Director of Reimbursement Management

Job Number: 21-663-6874 

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.

Knowledge, Skills and Abilities:

  • Knowledge of the Texas insurance market. Excellent communication skills both verbal and written.
  • Superior organizational skills.
  • Ability to maintain and promote effective relationships among diversified stakeholders.
  • Ability to analyze broad market trends, identify problems and apply solutions to individual center contracting and billing operations for third party payor contracting.
  • Demonstrated ability in contract negotiation. Experience with fee schedule, case rate, per diem, and capitation reimbursement; familiar with patient accounting tasks including billing, collections, and reimbursement analysis. Knowledge and experience in revenue cycle management.

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.).

Experience:

  • 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.  Experience in working in the Texas healthcare industry preferred.

Licensure:

  • Must have a current and valid driver's license.

Hours:  Full-time; Monday-Friday, 8:00am-5:00pm with some flexibility. 

Salary:  $113,022 annually. 

Sign-on incentive: Integral Care looking to grow our teams with talented and caring people just like you. Currently, we are offering a $2,000 sign-on incentive for all newly hired employees! All newly hired employees will receive $1,000 on their first paycheck and $1,000 on the paycheck following their six-month anniversary. 

Why join us: Integral Care has proudly served Travis county residents for the past 50 years. As the largest provider of behavioral health services in Travis County, we are dedicated to improving the lives of adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities. 

By joining our team, you will 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: 

  • Excellent Medical, Dental and Vision insurance

  • Generous vacation/holiday/sick leave 

  • Life and Short-term/Long-term Disability Insurance

  • Employee Assistance Program (EAP)

  • 403(b) retirement account

  • 401(a) employer contribution retirement account

  • Gold's gym membership discount

  • Mileage reimbursement

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.

All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, national origin, sexual orientation, gender identity, disability, veteran status, sex or age.

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)