THE POSITION

The Vice President, Financial Policy & Government Reimbursement provides executive level expertise in strategizing, estimating, planning and organizing the fiscal activities related to government policy and payments to the health system. Works with the cost reimbursement division to ensure the integrity of government filings, AR valuation estimates, Medicare and Medicaid cost reports and various strategies and financial reports relating to government payors. This individual will be knowledgeable of industry leading best practices and apply those to the benefit of Grady Health System.
Additionally, responsible for assisting in producing timely and accurate financial statements, ensuring internal controls over Government Reimbursement Division, producing reports and information on a monthly basis. This professional will also assist with various financial and accounting activities related to reimbursements and various government estimations, recoveries and valuations, implementation and utilization of pricing strategies, reviewing ICTF and various hospital surveys and third party reimbursement estimations.
Act as a public voice on healthcare financial policy and healthcare reimbursement.

RESPONSIBILITIES

• Under the direction of the Senior Vice President of Finance is responsible for supporting the effective operations of the following departments: Government Relations, Cost and Reimbursement Accounting and Financial Operations. Assesses staff and resource needs and addresses as appropriate. Mentors, coaches, trains, and develops staff. Ensures appropriate distribution of workload and alignment of resources.
• Develops and maintains policies and procedures to support strong internal controls.
• Attends all required meetings. Serves on project teams and attends meetings as assigned to represent the Government and Fiscal Divisions. Participates at the state level in UPL and other state plan amendment discussions related to healthcare.
• Maintains professional affiliations and ensures continuing self-development in all related fields of expertise including but not limited to health care, finance, accounting, economics, information systems and federal and local laws and regulations.
• Participates in the establishment of performance goals, allocates resources, and establishes and revises policies as needed for areas of responsibility. Monitors performance against goals and ensures an effective operation of all areas of responsibility.
• Recommends opportunities to contain costs, increase efficiency and enhance revenues in areas of responsibility throughout the organization and assists in the direction and coordination of the design, development, modification and implementation of financial systems.
• Ensures that the methods relative to the valuation of accounts receivable are built upon good data and sound assumptions and internal controls are in place relative to the development of estimates and ensures that all required surveys, 990s and other filings are completed timely and accurately.
• Contributes to the timely and accurate filing of Medicare and Medicaid cost reports and identifies the need for outside review or assistance with appeals, etc. Participates in the review of cost report liabilities, ensuring they are appropriately reserved for and communicates issues, which can affect reimbursement positively or negatively to senior management. Ensures that information received from the medical schools relative to residents is accurate. Identifies potential opportunities to maximize reimbursements within the guidance of the governing rules and laws.
• Participates in the monthly closing process with accounting staff and finance division leadership in order to review financial statements for accuracy and gain an understanding of significant historical and budget variances related to government funding.
• Plans and directs analysis of government reimbursement impact of proposed final Medicare and Medicaid regulation changes. Keeps leadership abreast of changes and the potential impact of such changes. Supports governmental affairs in understanding Medicare and Medicaid regulations and the impact changes may have on reimbursement.
• Participates in the internal and external audit in conjunction with the cost reimbursement leadership. Conducts and reviews analyses of significant variances and trends in the financial performance of the organization and coordinates with government relations team. Acts as a leading public voice on healthcare financial policy and healthcare reimbursement.

What success looks like:

• Aspirational and passionate about Grady and the role working in sync with the SVP Finance to fine tune a “gold standard” level of policy and reimbursement performance.
• Successfully integrate into a finance team culture that is forward thinking, transparent and collegial.
• Realizing additional reimbursement monies from governmental and other funding sources. Inquisitive, seeks out new funding models.
• No material reimbursement-related audit adjustments. Works very well with outside accounting and other professional service firms.
• Growing team knowledge, building bench strength, molding his/her own replacement. Modeling an ambitious leader with staying power.
• Building a strong understanding of the relationship between revenue cycle and reimbursement in the overall context of financial operations and performance.
• Being continuously inquisitive about the underlying forces driving reimbursement and varied government funding sources. Ability to communicate findings to varied stakeholder groups in a clear, understandable and instructive manner to encourage supportive actions.