Assistant Director, Managed Care Contracting
About NYC Health + Hospitals
Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible
NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.
Job Description
SUMMARY OF DUTIES AND RESPONSIBILITIES:
The Assistant Director will support the Director and the Managed Care team to carry out the accounting, reporting, and managed care negotiation functions of the NYC Health + Hospitals Corporation. This position is responsible for assisting in proposal creation of managed care negotiations and review and communication of provider language protections. This role will require a healthcare, revenue experienced person as well as strong interpersonal and communication skills.
General tasks and responsibilities will include:
- Assist in maintaining relationships with third party managed care organizations.
- Participating in the negotiation of H+H managed care contracts, in collaboration with the Office of Legal Affairs and other departments.
- Assist in reviewing contract proposals and language to ensure compliance with model terms and conditions.
- Prepare reports as necessary of managed care terms.
- Assist in collecting market intelligence, insurer profiles and benchmarks on costs to help develop pricing strategies.
- Participate in team meetings and projects and complete independent assignments.
- Perform other job-related duties as required.
Minimum Qualifications
- A master’s degree with a major in accounting, finance or business administration, with emphasis on accounting and financial systems from an accredited college or university; and five (5) years of responsible-level experience in fiscal management or administration with an emphasis in financial systems, management information and controls, of which at least three (3) years shall have been in a responsible supervisory, administrative or management capacity; or
- A baccalaureate degree with a major in related fields, as indicated in (1) above, from an accredited college or university; and six (6) years of experience as indicated in (1) above, of which at least three (3) years shall have been in a responsible supervisory, administrative or management-level capacity; and
- Knowledge of total accounting and financial management both in systems theory and practice; or
- A satisfactory equivalent of education, training and experience.
Department Preferences
YEARS OF EXPERIENCE:
- Two years of progressively responsible experience
- Four years of full-time experience in healthcare.
KNOWLEDGEABLE IN:
- Health, medical and public service administration, with an emphasis on planning, managerial functions; including but not limited to a high volume of reading and writing.
PREFERRED SKILLS:
- Proficiency in Excel and Word
- Knowledge of EPIC helpful
- Strong analytical and communication skills
- Must be able to read and comprehend large documents
How To Apply
Please be advised that proof of Covid-19 vaccination is required prior to hire.
Posted 10/15/2021
Senior Vice President of Finance Maimonides Medical Center Brooklyn, NY
The Opportunity:
Maimonides Medical Center (Maimonides) seeks a proactive and enthusiastic leader who will join the organization as the Senior Vice President of Finance. The SVP of Finance will provide leadership and oversight for many aspects of the finance function for Maimonides and other entities and will have responsibility for the delivery of high-quality, customer-focused and progressive financial services across the organization.
The Position:
Reporting to Maimonides’ EVP and Chief Financial Officer, the SVP of Finance will provide financial leadership and direction for Maimonides and its various entities and direct the activities of all aspects of the organization’s core financial functions, including: general accounting, financial reporting, accounts payable, payroll, financial planning and analysis, budgeting, treasury (which includes debt and cash management), cost accounting, government reimbursement and reporting and grant research.
This executive will:
- Initiate and oversee institutional projects related to improving financial performance, budgeting, and planning processes and financial decision making.
- Partner closely with other executive leaders in the hospitals and physician practices to enhance the organization’s performance while ensuring compliance and regulatory integrity.
- Work closely with the CFO in designing and executing strategic financial plans for clinical initiatives that will grow inpatient/outpatient volume, build new programs, adapt to new payment models and ultimately build ROI.
- Partner closely with the CFO around the planning and execution of initiatives focused on improving the system’s cost infrastructure over the next several years.
- Partner with the SVP, Revenue Cycle, to ensure that financial functions are well coordinated with revenue cycle functions.
The Ideal Candidate:
The ideal candidate will have 10-plus years of progressive financial leadership experience with a demonstrated management capability and broad knowledge of financial services in a sizable, complex healthcare organization or multi-hospital system. A Bachelor’s degree is required. Also, comprehensive knowledge of accounting, tax, compliance and internal audit, typically acquired through a Master’s degree in Finance or a closely related field is required. A CPA is preferred as is early career experience working in a public accounting firm. Experience leading an ERP implementation is a plus.
The Organization:
Maimonides Medical Center (Maimonides) is a 711-bed, not-for-profit, teaching hospital located in the Borough Park section of Brooklyn, New York, and is one of the largest independent teaching hospitals in the United States. As the largest hospital in New York City’s most populous borough, it is a destination center for tertiary care, featuring advanced clinical capabilities and outstanding patient outcomes. Maimonides is an affiliate of Northwell Health and a major teaching site for the SUNY Downstate College of Medicine.
The Location:
Brooklyn is the most populous borough of New York City with an estimated 2,648,403 residents in 2020. Named after the Dutch village of Breukelen, it borders the borough of Queens at the western end of Long Island. Brooklyn has several bridge and tunnel connections to the borough of Manhattan across the East River and the Verrazzano-Narrows Bridge connects Staten Island. Since 1896, Brooklyn has been the most populous county in the U.S. State of New York and the second-most densely populated county in the United States after New York County. Given the diversity of ethnicity, religions, and languages in Brooklyn, there are thriving communities and community events associated with each.
Please direct all inquiries, applications, and referrals to:
Hisham Siddiqi
hisham.siddiqi@amnhealthcare.com
About AMN Leadership Solutions, Executive and Physician Leadership Search
This search is being led by AMN Leadership Solutions, Executive and Physician Search (EPLS), a division of AMN Healthcare. EPLS is a retained executive search firm serving the healthcare and life sciences industries. Ranked as one of the top healthcare recruiting firms in the country, AMN Leadership Solutions, is known for leading healthcare into the future by its growing base of clients across the country, drawing on a national pool of candidates. For more information, please visit their website at www.phillipsdipisa.com.
Posted 10/15/2021
CORPORATE FINANCIAL ANALYST
NORTHWELL HEALTH
NSHS PARENT AND SHARED SERVICES, WESTBURY, NY
DEPARTMENT : FINANCE-GOVERNMENT RATES AND REPORTING
REPORTS TO : SENIOR MANAGER, CORPORATE FINANCE
POSITION SUMMARY : Analyzes, verifies, authorizes, processes and reports on financial information related to system-wide Corporate Finance activities. Designs, develops and implements systems or procedures resulting in the accurate reporting of financial or system data.
RESPONSIBILITIES
- Analyzes, verifies, tracks and reports on financial indicators (for example, accounts receivables, account coding and charging, cash flow, budgets, GL & P&L, statistical data, and reserves) in support of system-wide corporate financial activities.
- Reports on results on a monthly, quarterly and/or annual basis.
- Tracks and reports on statistical variances.
- Reports discrepancies to Supervisor/Manager.
- Designs, develops, and modifies systems and procedures to enhance departmental processing as needed.
- Responsible for maintaining proprietary databases including data integrity, timeliness of data input and accuracy of data.
- Conducts internal audits to ensure compliance to departmental policies and procedures and state and federal regulations.
- Maintains compliance with various state, federal and industry standards and regulations.
- Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
- Performs related duties, as required. All responsibilities noted here are considered essential functions of the job under the American with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
REQUIRED EXPERIENCE AND QUALIFICATIONS
- Bachelor’s Degree required or equivalent combination of education and related experience.
- 1-3 years of relevant experience required.
How to Apply : https://jobs.northwell.edu/apply/join/?job=13331905
Posted 11/08/2021
SENIOR CORPORATE FINANCIAL ANALYST
NORTHWELL HEALTH
NSHS PARENT AND SHARED SERVICES, WESTBURY, NY
DEPARTMENT : FINANCE-GOVERNMENT RATES AND REPORTING
REPORTS TO : SENIOR MANAGER, CORPORATE FINANCE
POSITION SUMMARY : Analyzes, verifies, authorizes, processes and reports on complex and critical financial information related to system-wide Corporate Finance activities. Designs, develops and implements systems or procedures resulting in the accurate reporting of financial or system data. Guides Financial Analysts and support staff in completion of projects and duties.
RESPONSIBILITIES
- Analyzes, verifies, tracks and reports on financial indicators (registration dates, accounts receivables, account coding and charging, cash flow, budgets, GL & P&L, statistical data, and reserves) in support of system-wide Corporate Financial activities.
- Reports results monthly, quarterly, year to date or yearly on departmental requests, as directed.
- Research, tracks, and reports on statistical variances; identifies and investigates issues.
- Designs, develops, and modifies systems and procedures to enhance departmental processing as needed.
- Conducts complex and critical studies and analyses.
- Maintains proprietary databases including data integrity, timeliness of data input and accuracy of data.
- Serves as audit team lead as directed.
- Maintains compliance with various state, federal and industry standards, and regulations.
- Troubleshoots problems and research variance causation; interprets data and recommends appropriate course of action.
- Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
- Performs related duties, as required. All responsibilities noted here are considered essential functions of the job under the American with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
REQUIRED EXPERIENCE AND QUALIFICATIONS
- Bachelor’s Degree required or equivalent combination of education and related experience.
- 3-5 years of relevant experience required.
How to Apply : https://jobs.northwell.edu/apply/join/?job=12462510
Posted 11/08/2021
SENIOR MANAGER, CORPORATE FINANCE
NORTHWELL HEALTH
NSHS PARENT AND SHARED SERVICES, WESTBURY, NY
DEPARTMENT : FINANCE-GOVERNMENT RATES AND REPORTING
REPORTS TO : DIRECTOR, CORPORATE FINANCE
POSITION SUMMARY : Supervises and coordinates the daily activities of analytics and reporting staff in assigned Finance department. Assesses and monitors staff productivity through standards and metrics to optimize performance and increase efficiency. Develops and maintains reporting processes for department. Ensures reports are prepared and updated according to established policies and procedures. Provides direction, training and guidance to department managers and staff.
RESPONSIBILITIES
- Oversees the preparation of monthly and annual reports to government entities. Provides variance explanation to administration, as necessary.
- Maintains responsibility for third-party accounts, including general ledger, journal entries made to the general ledger, reviewing and/or posting entries.
- Prepares various financial and account analysis including general ledger accounts on a timely basis.
- Monitors, identifies and reports statistics, trends and analysis to management.
- Supervises, hires, trains and evaluates the performance of staff. Ensures performance appraisals are completed in a timely manner.
- Assesses and monitors staff productivity through standards and metrics to optimize performance and increase efficiency.
- Identifies, recommends and implements approved process improvements.
- Performs ad hoc analyses on an as need basis.
- Performs related duties, as required.
REQUIRED EXPERIENCE AND QUALIFICATIONS
- Bachelor’s Degree in Finance or related field, required. (Master’s Degree Preferred)
- Minimum of six (6) years healthcare reimbursement experience, including prior supervisory experience, required.
- Advanced proficiency in Microsoft Access, Microsoft Excel, and Microsoft SQL Server
- Excellent analytical and leadership skills, required.
How to Apply : https://jobs.northwell.edu/apply/join/?job=14039445
Posted 11/08/2021
Associate Director Patient Financial Services
Position Summary:
Reporting to the Director of Patient Financial Services, the Associate DirectorPatient Financial Serviceswill oversee the day-to-day operations of the Patient Accounting Billing, Claims Follow-up, Customer Service and Financial AssistanceUnits. The Associate Director will directdaily functional operations and work to ensure the hospital’s patient services receivables are billed and collected effectively and timely. As part of the PFS Leadership team, they will drive work flow strategy and maximize efficiency in order to achieve departmental cash goals and operational benchmarks. Candidates must have significant management experiencewithin the acute hospital billing, reimbursement and compliance arena with a demonstrated history of successful collaboration with Patient Accounting, Revenue Integrity/HIM, Care Management, Compliance, Finance, Information Technology and clinical service departments.
Job Responsibilities Include:
- Manages departmental through-put/productivityensuring that hospital accounts receivable is worked and resolved effectively and timely.
- Develops and monitorskey performance indicators and conducts focused A/R portfolio reviews with staff.
- Identifies billing and collection risks and opportunities and works to develop policies, procedures and systems which help to maximize cash flow.
- Works collaboratively to introduce best practices and optimize work flows as business trends and regulatory, financial and operational needs require.
- Monitors and reports operational status. Provides written and verbal progress reports and analyses to Revenue Cycle and PFS leadership. Including but not limited to A/R management, billed/unbilled status, productivity, and staffing.
- Contributes to improving internal operations controls.
- Manages staff who oversees the hospital’s outsource billing and collection vendor relationships;tracks performance and monitors referral through-put and resolution.
- Works to ensure favorable patient financial experience outcomes including oversight for the hospital systems Financial Assistance Program.
- Manages staff who perform the hospital’s research billing and affiliated facility billing.
- Liaises with the Attorney General for Civil Recoveries for Stony Brook.
- Collaborates with Revenue Cycle Leadership on denials prevention and appeals strategy including root cause analysis and workflow re-engineering.
- Participates in the development and implementation of short and long-range goals and objectives for the department.
- Works with Clinical and Revenue Cycle Departments, PFS Leadership, I.T. and third party vendors/consultants to operationalize billing work flow changes, fixes and new service line and system “go-lives”.
- Special projects as assigned.
Required Qualifications:
- B.S. Accounting/Finance, Health Information Management, Healthcare Administration, Computer Science or related field and at least 10 years’progressive experience working within an Acute Care Hospital Revenue Cycle or Business Office including 5+ years at a Management or Director Level OR10+ years’ experience Managing or Directing within an Acute Care Hospital/Health System Revenue Cycle or Business Office.
- 5+ Years’ Experience in planning, leading and/or managing revenue cycle projects of at least moderate complexity.
- Extensive experience with healthcare reimbursement and facility claims submission, collection and analysis (DRG, APC, APG, Managed Care Contracts, UB-04, 837i, 835)
- Broad understanding of insurance eligibility and benefit design, prior-authorizations, ABN’s, coordination of benefits, financial clearance and financial assistance.
- Significant healthcare denials and appeals management experience. Including an Understanding of healthcare utilization management, medical necessity criteria and administrative, clinical and DRG/coding denials/appeals processes.
- Experience creating and monitoring Revenue Cycle Key Performance Indicators and Dashboards.
- Experience working and resolving governmental and third party audits.
- Experience with Managed Care contracts; reimbursement and administrative terms and terminology.
- High degree of proficiencyutilizing and/or configuring hospital patient accounting, claims scrubber and contract management information systems.
- Working knowledge ofCPT, HCPCs and ICD-10 coding principles.
- MSOffice experience
- Excellent written and verbal communication skills.
Preferred Qualifications:
- Master’s Degree
- CCS, CCS-P, CPC, CCDS, RHIA or RHIT certification.
- Knowledge of Cerner Unity/Invision Patient Accounting system configuration and master files.
- Experience with work flow visualization software (Visio.)
- Proficiency with MS PowerPoint and/or Desktop Publishing software.
- Experience utilizing visualization software (Tableau, MS Power BI, etc.)
- Proficient withbilling or healthcare financial decisions support software and/or query tools.
Posted 11/22/2021
