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Company: MedStar Medical Group

Location: MD

Career Level: Director

Industries: Not specified

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Description

General Summary of Position
Performs reimbursement functions to maintain compliance with the regulatory mandates per the Health Services Cost Review Commission (HSCRC). Supports 4 of the following 7 MedStar hospitals (could vary): MedStar Franklin Square Medical Center (MFSMC), MedStar Good Samaritan Hospital (MGSH), MedStar Harbor Hospital (MHH), MedStar Union Memorial Hospital (MUMH), MedStar Montgomery Medical Center (MMMC), MedStar St. Mary's Hospital (MSMH), and MedStar Southern Maryland Hospital Center (MSMHC).

Primary Duties and Responsibilities

Acts as a liaison for hospitals issues with the HSCRC staff, maintaining a collaborative working relationship.

Acts as the reimbursement liaison to hospitals by communicating to designated staff.

Collaborates with external consulting firms as resources demand.

Coordinates the completion of HSCRC and Medicare audits.

Develops and contributes to department goals and objectives and adheres to department policies, procedures, and quality and safety standards. Complies with governmental and accreditation regulations. Participates in multi-disciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and hospital in community outreach efforts. Demonstrates sound moral and ethical judgment.

Develops reimbursement models that include changes and/or new additions to regulations; collaborates with IT and other support departments as needed.

Maintains compliance with HSCRC rate orders: GBR targets and rate center corridors.

Participates in Maryland Hospital Association technical task forces and HSCRC workgroups as deemed necessary.

Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.

Performs other duties as assigned.

Prepares rate changes to provide to CDM Director.

Provides a review of annual cost reports including HSCRC Annual Filing and Medicare Cost Report and assists in completion as necessary.

Provides analytical data such as but not limited to case mix, budget, volume, quality and infrastructure reporting.

Provides monthly revenue/financial reporting and statistics to Corporate Accounting.

Responsibilities are provided in the goals for each incumbent, which usually outline new projects or substantial changes in regulations that require operational changes, including managing and training the necessary staff to complete assignments.

Reviews monthly and quarterly regulatory reporting.

Validates and submits inpatient and outpatient HSCRC tapes including implementation of changes/additions/deletions to reporting data elements , reconciliation process and error reporting.

Works with VP and AVP on rate issues or analytical requests.

Minimum Qualifications
Education

Bachelor's degree in Accounting or Finance. required

Experience

4 years of reimbursement experience with management responsibilities required or
6 years of finance management experience in related healthcare environment required

Knowledge, Skills, and Abilities

Strong computer skills in Microsoft Excel and Access.
Strong verbal and written communication skills.

This position has a hiring range of $131,497 - $256,630

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Director Maryland Regulatory Job Listing at MedStar Medical Group in MD (Job ID req35794)

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Director Maryland Regulatory Job Listing at MedStar Medical Group in MD (Job ID req35794)

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