Overview
Looking to be part of something more meaningful? At HonorHealth, you'll be part of a team, creating a multi-dimensional care experience for our patients. You'll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.
HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.
Join us. Let's go beyond expectations and transform healthcare together.
HonorHealth is one of Arizona's largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses nine acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With more than 16,000 team members, 4,000+ affiliated providers and over 1,100 volunteers, HonorHealth seamlessly blends collaborative care and approachable expertise to improve health and well-being. People often say care feels different here -- because it does. Learn more at HonorHealth.com.
Responsibilities
Job Summary
The Reimbursement Manager will be responsible for overseeing and maximizing reimbursement from government payors, including state Medicaid (AHCCCS) Reimbursement Initiatives and CMS final rules. Compiles public data from Medicare and Medicaid websites to model reimbursement effect of programs. Analyzes data and makes recommendations to CFO on how to maximize reimbursement. Assists with preparation of cost report filings and other regulatory matters to provide maximum allowable reimbursement for the health system. Maintains knowledge of and communicates the impact of changes related to current and proposed federal and state reimbursement regulations, which includes provider enrollment requirements and NPI numbers.
The ideal candidate should have a deep understanding of government reimbursement policies and regulations, strong analytical skills, and the ability to effectively communicate and collaborate with internal stakeholders.
- Stay up-to-date with the latest CMS regulations and final rules related to reimbursement and payment methodologies. Interpret CMS final rules and communicate the impact on reimbursement to relevant departments within the organization. Develop and implement strategies to maximize reimbursement from government payors, ensuring compliance with CMS guidelines. Advise on wage index/ reclass designation strategies. Track and identify opportunities related to AHCCCS supplemental payment programs (HEALTHII, GME, DAP, Prop 202 trauma, etc).
- Analyze reimbursement data and trends to identify opportunities for improvement and cost-saving measures.
- Proactively identify potential risks and compliance issues related to reimbursement and develop mitigation strategies. Maintain strong relationships with government payors, participating in meetings and negotiations as necessary.
- Prepare reports and presentations on reimbursement performance, trends, and strategies for senior management.
- Collaborate with cross-functional teams, including finance, billing, and coding departments, to optimize reimbursement processes. Provide guidance and training to internal teams on government reimbursement policies and procedures.
Qualifications
Education
Bachelor's Degree in healthcare administration, accounting, finance, or a related field. Required
Experience
8 years Minimum of 8 years of experience in healthcare reimbursement, with a focus on government payors and CMS regulations. Required
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HonorHealth
May 01, 2025