Director, Health Care Payments & Reimbursements

The District of Columbia Hospital Association (DCHA) has, for 45 years, worked to advance the missions of the hospitals and health systems of the District of Columbia by promoting policies and initiatives that strengthen the system of care, preserve access and promote better health outcomes for the patients and communities they serve. The Director, Health Care Payments & Reimbursements, will coordinate and assist with addressing key financial services needs of member hospitals focusing largely on hospital billing and reimbursement as well as implementation of various projects that meet the financial services needs of member hospitals. Aids in developing positions and policies for the Association that benefit member hospitals.

The Director, Health Care Payments & Reimbursements, will achieve success by:

• Working closely with the Financial Services and Public Policy teams to assist with managing the various billing and reimbursement projects as needed by hospitals.
• Work closely with other DCHA staff in addressing ongoing payment reform options available to member hospitals including the Hospital and Physician Directed Payment Programs.
• Embrace the DCHA mission of advancing hospitals and health systems in the District of Columbia by promoting policies and initiatives that strengthen our system of care, preserve access, eliminate disparities and promote better health outcomes for patients and communities.
• Support the vision for an efficient and effective health care delivery system that supports a healthy, equitable and vibrant community.
• Demonstrate the association’s core values in all relationships, at all times. Trust. Excellence. Transparency. Collaborations. Courage.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Project Management

• Work with project team members to develop workplans, project timelines, and deliverables.
• Monitor workplans and timelines to develop interventions necessary to facilitate adherence to project deliverables.
• Provide administrative support and engagement including agenda setting, planning, and associated communications.
• Assist with coordination and administration of grants, workgroups and other collaborations.
• Tracking progress against project milestones and holding others accountable for assigned tasks.
• Create consensus recommendations among District’s hospitals to shape reimbursement policies and methodologies.
• Coordinate with DCHA’s Public Policy team on legislative and regulatory policy matters impacting consumer cost exposure hospital payments.
• Lead or support DCHA’s efforts to address hospital billing and compliance issues.

Data Analytics

• With DCHA’s consultants, create methodology projections and data driven analyses that support advocacy positions and policy recommendations.
• Support DCHA’s goals to transform care delivery and improve population health.
• Create documents that represent the Association to members and the public, such as meeting materials, comment letters, talking points, etc.
• Provide guidance and assistance to member hospitals with billing, reimbursement, and compliance issues for multiple payers, including Medicare, Medicaid, and commercial payers.
• Assists in completing financial analyses to determine the impact of reimbursement policies.
• Perform basic data quality and analytics activities.

Relationship Management

• Drafts written materials as needed to NCHA Financial Services leadership of important financial issues and current developments at the national and District levels.
• Develop strong working relationships with hospital members and regulatory staff.
• Lead DCHA internal and member facing issue-based work groups; as needed, and serve as lead or supporting representative to the Department of Health Care Finance related to Medicaid Reimbursement.
• Preparing presentations at education and membership programs, and other meetings related to hospital financial topics of interest.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education & Experience

• Significant experience, at least three to five years, with Medicaid and Medicare policies and underlying methodologies.
• Strong understanding of hospital patient financial services and hospital billing compliance matters.
• Knowledge of evolving policy trends that affect health care payment.
• Understanding of the goals of the Centers for Medicare and Medicaid Services.
• Experience in giving and receiving feedback on content in a collaborative environment.
• Ability to interact and communicate with individuals ranging from hospital executives to hospital staff, to government agencies.
• Bachelor’s degree in Finance, Accounting, Economics or other related field or equivalent work experience; Master’s degree preferred.

Skills & Abilities

• Ability to coordinate basic project tasks.
• Basic understanding of statistical techniques.
• Ability to facilitate large and small meetings to achieve results.
• Excellent communication skills (listening, writing, and speaking).
• Skills in establishing and maintaining relationships with stakeholders.
• Strong leadership and motivational skills.
• Strong skills in collaboration.
• Strong sense of personal and professional integrity.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment described below represent the activities and surroundings of the positions. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This position is hybrid (in-office/telework) and is required to report to the office a minimum of at least 50% a pay period with in-person presence above that as the position requires certain weeks. The work is typically performed in an office environment, with a moderate noise level. The position requires working in an office environment with the usual office equipment, including copiers, technology equipment and computers. The position requires incumbent has at adequate off-site office environment for remote work. The employee is frequently required to talk and hear on the telephone and in person with individuals and groups.  The incumbent may carry materials/equipment weighing up to 25 lbs. on occasion. The incumbent is required to read and respond to documents in hard copy and electronic form. The position requires occasional travel to member facilities and meetings requiring transportation.

SALARY RANGE

• $95,000-$115,000