Director, National Medicare Finance (Mid-Atlantic)

Director, National Medicare Finance (Mid-Atlantic)POSITION OVERVIEW: The Director, National Medicare Finance is one of the key leadership positions within National Medicare Finance. The primary responsibility of this role is to ensure that the program receives the appropriate amount of Medicare reimbursement for members enrolled in Medicare Managed Care Products (Medicare Advantage and Medicare Cost), members enrolled in Commercial products with Medicare entitlement and Medicare Fee for Service patients. In addition to being a key member of NMFs Senior Leadership Team, s/he is the key NMF leadership position for several regions.In the NMF Regional lead role, the Director, National Medicare Finance is the primary liaison between National Medicare Finance and the Regional CFO and works closely with the risk adjustment project leaders to improve encounter data capture for risk adjusted payment.ESSENTIAL FUNCTIONS:The person filling this role is an influential leader with internal and external constituents for the Programs National Medicare Finance team. S/he provides leadership in these functional areas, sets strategic direction, implements performance assessment and analysis criteria, develops reports to track revenue enhancement results, develops staffing plans, identifies and implements performance measurements for functional areas, and develops policies/procedures to support and improve performance. S/he will play a leadership role in identifying, developing, promoting, and executing process improvement strategies and priorities to reduce redundancies, to ensure maximum efficiencies, to align with National systems and processes, as well as to document procedures and policies such as those established in accord with Sarbanes Oxley compliance. S/he will also lead the standardization of methodologies/tools and implement leading practices throughout the Program in these areas. This is particularly challenging as it requires the cooperation of constituencies whose interests are not always aligned. Therefore, the person filling this position must possess solid change management and transformation skills. The person filling this role improves current team competencies by working closely with the Vice President and other senior leaders within National Medicare Finance to develop and implement training programs for each functional area within his/her scope of responsibility. The incumbent supports the Vice President, National Medicare Finance and is a major contributor to the financial leadership team across the Program.Strategic leadership, i.e. using creative financial and business insight to play a key role in helping the organization to optimize revenue and comply with Medicare policies and procedures; providing analytical support to the Program regarding the financial impact of changes in Medicare reimbursement to help the organization in its decision-making regarding this business line.Core financial operations, i.e. overseeing reporting, revenue accounting, staffing, performance measurements, forecasting/financial planning, management of compliance issues, policies/procedures and management information.Transformational leader, i.e., motivates the staff and Partners of National Medicare Finance to standardize methodologies, create a culture of customer service and excellence, and commit themselves to continuous improvement. In conjunction with the National Medicare Finance Senior Leadership Team and its Regional partners, sets the strategic direction for these functional areas, ensuring consistency with organizational goals and objectives and managing departmental resources to achieve objectives.Leads large-scale, cross-functional improvement efforts to identify opportunities and implement new business processes and systems to appropriately account for Medicare revenues, decrease expenses or achieve efficiencies in business operations, including increased use of technology. Lead efforts to identify leading practices and implement standardized business processes and procedures to optimize revenues within strict compliance guidelines, including related systems. Develops and maintains controls within National Medicare Finance functional areas of responsibility. Ensures proper systems are in place to optimize business operations including adequate financial controls and compliance with all administrative and legal requirements concerning Medicare revenues.Establishes effective working relationships at all levels of the organization; works collaboratively with other departments including Medicare Compliance and Legal Departments, Pricing and Underwriting, Medicare Sales and Marketing and other related areas.Serves on numerous cross-functional and special projects and committees involving key managers and senior managers, particularly regarding encounter data capture for Medicare risk-adjusted payment.MINIMUM QUALIFICATIONS:* Extensive experience (10+ years) in healthcare management, especially in finance areas including financial planning and analysis, strategic planning, etc. CFO experience in a health plan or hospital organization a plus. * Proven leadership in project management, especially in managing multi-faceted projects. Familiarity with governmental payor programs in the health care field, which will affect the financial operations of the business is essential. * Bachelors degree in Business Administration or Economics, Finance or Accounting (or related fields) required. * MBA, CPA or CMA also required.PREFERRED CREDENTIALS:Extensive knowledge of Medicare reimbursement, regulations and requirements strongly preferred.ADDITIONAL INFO:Kaiser Permanente offers exceptional benefits. A competitive compensation package will be offered to applicants, commensurate with experience.For immediate consideration, please submit your resume online at www.kaiserpermanentejobs.org and create a personal profile. Please use the Copy and Paste option to attach an unformatted (text only) resume. Refer to job number 67767.This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.The above statements are intended to describe the general nature and level of work being performed by incumbents assigned to the job. This is not intended to be an exhaustive list of all the responsibilities, duties and skills required. The time devoted to the activities may be changed and other duties may be assigned.Kaiser Permanente is proud to be an equal opportunity/affirmative action employer. Additional Information Reference Code: 913974 Position Type: Full Time