Dir Provider Audit & Reimbursement

Overview

• Remote / work-from-home eligible (telecommuting eligible: Yes)
• Department: Provider Audit
• Job grade: E16
• As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.
• Job title: Director Provider Audit and Reimbursement

Responsibilities

• Lead the Provider Audit & Reimbursement department and develop strategies and plans aligned with organizational standards for service excellence and growth.
• Manage, monitor, and coordinate provider audit and reimbursement activities to meet metrics, maintain contract expectations, and improve operational efficiency.
• Provide technical guidance to staff regarding Medicare Cost Reporting and related activities.
• Serve as key personnel for Audit & Reimbursement activities in accordance with contractual requirements for government, commercial, and/or private industry standards (when/where applicable).
• Provide leadership and strategic direction for Provider Audit teams, projects, and services.
• Ensure contractual obligations and performance standards are met.
• Coach and develop staff to encourage growth and ensure performance expectations are met.
• Drive accountability through performance management, including leadership and direction focused on productivity, performance, timeliness, problem-solving, and education.
• Participate in divisional and corporate strategic planning, establish short- and long-term departmental goals, identify process improvement needs, and provide input into departmental budgets.
• Provide strategic oversight of departmental budgets to meet contract requirements and optimize efficiency.
• Maintain comprehensive knowledge of audit and reimbursement, including awareness of trends, standards, and current events.
• Oversee responsiveness to audit findings and timely implementation of changes as appropriate.
• Partner with technical and systems development staff to develop application tools supporting ongoing operations.
• Collaborate with internal and external stakeholders (including state and federal agencies, institutions, representatives, and project consultants) to ensure coordination and effective information exchange.
• Translate organizational business strategies into actionable plans by applying market and functional knowledge while aligning with unit mission and objectives.
• Support organizational and corporate growth opportunities.
• Represent and mentor management staff, serving as a subject-matter expert to support responsiveness to customers.
• Work closely with other Operations Executives and Directors to align strategic initiatives for growth and diversity.
• Coordinate with Project Managers, Contract Administration, and Finance for each customer the department supports.

Requirements

• Bachelor’s degree in Accounting or a business-related field from an accredited institution with a minimum 24 credit hours in accounting OR Certified Public Accountant, plus knowledge of Medicare laws and regulations and Government Auditing Standards (GAS).
  • In lieu of education: 15 or more years of significant management experience in Medicare Audit and Reimbursement.
• 5 years’ Medicare Cost Report Audit and Reimbursement experience, 3 of which must be as a manager of Medicare Cost Report Audit or Reimbursement (or an equitable role).
• Understands and abides by HIPAA and other applicable regulations.
• Broad experience creating and leading teams to achieve results and maintain efficiencies.
• Strong leadership, interpersonal, communication, and organizational skills.
• Strong data analytical skills.
• Excellent problem-solving skills.

Preferred Qualifications

• Certified Public Accountant
• Master Business Administration
• 5 years’ management experience managing complex systems and workflows

Environment & Physical Demands

• Office environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively, and problem-solve
• Prolonged sitting and telephone use
• Use of office equipment such as computer terminals, telephones, copiers, and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping
• Travel up to 25%

Compensation & Benefits

Salary Range: $104,831.40 – $137,936.05 annually (base pay may vary by geographic region, internal equity, job-related knowledge, skills, and experience).

Other Compensation: Incentive Plan & Lifestyle Benefit

Total Rewards Package includes:

• Health, Dental and Vision Insurance
• Voluntary Insurance Plans
• Health Savings and Flexible Spending Accounts
• 401k and Company Match
• Company-paid Life Insurance
• Education Assistance Program
• Paid Sick Leave
• Paid Holidays
• Increasing PTO Accrual Plan
• Medical/Parental/Disability Leave
• Workers Compensation
• Retiree Benefits
• Severance Package
• Employee Assistance Program
• Financial and Health Wellness Benefits
• Casual Dress
• Open Office Setting
• Online Learning System

Compliance / Credentialing Requirements

Some positions require compliance with (i) federal and agency-specific regulations and federal contract requirements, and (ii) eligibility to obtain and maintain federal identity credentials and authorized access to government facilities, information systems, networks, sensitive information, or applications.

Employees may be required to complete federal identity verification, federal background investigation and adjudication, credentialing, and access authorization processes in accordance with applicable federal requirements.

Federal identity credentials and authorized access will not be issued to candidates who have not resided in the United States at least three (3) out of the last five (5) years.

Failure to obtain and maintain eligibility for required federal credentials and access authorization may result in removal from the position or termination of employment.

Equal Employment Opportunity

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Application Deadline

This job will be closed 11/09/2026 at 8:00AM CST. No further applications will be considered.