Director of Reimbursement

Job Number: 20-351-6874

Why join us: Integral Care helps people build health and well-being so everyone has the foundation to reach their full potential.  By joining our team, you'll find rewarding work every day alongside people who have as much compassion as you. Join us and together we can help improve the quality of life for the people we serve. Imagine your career at Integral Care!

Employee Benefits:

  • Health/Dental/Vision insurance

  • Life and Disability Insurance

  • Employee Assistance Program (EAP)

  • Generous vacation/sick leave

  • 403(b) and 401(a) retirement account

  • And much more!

Job Summary: Under the supervision of CAO/CFO the Director of Reimbursement Management has oversight and responsibility of the business processes of service reimbursement management to include contracts management, health plan liaison and development, data analysis and partner's data exchanges, and supervision of the reimbursement billing department.  Evaluate rates and contract terms of new and existing contracts with health plan payers/managed care organizations/third party insurance companies. The position entails leading contract negotiations, assisting in the resolution of contract payment issues, analyzing contract performance and lead in collection efforts.  The position will work closely with the CFO who retains final authority related to contract negotiation and execution.

Responsibilities include evaluating the managed care environment for the development of contracting tactics and strategy and become familiar with state contracts with MCOs.  This position will work closely with program management to develop innovative payment mechanisms for services currently provided or could provide in the future (examples include: value based pricing, case rates, at risk contracting). 

This position will work closely with the Director of Budget and Financial Analysis will supervise client eligibility, credentialing, and Medicaid Administration Claiming (MAC).

Performs highly advanced (senior-level) managerial work providing direction and guidance in strategic operations and planning.  Work involves establishing the strategic plan and goals and objectives, developing policies, reviewing guidelines, procedures, rules, and regulations, establishing priorities, standards, and measurement tools for determining progress in meeting goals; coordinating and evaluating management activities; and reviewing and approving budgets.  Plans, assigns, and supervises the work of others.  Works under minimal supervision, with extensive latitude for the use of initiative and independent judgement.

Education:

Required:

  • Bachelor's Degree in a related field, such a business, business administration, health administration, etc.

Preferred:

  • Master's Degree (MBA, MHA, MPH, etc.).

License: 

Required:

  • Current and valid Texas driver's license and a clean driving record. 

Experience: 

Required: 

  • Minimum of five years working in a healthcare environment, and understands the industry's concepts, practices, and procedures. 
  • Relies on extensive experience and judgement to plan and accomplish goals. 

Preferred:

  • Experience in working in the Texas healthcare industry

Hours:  Monday-Friday

Salary:  $113,022 annually. 

Integral Care strives to maintain a diverse workforce. We encourage all to apply, including those who have knowledge and/or experience working with underserved populations, including Asian and Pacific Islander, Black/African American, Hispanic/Latino, and LGBTQA communities.

For specific positions, additional compensation may be available to those who are bilingual in both English and one of the following languages:  Spanish, Chinese, Vietnamese, Korean, or Burmese. (PM16)