AVP, Reimbursement - Jefferson Health

Thomas Jefferson University•Philadelphia, PA

19d•Onsite

About The Position

The Associate Vice President of Reimbursement leads Jefferson Health’s enterprise government reimbursement strategy, regulatory reporting, and payment optimization initiatives. The role oversees the preparation, review, certification, and filing of Medicare and Medicaid cost reports and other required government submissions; directs audits, reopenings, appeals, settlements, and regulatory responses; and advises senior leadership on reimbursement risks and opportunities. The position develops strategies, policies, governance standards, and controls to strengthen financial performance, regulatory compliance, and consistent reporting across hospitals, regions, and affiliated entities. The role provides subject-matter leadership across government payment methodologies and state supplemental payment programs. It develops reimbursement assumptions for budgets, long-range plans, forecasts, and period-end close, and partners with finance, accounting, revenue cycle, legal, compliance, operations, clinical leadership, and external advisors on complex reimbursement matters and enterprise initiatives. The Associate Vice President also represents the organization with external stakeholders and builds and leads a high-performing reimbursement team. The position is based at 1101 Market in Philadelphia, Pennsylvania. The listed work shift is Workday Day. Physical demands include lifting and carrying 25 pounds, frequent sitting and standing, and frequent keyboard use. The posting also notes that patient care providers may need to perform role-specific activities such as kneeling, bending, squatting, and CPR.

Requirements

Bachelor’s degree in accounting, finance, health administration, or a related field.
10 years of progressively responsible hospital reimbursement experience, including complex Medicare and Medicaid cost reporting, audits, settlements, and payment analysis.
Prior experience leading professional reimbursement or finance staff, including goal setting, delegation, staff development, succession planning, and performance management.
Experience directing financial close, audit, budgeting, forecasting, regulatory reporting, and cross-functional decision-support processes.
Comprehensive knowledge of Medicare and Medicaid regulations, cost-reporting requirements, and hospital payment methodologies.
Ability to establish and maintain reimbursement policies, procedures, governance standards, internal controls, and supporting documentation.
Ability to interpret complex regulations, assess financial and operational effects, formulate defensible positions, and translate findings into actionable recommendations.
Strong executive communication and presentation skills, including explaining complex financial matters to senior leaders, auditors, operational partners, and other stakeholders.
Strong project-management and change-leadership skills, including guiding cross-functional initiatives, organizational integrations, and process standardization.
Ability to manage multiple priorities, exercise sound judgment, and deliver accurate, timely results in a complex regulatory environment.
Advanced proficiency in spreadsheet modeling, reimbursement systems, financial reporting platforms, and data-analysis tools, with the ability to turn complex data into actionable insights.
Ability to build relationships, influence decisions, and collaborate across finance, operations, clinical, legal, compliance, and executive leadership functions.

Responsibilities

Lead enterprise Medicare and Medicaid reimbursement strategy and identify, evaluate, and realize payment opportunities.
Oversee preparation, review, certification, and filing of Medicare and Medicaid cost reports and other government submissions, with effective controls and documentation.
Direct cost-report audits, reopenings, appeals, and settlement activities, ensuring positions are timely, supported, defensible, and compliant.
Establish reimbursement policies, procedures, governance standards, and internal controls across assigned entities.
Monitor and interpret Medicare and Medicaid regulations, assess their financial and operational impacts, and advise senior leadership on risks, opportunities, and actions.
Provide subject-matter leadership on disproportionate share hospital payments, graduate medical education, wage index, geographic reclassification, value-based purchasing, and other government payment methodologies.
Direct participation in state supplemental payment programs, including strategy, data validation, submissions, reconciliation, and compliance monitoring.
Develop reimbursement assumptions for budgets, long-range plans, financial forecasts, and period-end close; evaluate variances and recommend adjustments or reserves.
Partner with finance, accounting, revenue cycle, legal, compliance, operations, clinical leadership, and external advisors to resolve complex reimbursement matters and support enterprise initiatives, integrations, and transactions.
Represent the organization in interactions with government agencies, auditors, contractors, consultants, and other external stakeholders.
Build and lead a high-performing reimbursement team through expectation setting, delegation, performance management, feedback, development, and succession planning.

Benefits

Medical and prescription insurance
Supplemental insurance
Dental insurance
Vision insurance
Life and AD&D insurance
Short- and long-term disability insurance
Flexible spending accounts
Retirement plans
Tuition assistance
Voluntary benefits, including access to group insurance rates and discounts
Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service
Medical and prescription insurance access for all colleagues, including per diem colleagues, adjunct faculty, and Jeff Temps