What are the responsibilities and job description for the Director of Reimbursement & Managed Care position at MaineGeneral Health?
**On-site position in Waterville, Maine; Eligible for relocation reimbursement up to $12,000**
MaineGeneral Health is a leading health care system proud of the culture of excellence, compassion, and collaboration that extends to our patients and their families. We are committed to attracting talented, ambitious people who share our values and strive to provide excellent customer service. We are actively seeking a finance professional to join our experienced team as the Director of Reimbursement and Managed Care who will oversee all aspects of reimbursement, managed care contracts, and payer enrollment.
The successful candidate will have a deep understanding of healthcare finance, regulatory requirements, and a proven track record in a similar role. Additionally, they will have a strong work ethic, intuitive problem-solving skills, and the drive to meet evolving organizational needs.
The Work:
- Manage and oversee the Charge Description Master (CDM) rate setting
- Lead contract negotiations and manage payer relationships
- Utilize Sorian and StrataJazz contracting modules
- Perform contract modeling and troubleshoot payer issues
- Oversee contract management and reporting
- Ensure compliance with price transparency regulations
- Support the revenue budget process, including revenue/statistical variance analysis
- Prepare monthly and ad-hoc net revenue reporting
- Assist in service line analysis with FP&A
- Oversee cost reporting for most companies and conduct regulatory research
- Analyze government reimbursement and assist with provider and payer enrollment
- Manage professional enrollment, facility credentialing and re-credentialing, including CAQH processes
- Lead PHO contract negotiations and planning
You Have:
- Bachelor’s degree in Finance, Accounting, Business Administration, or related field (Master’s preferred)
- Minimum of 7 years of experience in healthcare reimbursement and managed care – some leadership experience is preferred
- Extensive knowledge of healthcare finance, reimbursement methodologies, and regulatory requirements
- Experience with Soarian, StrataJazz, and other relevant software systems preferred
- Strong analytical, problem-solving, and decision-making skills
- Excellent communication and negotiation abilities
- Demonstrated ability to lead and manage a team effectively
Ready to join our team? Apply today!
This position is available immediately and we’re excited to welcome passionate individuals who share our commitment to providing exceptional healthcare services.
Salary : $140,000 - $180,000
