Tenet Healthcare has an immediate opportunity for a Manager, Operations Reimbursement at our corporate office in Nashville, Tennessee. Reporting to the Senior Director, Operations Reimbursement, the Manager Operations Reimbursement serves as an in-house industry expert on facility reimbursement policy from the hospital and payer perspective.
ï¿½Review monthly and month end contractual models for Medicare, Medicaid and all managed care payors for compliance and accuracy.
ï¿½Provide applicable Medicare, Medicaid, Blue Cross and all other managed care payors contractual models, related reimbursement factors and other necessary data.
ï¿½Manage Medicare, Medicaid, Blue Cross and CHAMPUS cost report preparation and submissions.
ï¿½Interact with program auditors regarding Medicare, Medicaid and Blue Cross cost report audits.
ï¿½Provide guidance and review third party (Medicare, Medicaid and managed care) budget process for facilities.
ï¿½Provide third party (Medicare, Medicaid and managed care) review information as required to financial auditors.
ï¿½Monitor governmental reimbursement changes that would affect current reimbursement.
ï¿½Monitor Medicare, Medicaid and Blue Cross interim payment rates for compliance and accuracy.
ï¿½Maintain payment rate files for patient logging systems and investigate discrepancies.
ï¿½Research websites and industry sources, as well as work with user groups to source information.
ï¿½Assist in oversight in the development and maintenance of Medicaid supplemental payment and State Medicaid DSH programs for assigned facilities.
ï¿½Prepare analytical service line reviews and pro-formas as required.
ï¿½Provide knowledge resource to internal reimbursement, hospital and Regional personnel.
KNOWLEDGE, PRACTICAL EXPERIENCE AND LICENSURE/REGISTRATION REQUIRED:
1.Bachelorï¿½s Degree in Accounting or Finance.
2.5-7+ years of hospital, fiscal intermediary or Corporate reimbursement experience; Hyperion experience a PLUS
3.Advanced knowledge of cost reporting applications and concepts.
4.Advanced knowledge of Medicare statutes, regulations, and administrative rules as well as their related legislative and regulatory processes.
5.Working knowledge of Microsoft Excel and Word.
6.Working knowledge of cost report software programs (Comp U Max preferred).
7. Travel may be required
Primary Location: Dallas, Texas
Facility: 979-Dallas, Texas
Other Locations: Nashville
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905043510
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.