Supervisor, Financial Counseling

Hebrew Rehabilitation Center•Dedham, MA

5d•Hybrid

About The Position

The Supervisor, Financial Counseling leads a team responsible for the full financial-counseling lifecycle of residents in our long-term care facilities, from pre-admission financial screening through MassHealth Pending and Annual Renewal management, Self Pay collections, income and resource coordination, and Patient Paid Amount (PPA) computation. The Supervisor is a working leader: approximately 20-25% of capacity is reserved for individual casework on the highest-risk MassHealth Pending and complex collections accounts, and 75% is dedicated to leading, coaching, and developing the team; building and enforcing policies and procedures; managing external vendors (notably ParentCare); and reporting performance to the VP, Revenue Cycle. The Supervisor is the single point of accountability for the team's financial performance against the KPIs defined in the program business case (Self Pay AR aging, MassHealth Pending conversion rate, MassHealth Renewal completion rate, Admission Financial Risk Score adoption, ParentCare SLA compliance, cross-training certification).

Requirements

Minimum five years of experience in healthcare, with at least three years in a supervisory or lead role.
Demonstrated track record running a healthcare collections function. The candidate must be able to walk through specific aged AR portfolios personally turned around, with measurable results.
Direct hands-on experience helping residents, families, and guarantors complete Medicare and MassHealth (or other state Medicaid) applications and renewals. This is not theoretical familiarity. The candidate must be able to walk through specific complex cases personally guided to approval, including spend-down, 5-year lookback, and asset-disclosure scenarios.
Demonstrated experience writing policies and procedures from scratch (written workflows, audit-ready SOPs, training materials). Must be able to provide examples on request.
Experience managing external vendors (Medicaid filing agencies, lockbox vendors, claims-management vendors), including SLA negotiation and performance management.
Strong analytical skills. Comfortable working with AR aging reports, conversion rates, productivity metrics, and dashboards. Will own the team's reporting cadence.
Entrepreneurial mindset. Will be standing up a team that does not exist today, designing workflows, choosing tools, building from a blank slate. Comfort with ambiguity, ownership, and self-direction is required.
Brilliant coach and people leader. Track record of developing direct reports, particularly staff in transitional or expanded roles. Reference checks include prior direct reports.
Excellent communication skills with residents, families, clinical teams, payers, and executive leadership.
Detail-oriented and audit-grade documentation discipline.
Deep working knowledge of MassHealth eligibility rules (income/assets, 5-year lookback) and application/renewal processes.
Working knowledge of Medicare Part A and Part B as applied to skilled nursing and long-term custodial care.
Understanding of LTC reimbursement, SNF reimbursement, managed care authorization, and the differences between custodial and skilled levels of care.
Familiarity with EHR and billing systems used in skilled nursing settings (Meditech, PointClickCare, or equivalent).
Awareness of federal and Massachusetts compliance requirements for long-term care.

Nice To Haves

Bachelor's degree in healthcare administration, finance, business, social work, or related field preferred. Equivalent practical experience considered.

Responsibilities

Lead direct reports through daily 15-minute team huddles, weekly 1:1s, and monthly performance reviews.
Coach staff into expanded specialist roles, including individualized 60-day onboarding plans for the Income & Patient Paid Amount Specialist (PPA computation, SS verification, pension review) and any Patient Financial Counselors transitioning from prior collections-only roles into broader counseling work.
Lead by example. Carry an individual caseload of approximately 20-25% of working capacity, focused on the highest-risk MassHealth Pending and most complex Self Pay collections accounts.
Build a shared work queue, daily target board, and escalation routing for the team.
Own the team's KPIs and weekly report to the VP, Revenue Cycle. Diagnose performance gaps and execute corrective action.
Personally handle escalations from the team: complex family conversations, ambiguous eligibility decisions, denied applications, large past-due balances.
Ensure 100% of new admissions are scored using the Admission Financial Risk Score (AFRS); ensure documented mitigation plans within seven days of admission for all medium- and high-risk admissions.
Ensure annual MassHealth renewals are completed on or before each deadline; build and maintain a rolling 12-month renewal calendar.
Establish written policies and procedures for the financial counseling function, including communication workflow and standardized handoff between Admissions and Financial Counseling; audit and compliance for admission files and financial agreements; non-compliant patient/guarantor escalation steps; staff training standards; and account closure across multiple billing systems.
Ensure all admissions agreements and Powers of Attorney are executed at admission; close documented gaps for residents already in the facility.
Maintain audit-ready documentation aligned with federal and Massachusetts regulatory requirements.
Own the ParentCare relationship: weekly case-status review; SLA enforcement; defined escalation path for stalled cases; quarterly performance review.
Triage at admission: decide which MassHealth Pending residents are routed to ParentCare versus handled in-house, based on case complexity and AFRS score.
Manage facility-paid ParentCare investments for AFRS 61+ residents within an approved budget envelope.
Liaise with internal-legal, elder-law attorneys, state agencies, and managed care organizations as cases require.
Coordinate handoffs with Billing & Follow-up (MassHealth AR, Medicare AR, Therapy AR, OP/Other IP Billing).
Establish and run a weekly Medicaid Rejection Review with Billing leadership (FC Supervisor and Billing leadership are standing attendees; PFCs attend as rotating standing attendees based on which portfolios have cases on the agenda). Documented agenda, action log, and named owners with deadlines. Cadence is established within the first 30 days of tenure.
Establish and run a monthly Joint Operations Review with Billing leadership covering coordination-of-benefits performance, aging trends, write-off candidates, and joint KPIs.
Build and maintain a team performance dashboard. Identify trends in AR aging, MassHealth Pending conversion, AFRS distribution, and ParentCare effectiveness.
Recalibrate AFRS weights at 90 days based on observed admission outcomes.
Provide quarterly business review to CFO covering revenue protected, write-offs avoided, AR aging trend, and FTE productivity.
Identify revenue-cycle improvement opportunities outside the team's primary scope and surface them to the VP.