Providence Health & Services Reimbursement Regulatory Strategy Program Manager PSJH in Portland, Oregon
Providence St. Joseph Health is calling a Reimbursement Regulatory Strategy Program Manager PSJH to our location in Renton, WA; Portland, OR, Irvine, CA or Beaverton, OR. *other locations within the Providence footprint considered
We are seeking a Reimbursement Regulatory Strategy Program Manager PSJH to be responsible for developing and maintaining strategic value-added reimbursement initiatives for the system to include evaluation, planning, coordination, and follow through to completion of such initiatives. The Program Manager will support and assist in developing new strategies for any reimbursement methodology related to Medicare and Medicaid that has financial implications including, but not limited to: Medicare, Medicaid, and other Reimbursement/Finance regulatory strategies, Wage index strategies and Geographic Reclass Requests, and optimization of various cost based reimbursement strategies, Proposed and Final Rule analysis, preparing and communicating Financial Impact of new services or billing changes, understanding the various state Provider Tax Programs, supporting the system Pharmacy 340b initiatives, and Special Payment Status for our hospitals (RRC, SCH, MDH), as applicable. The Program Manager is also responsible for the efficient operation of various project teams, including mentoring of staff, assessing current workloads, and helping to determine prioritization of reimbursement-related projects.
In this position you will have the following responsibilities:
Responsible for effective interface with ministry finance leaders at the appropriate level; working in ways that are in compliance with all government reimbursement regulations and adequacy of internal controls; efficient operation of project teams, including supervision of staff work on various projects, assessing current workloads, and providing adequate oversight and prioritization of reimbursement related projects.
Serves as a liaison between the Reimbursement Department and ministry operational and finance leaders, at various levels across the organization.
Serves as a liaison with various leaders and departments within Providence St. Joseph Shared Services.
Develops and manages the analysis and calculation of the impact of routine regulatory changes.
Support due diligence efforts related to mergers and acquisitions and acts at the liaison for the Reimbursement Department to the M&A Team. May have a pivotal role in ensuring the entire Reimbursement Team meets agreed upon deadlines for integration and completes all tasks.
Serves as a technical expert on Medicare and Medicaid Reimbursement methodologies and initiatives across the organization.
Plans functional team workload and manages such that all reports, projects, etc., are completed timely, efficiently, and with a high degree of accuracy.
Continuously monitors workload and methodologies used to achieve results, making recommendations to improve efficiency and/or achieve cost savings whenever possible.
Performs reviews, research and other duties independently or as requested by the Dir Reimbursement Regulatory Strategy, Director Reimbursement Regulatory Reporting, Director Reimbursement Financial Reporting, or the VP Head of Reimbursement.
Ensures that any Regulatory Strategy initiatives are filed timely and that benefits and risk have been appropriately communicated. This includes filing Medicare cost report appeals, requests for special hospital status, Geographic reclassification requests and other determined by the regulatory agencies, which require them.
Responsible for providing feedback on staff performance from various project work.
Demonstrates leadership capabilities in every aspect of day-to-day work, including team and department meetings, daily interactions with others in PSJH Shared Services, Revenue Cycle, and across the organization.
Required qualifications for this position include:
Bachelor's Degree in Accounting, Finance, or Mathematics/Statistics Or equivalent education/experience.
7 years of demonstrated experience in the reimbursement field with expert knowledge of current reimbursement and reporting rules and regulations.
Preferred qualifications for this position include:
Master's Degree in Accounting, Finance or Healthcare
1 year of program management experience in consulting, in a multi-hospital system, or MAC
About the department you will serve.
Providence Shared Services provides a variety of functional and system support services for our Providence family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Project & Program Management (Non-Clinical)
Other Location(s): Oregon-Portland, Oregon-Beaverton, California-Irvine
Req ID: 320155