VP, Medicaid and Reimbursement

UofL Health•Louisville, KY

1d•Onsite

About The Position

The Vice President of Medicaid Financing and Reimbursement is responsible for providing executive leadership and strategic direction for all Medicaid financing, supplemental payment, and reimbursement initiatives across UofL Health. Reporting directly to the Chief Financial Officer, this role serves as the organization’s senior subject matter expert on Kentucky Medicaid financing and national Medicaid reimbursement strategy. The Vice President will lead the identification, development, implementation, and optimization of Medicaid financing programs designed to maximize sustainable reimbursement opportunities in support of the organization’s academic, clinical, and community mission. This executive leader will oversee the development of Medicaid financing applications, direct strategic reimbursement initiatives, monitor regulatory and policy developments, and ensure the organization remains positioned to capitalize on emerging Medicaid funding opportunities. The role will have executive oversight of Disproportionate Share Hospital (DSH) strategy, directed payment program negotiations, intergovernmental transfer (IGT) financing structures, and external consultant relationships supporting Medicaid financing initiatives. Working collaboratively across finance, government affairs, legal, compliance, population health, operational leadership, and clinical teams, the Vice President will provide strategic leadership in aligning Medicaid reimbursement strategies with the health system’s long-term financial and operational objectives.

Requirements

Bachelor’s or Master level degree in Finance, Healthcare Administration, Accounting, Public Policy, Economics, or related field.
Minimum of 10 years of progressive leadership experience in Medicaid reimbursement, Medicaid financing, governmental healthcare payment programs, or healthcare finance.
Extensive experience with Kentucky Medicaid financing methodologies and reimbursement structures.
Strong knowledge of federal Medicaid financing policy, CMS regulations, supplemental payment programs, directed payment programs, DSH funding, IGT structures, and waiver mechanisms.
Demonstrated experience developing and implementing complex Medicaid financing strategies within a health system, academic medical center, consulting environment, or governmental agency.
Experience managing Medicaid financing consultants, actuarial advisors, or external reimbursement partners.
Proven executive leadership experience managing teams and large-scale strategic initiatives.
Exceptional analytical, communication, negotiation, and relationship management skills.

Nice To Haves

Advanced degree in Business Administration, Healthcare Administration, Finance, Public Health, Public Policy, or related field.
Experience interacting with an academic health system or integrated delivery network.
Experience interacting with CMS, state Medicaid agencies, managed care organizations, and external policy stakeholders.
Knowledge of value-based payment models and Medicaid managed care financing strategies.

Responsibilities

Provide executive oversight and strategic leadership for all Medicaid financing and reimbursement activities across the health system.
Develop and execute a comprehensive Medicaid financing strategy that supports organizational growth, financial sustainability, and the mission of the academic health system.
Identify and pursue innovative Medicaid funding opportunities, including supplemental payment programs, directed payment arrangements, waiver programs, quality incentive initiatives, and other state and federal reimbursement opportunities.
Advise executive leadership on emerging Medicaid policy, reimbursement trends, and regulatory developments at the state and national level.
Serve as a strategic advisor to the CFO and executive leadership team regarding Medicaid reimbursement optimization and financial risk.
Develop long-range Medicaid reimbursement strategies that align with organizational priorities and support sustainable financial performance.
Lead the design, preparation, submission, and implementation of Medicaid financing applications, proposals, and related reimbursement initiatives.
Oversee the development of financial models, utilization analyses, reimbursement methodologies, and program performance metrics.
Evaluate current Medicaid utilization and payment patterns to identify opportunities for reimbursement enhancement and operational improvement.
Direct strategic planning efforts related to Medicaid managed care reimbursement, supplemental payments, and value-based reimbursement programs.
Ensure organizational readiness and operational alignment for new Medicaid financing initiatives.
Collaborate with operational and clinical leadership to identify opportunities to improve reimbursement performance through enhanced documentation, utilization management, and care delivery strategies.
Provide executive oversight of Disproportionate Share Hospital (DSH) financing strategy, including modeling, reporting, optimization, and regulatory compliance.
Lead negotiations and strategic development related to Medicaid directed payment programs with managed care organizations and state agencies.
Oversee intergovernmental transfer (IGT) financing structures and related funding mechanisms supporting Medicaid reimbursement programs.
Develop long-range strategies to protect and expand Medicaid supplemental funding streams for the organization.
Coordinate closely with internal finance, legal, compliance, and governmental affairs teams regarding financing structure design and implementation.
Monitor supplemental payment program performance and identify opportunities for optimization and expansion.
Maintain executive-level relationships with the Kentucky Cabinet for Health and Family Services, Medicaid managed care organizations, consultants, policymakers, and other external stakeholders.
Monitor federal and state Medicaid regulatory developments, CMS guidance, and reimbursement policy changes impacting the organization.
Collaborate with legal and compliance teams to ensure all Medicaid financing programs remain compliant with applicable state and federal requirements.
Support legislative, advocacy, and public policy efforts related to Medicaid financing and reimbursement strategy.
Represent the organization in state, regional, and national Medicaid financing discussions and workgroups as appropriate.
Direct relationships with external consultants, actuarial partners, reimbursement advisors, and other third-party experts supporting Medicaid financing initiatives.
Oversee consultant work plans, deliverables, financial analyses, and strategic recommendations to ensure alignment with organizational objectives.
Evaluate external market intelligence and benchmarking data to support reimbursement strategy development.
Coordinate consultant activities across multiple Medicaid financing and reimbursement initiatives to maximize organizational value.
Provide executive oversight of Medicaid reimbursement analysis, forecasting, and reporting activities.
Lead financial evaluations of reimbursement opportunities and assess the financial impact of proposed Medicaid policy changes.
Oversee data-driven initiatives aimed at improving Medicaid reimbursement performance and reducing reimbursement risk.
Collaborate with operational and revenue cycle leadership to improve documentation, coding, utilization management, and reimbursement outcomes.
Present financial analyses, strategic recommendations, and program performance updates to executive leadership and governing bodies.
Build, lead, and mentor a high-performing team focused on Medicaid financing strategy, reimbursement analytics, and program implementation.
Foster strong collaboration across finance, operations, government affairs, revenue cycle, population health, and clinical leadership.
Establish accountability structures and performance expectations for Medicaid financing initiatives and related operational outcomes.
Lead cross-functional efforts supporting Medicaid reimbursement optimization and strategic financing initiatives.