Director of Supplemental Medicaid Revenue Collections (Director of Finance)
NYC Health Hospitals, New York, New York, us, 10261
NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Work Shifts
9:00 A.M - 5:00 P.M
Duties & Responsibilities
Purpose of Position :
Reporting to the Senior Assistant Vice President of Managed Care Operations, the Director of Supplemental Medicaid Revenue Collections will lead the tracking and oversight of state-directed payment revenue collected by NYC Health + Hospitals through Medicaid managed care claims. NYC Health + Hospitals expects to collect a significant portion of the system's $12B revenue budget through these state-directed payments annually.
General tasks and responsibilities will include:
Enhance and maintain internal reporting to track whether claims paid by Medicaid Managed Care plans include add-on rates within the revenue collected for our inpatient and outpatient encounters; Analyze and organize massive data files to categorize claims that require follow up with each Medicaid Managed Care plan when add-on payments are not processed; Routinely prepare, transmit and manage resolution of claims project files with contracted Medicaid Managed Care plans to hold payers accountable for paying each claim warranting an add-on payment; Strategically evaluate payers' claims processing trends to discern risks that NYC Health + Hospitals might not collect as much of the state-direct payment dollars as budgeted and synthesize into talking points for NYC Health + Hospitals leadership; Leverage internal reports to disseminate monthly updates on collections stats (by payer and by site) with colleagues in Finance and Managed Care; Develop tight collaboration with colleagues in Revenue Cycle Services to better monitor appeal status of denied claims that are temporarily ineligible for add-on payments; Perform other job-related duties as required. Minimum Qualifications 1. Master's degree from an accredited college or university in Accounting, Finance, Business Administration or a related discipline with an emphasis on accounting and financial systems; and four (4) years of responsible-level experience in fiscal management or administration with an emphasis on financial systems, management information and controls, three (3) years of which must have been in responsible administrative or managerial capacity; or 2.Bachelor's degree from an accredited college or university in disciplines, as listed in "1" above; and five (5) years of experience, as described in "1" above, three (3) years of which must have been in aresponsible administrative or managerial capacity.
Department Preferences
Knowledge, Skills, Abilities and other Requirements:
Knowledge of Managed Care market in NYC Ability to interpret claims and remittances Proficiency in Epic, Microsoft Access, Excel, and Word Strong analytical, communication and presentation skills required Must be able to read and comprehend large Excel data files Four years of work experience in health care or insurance industry preferred Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs
If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Work Shifts
9:00 A.M - 5:00 P.M
Duties & Responsibilities
Purpose of Position :
Reporting to the Senior Assistant Vice President of Managed Care Operations, the Director of Supplemental Medicaid Revenue Collections will lead the tracking and oversight of state-directed payment revenue collected by NYC Health + Hospitals through Medicaid managed care claims. NYC Health + Hospitals expects to collect a significant portion of the system's $12B revenue budget through these state-directed payments annually.
General tasks and responsibilities will include:
Enhance and maintain internal reporting to track whether claims paid by Medicaid Managed Care plans include add-on rates within the revenue collected for our inpatient and outpatient encounters; Analyze and organize massive data files to categorize claims that require follow up with each Medicaid Managed Care plan when add-on payments are not processed; Routinely prepare, transmit and manage resolution of claims project files with contracted Medicaid Managed Care plans to hold payers accountable for paying each claim warranting an add-on payment; Strategically evaluate payers' claims processing trends to discern risks that NYC Health + Hospitals might not collect as much of the state-direct payment dollars as budgeted and synthesize into talking points for NYC Health + Hospitals leadership; Leverage internal reports to disseminate monthly updates on collections stats (by payer and by site) with colleagues in Finance and Managed Care; Develop tight collaboration with colleagues in Revenue Cycle Services to better monitor appeal status of denied claims that are temporarily ineligible for add-on payments; Perform other job-related duties as required. Minimum Qualifications 1. Master's degree from an accredited college or university in Accounting, Finance, Business Administration or a related discipline with an emphasis on accounting and financial systems; and four (4) years of responsible-level experience in fiscal management or administration with an emphasis on financial systems, management information and controls, three (3) years of which must have been in responsible administrative or managerial capacity; or 2.Bachelor's degree from an accredited college or university in disciplines, as listed in "1" above; and five (5) years of experience, as described in "1" above, three (3) years of which must have been in aresponsible administrative or managerial capacity.
Department Preferences
Knowledge, Skills, Abilities and other Requirements:
Knowledge of Managed Care market in NYC Ability to interpret claims and remittances Proficiency in Epic, Microsoft Access, Excel, and Word Strong analytical, communication and presentation skills required Must be able to read and comprehend large Excel data files Four years of work experience in health care or insurance industry preferred Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs
If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.