecting others' values and opinions and promoting cooperation;
  Effectively prioritizing workload to meet required deadlines and setting work goals and objectives in consultation with the Manager of Reimbursement and/or Director of Reimbursement;
  Pre-planning to allow adequate time for task completion and to identify needs/problems before starting the task;
  Initiating follow-through when necessary;
  Cooperatively trouble-shooting potential and actual problems;
  Offering ongoing training and consulting to direct reports and customers;
  Effectively using and planning personal leave time.
• System integration
  Individual System Integration Goal Related to Relationship Development is 100% Achieved:
  Ensures the successful and timely transition from the HMSI contract for reimbursement reporting of operating units to Sharp HealthCare staff.
  Ensures that effective and timely training is provided to operating unit and financial services, and reimbursement personnel.
  Individual System Integration Goal Related to Program Development is 100% Achieved:
  Innovation - Recommends, develops and implements strategies and policies and procedures, as appropriate, to improve quality of financial statements, to improve efficiency and timeliness of the reporting process, to improve efficiency and quality of results of responsible departments, to ensure accounting is consistent among operating units and in accordance with regulations, to reduce operating costs and maximize reimbursement, etc.
• Work quality regulations
  Legislative - Maintains and apply updated Medicare/Medi-Cal regulations. Assist in identification, education and implementation of controls that will prevent unintentional violations. Support the Corporate Compliance program as requested.
  Financial - Ensures entity-specific quantitative and qualitative analyses are completed in accordance with regulatory guidelines. Provide educational lectures on regulatory changes to subordinates and hospital personnel.
• Work quality reporting
  Responsible for the preparation of meaningful, accurate and timely entity specific cost reports for the System, and the quantitative and qualitative analyses and supporting documentation thereto.
  Responsible for the review of the final cost reports for accuracy and determine reopening items or appeal issues. Filing timely and accurate reopenings or appeals and meet all filing deadlines thereafter.

Knowledge, Skills, and Abilities

• The position requires strong verbal and written communication skills and the ability to communicate effectively with all levels of the organization, including significant interaction with operating units and Senior Management.
• The candidate must be able to analyze and interpret data, as well as prepare or direct the preparation of concise, accurate and meaningful documentation.
• Knowledge of procedures for preparing financial reports in accordance with Generally Accepted Accounting Principles is required, as well as knowledge of government healthcare reimbursement regulations.
• The candidate should be highly analytical, focused and dedicated with a strong sense of loyalty and accountability to the organization.
• The position requires strong customer service skills and a commitment to excellence.
• The candidate must have a strong professional demeanor and the ability to establish credibility throughout the organization.
• Good understanding of operations and the ability to relate financial results to operations.
• Have a collaborative and participative management style, be a strong consensus builder and a successful change agent.
• A interdisciplinary team leader with an interest in developing and educating customers regarding financial issues.
• Be energetic and results-oriented with the ability to balance other organizational considerations.
• Be highly motivated and appreciative of the opportunity to excel in a challenging and dynamic environment.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

Bachelor's Degree