<p>Inspire health. Serve with compassion. Be the difference.</p> <p>Job Summary</p> <p>The Business Office Director will perform various functions, which primarily involve providing data, financial reports, and analyses in support of an organization's plan to facilitate data driven decision-making. He/(She) provides summary analyses in an easy-to-understand format and proffer recommendations to solve business problems and improve processes/decisions that may have negative financial performance. The position also supports and assists in the development of more efficient and effective revenue cycle management processes to optimize cash collections and reduce negative prior month settlements. He/(She) will manage business office operations (i.e. assigned business office team members) to support standardization, efficiency and service levels as required for the PACE health plans under Prisma Health Post-Acute Services.</p> <p>Essential Functions</p> <ul> <li> <p>Business Analytics</p> </li><li> <p>Deliver metrics, reporting platforms, dashboards, and analytical models vital for tracking and managing the 2 health plans included in PACE Seniorcare</p> </li><li> <p>Identify business challenges and initiate process improvement projects</p> </li><li> <p>Facilitate the computerization of analytics and data collection processes</p> </li><li> <p>Responsible for carrying out complex analysis of datasets and conduct appropriate data validation in accordance with Prisma Health systems and methodologies</p> </li><li> <p>Financial Reporting & Budgeting</p> </li><li> <p>Supervises timely delivery of monthly financial results utilizing GAAP</p> </li><li> <p>Reports on monthly financial results to Post-Acute Services leadership</p> </li><li> <p>Maintains and monitors subsidiary account balances by verifying, allocating, posting, and reconciling transactions and resolving discrepancies</p> </li><li> <p>Maintains knowledge of applicable general ledger accounts</p> </li><li> <p>Develops annual budgets and intermittent forecasts as requested</p> </li><li> <p>Revenue Cycle Management</p> </li><li> <p>Reconcile monthly capitation received from Medicare and Medicaid to census and report on monthly variances created by intermittent settlements</p> </li><li> <p>TPA vendor monitoring and management</p> </li><li> <p>Risk adjustment coding vendor monitoring and management</p> </li><li> <p>Contract and regulatory compliance - ie CMS, Part D bids, other required reports</p> </li><li> <p>Revenue integrity audits</p> </li><li> <p>Performs other duties as assigned.</p> </li></ul> <p>Supervisory/Management Responsibilities</p> <ul> <li>Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health or affiliate and will have direct reports. </li></ul> <p>Minimum Requirements</p> <ul> <li>6+ years of experience in areas such as Health Plan administration, Revenue Cycle, Medicare/Medicaid regs and Vendor Management </li><li>Business Office supervisory experience </li><li>Health Plan experience </li><li>Revenue cycle management experience </li><li>Working knowledge of medical coding and QA requirements </li><li>Reimbursement experience primarily with Medicare and Medicaid </li><li>Financial reporting - monthly and annual close </li><li>Vendor management and contracting </li><li>Excellent written and verbal communication skills </li><li>Great analytical, critical thinking and problem-solving abilities </li><li>Adaptability and capacity to work in fast-paced/changing environment </li><li>Bachelor of Science degree in Accounting or Finance - required </li><li>Master of Business Administration (MBA) or Master of Health Administration (MHA) - desired </li><li>Certified Public Accountant - desired </li></ul> <p>In Lieu Of</p> <ul> <li>NA </li></ul> <p>Required Certifications, Registrations, Licenses</p> <ul> <li>NA </li></ul> <p>Knowledge, Skills and Abilities</p> <ul> <li>Microsoft Office Products - Excel, Word, and Powerpoint </li><li>Workday and Strata - for monthly close, financial analysis, and budgeting </li><li>Kronos (UKG) - for productivity analysis </li><li>EPIC - EHR, claims and encounter data </li></ul> <p>Work Shift</p> <p>Day (United States of America)</p> <p>Location</p> <p>Centennial Way Practices</p> <p>Facility</p> <p>7001 Corporate</p> <p>Department</p> <p>70019154 Finance Administration</p> <p>Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.</p>