System Director, Reimbursement

For our client, we are seeking a System Director, Reimbursement to join the team of a leader in the Healthcare space.

This role will lead reimbursement strategy and operating discipline across an assigned state portfolio and related markets. The position is responsible for monitoring regulatory changes, managing cost report activity, and strengthening reimbursement processes that support financial performance and compliance. The ideal candidate will partner closely with senior leaders and cross-functional teams to help navigate Medicare and Medicaid complexity and reduce reimbursement risk.

Location: Remote - US based candidates only, no visa sponsorship available

Compensation: $120,000 – $150,000 annually

Responsibilities

• Lead the reimbursement operating model for the assigned state portfolio and markets, ensuring accountability for key reimbursement activities
• Monitor proposed CMS rules and state Medicaid changes to assess financial impact on the portfolio proactively
• Oversee the cost report lifecycle, ensuring timely preparation and compliance with deadlines and governance standards
• Lead Medicare and Medicaid payment integrity efforts, including proactive audit risk monitoring and compliance checks
• Maintain consolidated reimbursement forecasting and risk reporting across payer systems, ensuring clear communication to leadership
• Serve as the reimbursement subject matter expert on cross-functional teams, collaborating on root cause analyses and denial strategy reviews
• Champion digital literacy and AI adoption within teams to improve reimbursement analytics and reporting

Qualifications

• Bachelor's degree in accounting, finance, business administration, health care administration, or a related field, or equivalent experience
• Extensive progressive hospital reimbursement experience, particularly in Medicare and Medicaid cost reporting and audits
• Demonstrated expertise in complex Medicare and Medicaid reimbursement matters, including payment integrity oversight and regulatory analysis
• Working knowledge of hospital reimbursement across multiple care settings, including acute, post-acute, and ambulatory
• Proven leadership experience managing broad portfolios under competitive regulatory deadlines and financial risk
• Ability to advise senior executives and synthesize complex issues clearly for decision-making
• Experience establishing enterprise internal controls and audit-ready documentation
• Foundational digital literacy, including familiarity with AI and GenAI tools and prompt engineering

Benefits

• Healthcare benefits including medical, dental, and vision coverage
• Retirement plan options with company matching
• Professional development and training opportunities
• Remote work flexibility supporting work-life balance
• Paid time off and holidays

Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.