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.

Work arrangement
Yes