Director of Supplemental Payments

HCA Healthcare • Nashville, TN

21h

About The Position

The Director of Supplemental Payments serves as the primary operating manager and steward of institutional knowledge for HCA Healthcare’s enterprise Medicaid supplemental-payment and financing portfolio. The role supports the VP, Corporate Controller, and Group CFOs through sustained monitoring, documentation, issue management, and follow-through, working with Groups, Divisions, Finance/Reimbursement, Legal, Government Relations, and external consultants.

The director oversees the program inventory and documentation; tracks approvals, renewals, payments, reconciliations, and revenue realization; maintains enterprise Medicaid DSH and GME information; coordinates quality measures and operational dependencies; and manages modeling, governance, risks, decisions, and consultant deliverables. The position prepares scorecards, state updates, decision requests, and briefing materials, and escalates material risks and opportunities.

Requirements

• Bachelor’s degree in health care administration, public policy, business, finance, accounting, or a related field.
• 8–10 years of experience in Medicaid supplemental payment programs, Medicaid financing, healthcare reimbursement, healthcare finance, Medicaid program administration, or related areas.
• 3+ years of experience leading complex cross-functional initiatives, programs, or teams.

Nice To Haves

• Master’s degree in health care administration, public policy, business, finance, accounting, or a related field.

Responsibilities

• Maintain the complete state/program inventory and Group/Division crosswalk; monitor active programs, approvals, renewals, payments, reconciliations, and known changes; identify missing information and coordinate updates.
• Maintain standardized state/program profiles, source-document links, approval and preprint packages, historical versions, source logs, and decision history; convert consultant work and decisions into durable internal documentation.
• Maintain CMS and state approval and renewal calendars, along with assessment, payment, remittance, accounting, and reconciliation dates.
• Track expected versus actual payments and coordinate unresolved variances and recoupments with Finance/Reimbursement.
• Maintain the enterprise Medicaid DSH and GME register, covering methodology, pools, HCA allocation, payment, financing, audit status, recoupment, legislative activity, and advocacy.
• Escalate material DSH and GME risks and opportunities and coordinate supporting analysis.
• Maintain the quality measure and reporting inventory and associated dollars at risk; translate IT, clinical, reporting, and operational dependencies into financial deadlines and protection actions; track exception and extension processes.
• Maintain state assumptions, source provenance, and model version control with Finance/Reimbursement.
• Maintain risk/opportunity, decision, and action logs; prepare governance scorecards, state updates, decision requests, and VP briefing materials.
• Serve as the routine operating contact for consultants; coordinate assignments, deadlines, and deliverables; capture conclusions in the enterprise repository and identify coverage gaps.
• Support the VP, Corporate Controller, and Group CFOs through monitoring, documentation, issue management, and follow-through; work with Groups, Divisions, Finance/Reimbursement, Legal, Government Relations, and external consultants.

Benefits

• Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
• Wellbeing support, including free counseling and referral services.
• Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• 401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
• Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Fertility and family-building benefits and adoption assistance.
• Life insurance and supplemental health protection plans.
• Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

What This Job Offers

• Job Type: Full-time
• Career Level: Director