Primary Care Capitation Provider Reimbursement Lead
About The Position
The Primary Care Capitation Provider Reimbursement Lead is a financial specialist who supports DHB’s Provider Reimbursement team in the development, analysis, documentation, and implementation of reimbursement methodologies for the Medicaid Primary Care Capitation Pilot and associated Rural Health Transformation Program activities. The role partners closely with internal and external stakeholders to support rate development via rate modeling for the pilot program. Core duties include researching and applying reimbursement regulations, building and maintaining financial models, performing comparative cost and trend analyses, and preparing/validating program financial reports.
Requirements
- Bachelor's degree in accounting, banking, finance, business administration, economics, or related discipline from an accredited institution and 3 years of directly related experience OR An equivalent combination of education and experience.
- Ability to read and understand state, federal, and local laws, regulations, and guidance for incorporation into support activities.
- Ability to work independently and plan and organize work while remaining adaptable to continually changing priorities.
- Proficient in MS Office with moderate to advanced skills in MS Excel, including applied financial modeling analysis.
Nice To Haves
- In‑depth knowledge of accounting theories and principles.
- Knowledge sufficient to analyze and compile moderately complex data from various sources, supported by strong analytical and problem‑solving skills with experience in data analysis, forecasting, and modeling.
- Excellent written and oral communication skills with attention to detail.
Responsibilities
- Supports DHB’s Provider Reimbursement team in the development, analysis, documentation, and implementation of reimbursement methodologies for the Medicaid Primary Care Capitation Pilot and associated Rural Health Transformation Program activities.
- Partners closely with internal and external stakeholders to support rate development via rate modeling for the pilot program.
- Researches and applies reimbursement regulations.
- Builds and maintains financial models.
- Performs comparative cost and trend analyses.
- Prepares/validates program financial reports.
Benefits
- health insurance options
- standard and supplemental retirement plans
- NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
- paid vacation
- sick leave
- community service leave
- paid parental leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
