GENERAL SUMMARY

The Manager, Reimbursement and Payor Analytics will serve as the primary internal specialist on reimbursement trends.  He/she will create interactive payment analytics and partner with accounting to assure proper journaling and reporting of accounts receivable. 

The Manager, Reimbursement and Payor Analytics will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.

The Manager, Reimbursement and Payor Analytics will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, and Commitment to Excellence) while fulfilling job duties.

PRINCIPAL RESPONSIBILITIES

THE MANAGER, REIMBURSEMENT AND PAYOR ANALYTICS WILL:

1. Functional owner of the Crowe RCA tool to perform monthly analysis of third party receivables as part of accounting close process, including necessary journal entries.
2. Perform wide variety of payment analytics to support payor contract negotiations.
3. Assist with analytics for MD / Pro Fee billing.
4. Support Patient Financial Services with revenue and A/R related KPI’s.
5. Serve as the Subject Matter Expert (SME) for Net Patient Revenue and AR for a potential ERP implementation.
6. Work as part of the budget team to set annual contractual allowance and payor mix budget and track performance throughout the year.
7. Develops and maintains financial models related to potential changes in federal programs or managed care and proactively identifies opportunities for revenue growth based on changing regulations.
8. Support Internal Audit and Compliance with analytics when appropriate.
9. Educate self through industry readings, conferences, and other forums on government regulations and other critical healthcare reimbursement trends.
10. Complete special projects as directed.
11. Perform all other duties that may be assigned in the best interest of the Shirley Ryan AbilityLab.

REPORTING RELATIONSHIPS

1. Reports to the Director of Financial Planning

KNOWLEDGE, SKILLS & ABILITIES REQUIRED

1. Bachelor's degree required - preferably in Business, Finance, Economics, Accounting or a related field.
2. CPA preferred.
3. Three or more years of experience working in the reimbursement department of hospitals or Medicare Intermediaries, preferably in an analytic function.
4. Current understanding of government reimbursement regulations.
5. Experience with hospital accounting systems required.
6. Proven ability to apply critical thinking and analytic skills to formulate recommendations and resolve problems.
7. Exceptional financial skills, including a firm understanding of the relationship between income statement, balance sheet, and statement of cash flows.
8. Must be proficient with Excel.
9. Experience with Tableau strongly desired.
10. Ability to communicate (verbally and in writing) in a clear and concise manner
11. Ability to develop and/or present content to senior leaders and other groups
12. Ability to work independently under minimal supervision with a wide degree of creativity and latitude. May manage projects independently or lead/direct the work of others.
13. Ability to independently prioritize multiple projects, bring projects to completion, develop and monitor timelines.
14. Ability to work in a high pressure, deadline oriented, and complex health care environment.

WORKING CONDITIONS

1. Normal office environment with little or no exposure to dust or extreme temperature.
2. Work requires ability to sit at a computer for long stretches, and visual ability to read numbers clearly.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

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Required Skills Required Experience