Michigan Great Lakes Job Bank

Mrs. Michelle Whittaker-McCracken
Managing Partner
[email protected]
(734) 475-9300 (office)

Insurance Contract Administrator / Managed Care Contracting
Henry Ford Health System

Posted 1/19/2024

Introduction:

Henry Ford Health provides a full continuum of services – from primary and preventative care, to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other healthcare retail. It is one of the nation’s leading academic medical centers, recognized for clinical excellence in cancer care, cardiology and cardiovascular surgery, neurology and neurosurgery, orthopedics and sports medicine, and multi-organ transplants. Consistently ranked among the top five NIH-funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of health professionals, Henry Ford Health trains more than 4,000 medical students, residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network. The health system is led by President and CEO Robert G. Riney and serves a growing number of customers across 250+ locations throughout Michigan including five acute care hospitals, two destination facilities for complex cancer and orthopedics and sports medicine care, three behavioral health facilities, primary care and urgent care centers.

Job Summary:

Reporting to Director or Manager, assist in the development of Contract Strategy and work directly with Payors to lead negotiation of contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units.

Required Qualifications:

  • Bachelor’s Degree in Business, Healthcare Administration, or Finance required.
  • Five (5) years in the healthcare industry in a progressively more responsible professional capacity, with at least one (2) years of payor contracting, provider relations or provider reimbursement experience.
  • Knowledge of managed care organizations and integrated health systems.
  • Excellent oral and written communication and presentation skills.
  • Excellent organizational skills and ability to manage multiple projects simultaneously.
  • Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers.
  • Strong negotiation skills.
  • Understanding of legal, business, and insurance operations principles.
  • Proficient in Microsoft Word and Excel.

Preferred Qualifications:

Master’s Degree.

Compensation/Benefits:

Based upon experience, education, and skill level. Salary range from $76,000 – 90,000

Instructions for Resume Submission:

Please apply directly to position: Insurance Contract Administrator – Full Time- Remote/Hybrid https://www.henryford.com/careers

Contracting – Reimbursement Consultant
Henry Ford Health System

Posted 1/19/2024

Introduction:

Henry Ford Health provides a full continuum of services – from primary and preventative care, to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other healthcare retail. It is one of the nation’s leading academic medical centers, recognized for clinical excellence in cancer care, cardiology and cardiovascular surgery, neurology and neurosurgery, orthopedics and sports medicine, and multi-organ transplants. Consistently ranked among the top five NIH-funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of health professionals, Henry Ford Health trains more than 4,000 medical students, residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network. The health system is led by President and CEO Robert G. Riney and serves a growing number of customers across 250+ locations throughout Michigan including five acute care hospitals, two destination facilities for complex cancer and orthopedics and sports medicine care, three behavioral health facilities, primary care and urgent care centers.

Job Description:

Under minimal supervision of the Manager, independently leads financial and data analysis to evaluate rate proposals, contract terms, and health plan network reimbursement. This position will proactively identify rates, methodologies, and processes that need improvement and will develop and implement solutions to optimize reimbursement for the health system.

Principal Duties and Responsibilities:

  • Lead the development of financial reporting and analysis using software / tools such as EPSi, SQL, Epic, or Clarity to extract and analyze data for the purpose of assessing contracted rates and reimbursement methodologies
  • Generate proactive analysis and make recommendations to Contracting leadership based on review and identification of payer reporting trends.
  • Lead evaluation, and creation, of metrics and processes to improve and / or track rates against industry averages to identify gaps and areas for improvement.
  • Manage the rate review process for existing and proposed contracts to evaluate financial impact, verify that all necessary reimbursement terms are addressed, and the rates are depicted as negotiated.
  • Coordinate with contract modeling team the implementation and maintenance of contract management/pricing systems.
  • Maintain expertise in reimbursement methodologies, payer policies, and regulatory changes as they apply to payor contracts.
  • Manage and complete special projects and attends various committee meetings as assigned.
  • Coordinate and support financial projects for business units across the Health System

Required Qualifications:

Experience:

  • 5 to 7 years of experience in healthcare finance, managed care contracting, or reimbursement in a professional capacity including experience with various reimbursement methodologies (DRGs, per diems, fee schedules, case rates, etc.)
  • Report writing capabilities
  • Strong Analytical and Critical Thinking skills (via curiosity, creativity, skepticism, and adept in use of logic) relative to accomplishing business objective and problem solving
  • Detail oriented
  • Proficient in Microsoft Excel (queries, reports, pivots, “What If” scenarios and database mgmt. a plus)
  • Proficient in Data extraction & reporting tools (EPSi, SQL, Clarity, etc…)
  • Excellent oral and written communication skills
  • Strong organizational and interpersonal skills
  • Strong Understanding of Managed Care Reimbursement methodologies, coding and terminology

Education Qualifications:

Bachelor’s Degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement or related field. Master’s Degree Preferred.

Compensation/Benefits:

Based on experience, skill level, and education. Salary Range $98,000 – 118,000

Instructions for Resume Submission:

Please apply directly to the position:  “Managed Care Contract Reimbursement Consultant” at https://henryford.com/careers

Chief Accounting Officer (CAO)
Spartanburg Regional Healthcare System
Spartanburg, SC
Full-time

Posted 1/18/2024

Apply at https://careers.spartanburgregional.com/jobs/1755481-chief-accounting-officer.

Position Summary:

The Chief Accounting Officer (CAO) is a key financial leader, change agent, and close partner to the Chief Financial Officer (CFO) of Spartanburg Regional Healthcare System (SRHS). The CAO will be responsible for the vision, leadership, strategic direction, and performance of the accounting and treasury functions. The CAO will oversee the design and execution of the financial reporting, regulatory reporting, corporate accounting, tax, payroll, and accounts payable. CAO is responsible for development and implementation of related systems, controls, procedures, and policies for all SRHS business units and related corporations. The CAO will lead accounting policy and ensure compliance with U.S. Generally Accepted Accounting Principles (GAAP), the National Association of Insurance Commissioners’ Statutory Accounting Principles and other applicable rules and laws and will report on and review financial results with SRHS senior leadership. This leader will be responsible for leading a strong operational and business partner-oriented organization and will oversee all accounting data to support management decision-making, ensuring data is accurate and consistent. SRHS seeks a seasoned, hands-on finance executive with the ability to effectively lead and mentor accounting staff. The CAO will work closely with other finance leaders, external and internal auditors, internal customers of finance, and the audit team to develop and implement plans to achieve strong performance in all accounting functions.

Direct reports – Approximately 35 Employees, including an accounting leadership team of two supervisors, two managers, and two directors. The Accounting team includes general accounting, treasury, and net revenue analysts, as well as Payroll and Accounts Payable personnel.

Other key relationships: Executive Management Team Finance, Reimbursement, and Physician Compensation departments Senior Business Leaders External Auditors

Key Responsibilities:

Vision & Strategy Set the strategic direction for the development and deployment of financial and reporting processes that ensure compliance and rigor with U.S. GAAP, Statutory Accounting Principles, and any other local accounting standards and the regulatory environment, thereby mitigating risk for the system. Accounting & Controls Direct and oversee the development, deployment, and implementation of all company accounting methods, procedures, and practices to safeguard the enterprise’s assets and properly reflect its financial results. Be accountable for the accurate and timely interpretation of U.S. GAAP and the accurate incorporation of such interpretations into the company’s financial records. Oversee and control the general accounting activities for the enterprise, including recording company transactions, classifications, and reconciliation of account balances in accordance with U.S. GAAP, Statutory Accounting Principles and company policies. Accounting Operations Oversight of the Payroll and Accounts Payable areas, ensuring that all payroll related, trade payables, and other liabilities are paid accurately, on time, and in compliance with policies and procedures and any appropriate governmental regulations. Oversee the development and maintenance of appropriate internal controls related to accounts payable, payroll, fixed assets, and other disbursement transactions. Ensure applicable payroll and n-payroll tax reporting is handled timely as required by government regulations. Treasury Direct Cash Management and forecasting for SRHS. Ensure internal controls over the approval of wire transfers and other cash transactions. Plan and implement cash and investment policies to ensure the maximization of interest and investment gains. Oversight of the policies and procedures related to Investment Portfolio management. Audit Oversee and be accountable for planning and executing several annual audits for the enterprise, utilizing an external public accounting firm. Function as the enterprise subject matter expert and principal point of interpretation on all matters resulting from dealings with external accountants and auditors. Financial Reporting Be accountable for regulatory financial reporting. Accounting Policy Oversee and direct accounting questions and judgments for the enterprise; direct and control all accounting policies.

Candidate Profile:

The successful candidate will be an experienced, hands-on accounting executive with the excellent technical skills, business acumen and leadership capability to lead the accounting and treasury functions in a critical, high-visibility role. This person will have the agility, resourcefulness, multi-tasking ability and thoughtful presence to drive change and operate effectively across SRHS. This executive should have extremely strong reporting and accounting skills, exhibit a proven team leadership skillset, and be viewed as capable of supporting the continued growth of SRHS.

Minimum Requirements Education:

  • Bachelor’s Degree in Accounting or related field Experience
  • 15+ years of progressive accounting experience in a healthcare system or healthcare auditing firm.

License/Registration/Certifications:

  • CPA Preferred Requirements Preferred Experience
  • MBA or Master’s in Accountancy
  • 5+ years leading the accounting and treasury functions in a large healthcare system.

Apply:

https://careers.spartanburgregional.com/jobs/1755481-chief-accounting-officer

Director Reimbursement
Henry Ford Health System

Posted 1/12/2023

Introduction:

Are you ready to lead the charge in revolutionizing reimbursement practices for one of the nation’s top-tier academic and integrated health systems? Henry Ford Health is on the lookout for an exceptional Director of Reimbursement to drive strategic direction in governmental and third-party payer reimbursement programs. Reporting to the System Vice President of Contracting, Reimbursement & Revenue Integrity, this pivotal role involves overseeing the preparation of third-party cost reports, financial audits, and net revenue forecasts. As a visionary leader, you’ll play a key role in implementing cutting-edge reimbursement models and methodologies, fostering innovation, and optimizing automation to ensure industry-leading practices. If you’re a dynamic professional with a proven track record in strategic and operational leadership, don’t miss this opportunity to make a lasting impact on healthcare reimbursement. Join us and be at the forefront of shaping the financial future of Henry Ford Health!

Job Description:

The Director of Reimbursement is responsible for setting strategic direction for various governmental and third-party payer reimbursement programs. The position will lead evaluation and implementation of best practice reimbursement models and methodologies for the health system. This position will work closely with health system leaders to effectively manage the monthly financial close and net revenue reporting. HFH is seeking a leader with strong strategic and operational skills to drive industry-leading reimbursement practices and processes, including further leveraging automation. These responsibilities include overseeing:

  • Preparation of third party cost reports and other third party filings
  • Reporting and reconciliation of general ledger accounts related to third party payments & settlements, including third party payer receivables, payables and reserves
  • Planning and coordination of third party audits and appeals as well as quarterly and year-end financial audits
  • Preparation of monthly net revenue calculations and review with Vice President prior to financial statement due date
  • Preparation of net revenue forecasts
  • Maintain expertise in reimbursement regulations & strategies, including Medicare, Blue Cross and Medicaid, through appropriate education and provide education and consultation to staff
  • Development of impacts related to changes in reimbursement regulations
  • Provide a leadership role in developing goals and accomplishment of those goals for both team members and the department

Required Qualifications:

  • Bachelor’s degree in Accounting or Finance with a Master’s degree preferred
  • Approximately ten (10) years of progressive experience in healthcare reimbursement is required
  • Working knowledge of generally accepted accounting principles and a thorough understanding of third party reimbursement mechanisms
  • Working knowledge of the full Revenue Cycle process and implications on net revenue and accounts receivable valuation
  • Ability to communicate in clear, concise terms
  • Well developed conceptual and analytical skills
  • High level of interpersonal, management and organizational skills

Preferred Qualifications:

Corporate Reimbursement

Education Qualifications:

Bachelor’s degree in Accounting or Finance with a Master’s degree preferred

Compensation/Benefits:

Outstanding compensation commensurate with market including a target bonus with an exceptional track record of pay out.

Instructions for Resume Submission:

If you are interested, you can apply directly via this link http://phxc3c.rfer.us/HENRYFORD2wqo6V OR feel free to reach out to me directly at Brett Snellgrove – [email protected]

HFH is an amazing healthcare organization investing in the community and expanding services in a multi-billion dollar expansion. It’s a phenomenal time to consider this leadership opportunity with Henry Ford Health.

CBO Transaction Flow Consultant (revenue cycle project manager)
Henry Ford Health

Posted 10/6/2023

Introduction:

The Transaction Flow (TF) Consultant is responsible for leading and supporting teams through the design and implementation of initiatives that focus on people, process, and technology changes. In this role, the TF Consultant will function as a project manager and process improvement lead, facilitating continuous improvement efforts and applies a variety of improvement methodologies (including lean, six sigma, theory of constraints, TQM, human factors design) and group management techniques to support individuals and teams through process improvement initiatives. Identification of initiatives will occur through data gathering, technical analysis, and facilitation of multi-disciplinary, team-based root cause analysis on CBO workqueue inflow, claim edits, denials, and other forms of waste. TF Consultant should utilize knowledge of Epic optimization to implement identified initiatives and workflow procedures. The TF Consultant will be responsible for synthesizing issues at a high level and preparing recommendations for Leadership. The successful candidate will be flexible, innovative, creative, proactive, and takes initiative to act on process improvement opportunities.

Job Description:

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  1. Develop project plans and perform project management for the design and continuous evaluation of CBO insurance follow up and recovery functions and workflow, to organize work based on production action to achieve optimal efficiency and productivity.
  2. Deliver significant business results that utilizes strategic and creative thinking, problem solving, and individual initiatives.
  3. Leads and supports the development of new CBO work queue structures based on homogeneity and production action, including development and monitoring of WQspecific productivity metrics, and the development of WQ filtering and other methods to assign work.
  4. Perform surveillance of denial, edit, and other data elements to identify trends and opportunities for performance improvement.
  5. Coordinate and leads process improvement meetings to implement error prevention efforts. Research best practices for improvement and implement quantitative and qualitative benchmarking.
  6. Lead CBO department and cross-functional workgroups to implement initiatives to reduce denials and other errors. This includes coordination with other HFHS business units, Corporate revenue cycle, hospital departments, physician practices, and other teams across the organization.
  7. Coordinate and facilitate meetings with insurance payer representatives and internal leaders to develop a more efficient transaction flow and reduce transaction processing issues and administrative burdens. Prepare internal Leadership prior to external meetings.
  8. Manage the development of continuous feedback loops and communication with internal customers pertaining to denial and write off improvement opportunities.
  9. Assists with the development of process performance metrics. Documents current processes and new processes; facilitates design of new processes incorporating process improvement fundamentals (removing waste, hand-offs).
  10. Provides expertise using change management tools and methods to ensure successful and sustainable implementation of the transition to a production-oriented CBO recovery function, and process improvements to drive the reduction of denials, edits, and preventable loss write offs.
  11. With assistance on assigned projects, drives implementation of critical business metrics & ongoing end-to-end process reviews. This will include the following steps:
    • a) Identify key processes and their indicators;
    • b) Establish baseline metrics;
    • c) Report through financial and business review process; and,
    • d) Develop and maximize improvement plans.
  12. Supports, coaches, and mentors CBO team members and process owners to utilize a defined PDCA process improvement methodology.
  13. Communicate effectively in written and verbal formats to various situations and audiences

Required Qualifications:

Bachelor’s degree in Business Administration, Health Care Administration or related field. Master’s Degree preferred. Minimum of three (3) years of healthcare experience required with progressively increasing areas of responsibility including performance improvement, project management, or staff management. Epic, revenue cycle and /or, large healthcare system experience preferred.

Education Qualifications:

Bachelor’s degree in Business Administration, Health Care Administration or related field. Master’s Degree preferred.

Instructions for Resume Submission:

https://henryford.referrals.selectminds.com/jobs/consultant-cbo-transaction-flow-full-time-remote-80123

This position is hybrid WFH, with Wednesdays required to be present at our Troy office alongside our consultative staff and leaders.

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