System Director, Reimbursement Services

Job Description

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Directs the financial services for the organization in the functional areas of Reimbursement and Government Reporting and Financial Standardization. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.

Job Requirements:

Education and Work Experience:

• Bachelor's Degree in finance, accounting or business administration or equivalent combination of education/related experience: Required
• Master's Degree in business administration: Preferred
• Seven years' experience: Preferred
• Five years' leadership experience: Preferred
• Five years' experience in healthcare finance: Preferred

Licenses/Certifications:

• Certified Public Accountant (CPA): Preferred

Essential Functions:

• Distributes recommended assumptions for government payer programs including Medicare, Medicaid (including DSH) and Hospital Fee for incorporation into the long-term and annual planning results.
• Directs the financial processes used by the organization to ensure appropriate reimbursement by government payers and to ensure compliance with reporting requirements established by those payers. Responsible for filing the Medicare, Medicaid and California state OSHPD Annual Financial Disclosure reports, Medicaid RHC PPS Reconciliations and OSHPD quarterly financial utilization reports. Supports California Department of Health Care Services (DHCS) efforts to validate utilization data used for Medi-Cal DSH and Hospital Fee Directed Payment calculations. Assesses the appropriate appeal of adjustments made by government auditors to filed cost reports and ensures participation in appropriate appeals of government regulations which adversely impact it.
• Directs the processes for calculating, recording and explaining settlement estimates for inclusion into monthly financial statements. Provides the appropriate documentation and support requested by financial auditors.
• Directs the standardization of Net Revenue financial functions to ensure accurate and meaningful information available as
• Assists other financial or operational functions by providing technical assistance and support to the organization.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

About Us

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 90 communities on the West Coast and Hawaii with over 400 sites of care, including 26 acute care facilities, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.