Director of Reimbursement & Regulatory Analysis

Select Medical•,

13d

About The Position

The Director of Reimbursement & Regulatory Analysis oversees reimbursement and regulatory analysis processes assigned by the Vice President – Regulatory Analysis. The role ensures the organization complies with federal and state reimbursement and financial regulatory rules, advises the organization on proposed and finalized reimbursement and financial regulatory laws and regulations, and provides guidance and training to staff. The Director leads reimbursement and regulatory strategy, operational improvement, and reimbursement policy development. The position partners with Finance and other stakeholders on forecasting, audits, and strategic planning; monitors healthcare market and regulatory changes; maintains relationships with payors, government agencies, and other stakeholders; communicates complex reimbursement matters to senior leadership; and leads and develops team members.

Requirements

Bachelor’s degree in finance, Accounting, Healthcare Administration, or a related field.
Seven or more years of experience in a healthcare reimbursement role.
At least five years of experience in a leadership role.
Experience with electronic health record (EHR) systems, including Epic.
Understanding of and experience with healthcare CDMs.
Deep understanding of Medicare and Medicaid regulations, managed care reimbursement, and the DRG payment system.
Understanding of healthcare price transparency rules and regulations.
Excellent interpersonal and oral and written communication skills with all levels of the organization.
Proficiency in Microsoft Office Suite and cost report software.
Proven track record of increasing reimbursement rates.
Excellent analytical and problem-solving skills.
Ability to manage multiple tasks, prioritize, and meet deadlines in a fast-paced environment.
Proven ability to lead a team successfully in achieving goals and objectives.
Ability to navigate and adapt to change.

Nice To Haves

Master’s degree preferred.

Responsibilities

Oversee reimbursement and regulatory analysis processes assigned by the Vice President – Regulatory Analysis.
Ensure organizational compliance with federal and state reimbursement and financial regulatory rules.
Advise the organization on proposed and finalized reimbursement and financial regulatory laws and regulations.
Provide guidance and training to staff.
Lead regulatory and reimbursement strategy by managing comment letters, ensuring compliance with federal and state price transparency requirements, and maintaining CDMs.
Drive operational excellence through automation, process improvement, system optimization, and data-driven reimbursement analysis.
Develop and implement reimbursement policies, financial strategies, and revenue cycle initiatives that support organizational goals, regulatory compliance, and financial performance.
Partner with Finance and other stakeholders on forecasting, audits, and strategic planning to strengthen the organization’s financial health.
Monitor healthcare market and regulatory changes, adapting reimbursement strategies to mitigate risk and capitalize on opportunities.
Build and maintain relationships with payors, government agencies, and key stakeholders.
Communicate complex reimbursement matters to senior leadership.
Lead, mentor, and develop team members by setting expectations, monitoring performance, and fostering professional growth.