At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
The AVP, Government Reporting is a strategic executive leader responsible for overseeing, optimizing and innovating the Government Reporting functions for Memorial Hermann Healthcare System (MHHS). Reporting to the SVP, Chief Revenue Officer, this leader develops systems and policies to ensure that the related financial items are tracked and recorded accurately. This scope includes the Medicare, Medicaid, Champus and other governmental programs cost and supplemental program funds flow and reimbursements for all MHHS facilities inclusive of report preparation, audit, appeal and inquiry response. The responsibilities extend to completing the annual State Uncompensated Care and Disproportionate Share Surveys for all relevant operating units. This role also assists with annual facility budgeting process for contractual allowances for Medicare and Medicaid Supplemental Programs. This leader coordinates and administers all Audit and Appeals for both Federal and State filings. The work includes the oversight of supplemental and cost reporting consultants and vendors to insure proper handling of all funds and accounting entries.Job DescriptionEducation: Bachelors’ degree in Business, Healthcare Administration, Accounting, Finance, or related field required, Masters’ degree or CPA preferred.
Licenses/Certifications: (None)
Experience / Knowledge / Skills:
Ten plus (10+) years of progressive experience in healthcare management in a leadership or strategy role, with at least 7+ years in reimbursement experience in a healthcare system.
Strong understanding of RCM operations, payer rules, coding, billing, collections, and compliance.
Certification in at least one Epic application is strongly preferred.
Previous experience with Medicare IME, DGME, DSH and Organ Acquisition preferred.
Previous experience with Medicaid Supplemental Payments (Texas 1115 and DDP program experience preferred).
Knowledge and experience regarding compliance with all relevant laws, rules regulations and accreditation standards and requirement in respect to governmental reporting and reimbursement programs.
Demonstrated success in leading teams, manage multiple work streams, projects, tasks, goals and programs at scale.
Exceptional analytical, strategic thinking, and communication skills.
Proven ability to influence cross-functional teams and stakeholders.
Principal Accountabilities
Strategic Leadership & Vision
Define and execute the strategic vision for government reporting and reimbursements including process optimization, application maintenance, change management, automation adoption and project success.
Serve as a thought leader on supplemental program evolution.
Collaborate with executive leadership to align reimbursement strategy with overall company objectives.
Maintain and execute a strategic roadmap to drive innovation, efficiency, and scalability.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences.
Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Operational Excellence & Process Optimization
Plan, develop, supervise and evaluate daily work activity in the Government Reporting Department.
Develop and implement tailored optimization strategies to accelerate reimbursement and improve KPIs.
Plan, develop, and update the recorded contractual adjustments for pass-through dollars and work closely with other departments (Accounting, NPR, CBO, Internal Audit, Hospitals) to ensure that contractual adjustments and settlements with respect to Medicare/Medicaid/Champus and other agencies are accounted for appropriately.
Oversee all change management activities impacting cost reimbursement and supplemental funding functions.
Ensure seamless integration report preparation applications with Epic applications including training and change management.
Acts as resource contact with local, state, and national professional societies, correspond with, and work with the government relations department to protect System’s interest in evolving legislation.
Develop rates and supplemental payment budgets for contractual allowances related to governmental programs and provide monthly budget to actual variance analysis for use by administration and appropriate operating units.
Provides consultation and education materials on governmental and third-party reimbursement requirements and issue to departments and Senior Management.
Oversee, review and prepare the Medicare/Medicaid/Champus cost reports for MHHS and MHCCC within the appropriate time frames and in accordance with regulations.
Works closely with other departments (Accounting, CBO, and Internal Audit) in preparing year-end schedules for MHHCS external auditing firm. Explain to the auditors the accounting of all supplement-related contractual adjustments, settlement accounts receivable allowances and cost report receivable/payables.
Works closely with Corporate Compliance on Medicare / Medicaid related issues
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as a preceptor, mentor and resources to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
All other duties as assigned.
Team Leadership
Build, lead, and mentor a high-performing team of specialists and analysts to facilitate quality and timely deliverables
Foster a culture of continuous improvement, innovation, and accountability.
Manage the selection and delivery of education, training, and resource materials for the team.
Vendor & Technology Management
Assess new technologies and maintain vendor relationships. Create ROI analyses to support investment decisions.
Oversee vendor relationships and recommend new technology solutions to revenue cycle leadership.
Work closely with Epic Technical Support, Memorial Hermann ISD to influence product development and enhancements.
Develop action plans and communicate resolutions to senior leadership.
Skills Required
- Bachelor's degree in Business, Healthcare Administration, Accounting, Finance, or related field
- Master's degree or CPA
- Ten plus years of progressive experience in healthcare management
- At least 7 years in reimbursement experience
- Strong understanding of RCM operations, payer rules, coding, billing, collections, and compliance
- Certification in at least one Epic application
- Previous experience with Medicare IME, DGME, DSH and Organ Acquisition
- Knowledge and experience regarding compliance laws
- Demonstrated success in leading teams
- Exceptional analytical, strategic thinking, and communication skills
What We Do
At Memorial Hermann, we are all about advancing health. Yours. It begins by redefining healthcare. Our 6,400 affiliated physicians and more than 26,000 employees practice evidence-based medicine with a relentless focus on quality, safety and exceptional service for all patients, consumers and Health Plan members. Our efforts continue to result in national awards and recognition, including for our nationally acclaimed Accountable Care Organization. With a focus on providing enhanced access to care, Memorial Hermann offers Virtual Clinic for digital access and has 300 care delivery sites conveniently located across the Greater Houston area, including our flagship hospital in the world-renowned Texas Medical Center, which serves as the teaching hospital for McGovern Medical School at UTHealth. We have proudly served this community for more than 110 years, and we contribute more than $588 million annually through school-based health centers and other community benefit programs. Because at Memorial Hermann, the health of our community is always at the center of what we do. Learn more about Memorial Hermann Health System.
