Director Provider Audit & Reimbursement

Overview

Remote / Work from Home opportunity available, with the requirement that the physical work location must be in one of the 50 states or the District of Columbia as a condition of employment.

Responsibilities

• Act as a key personnel for Provider 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, encouraging growth and ensuring staff meet performance expectations.
• Drive accountability through performance management, providing leadership, direction, and motivation in areas of productivity, performance, timeliness, problem-solving, and education while effectively and efficiently managing staff and resources.
• Participate in divisional and corporate strategic planning; establish short- and long-term departmental goals; identify process improvements; provide input into department budgets to ensure adequate funding to meet performance expectations and requirements.
• Provide strategic oversight of departmental budgets to meet contract requirements and optimize efficiency.
• Maintain comprehensive knowledge of audit and reimbursement trends, standards, and current events related to Provider Audit & Reimbursement operations.
• Oversee responsiveness to audit findings and the implementation of timely changes as appropriate.
• Work with technical and systems development staff to develop application tools needed to support ongoing operations.
• Collaborate with internal and external stakeholders, including state and federal agencies, institutions, representatives, project consultants, and others, to ensure coordination of effort and information exchange with appropriate management.
• Develop solutions and innovations based on customers’ changing needs by using informed decision-making and applying critical thinking, financial management, and project management capabilities to operations.
• Translate organization business strategies into actionable plans by leveraging market and functional knowledge while aligning the unit’s mission and objectives.
• Assist with organizational and corporate growth opportunities.
• Represent and mentor management staff as the area subject-matter expert to support responsiveness to the organization’s customers.
• Work closely with other operations executives and directors to align strategic initiatives for growth and diversity.
• Collaborate with Project Managers, Contract Administration, and Finance for each customer the department supports.

Minimum Qualifications

• Bachelor’s degree in Accounting or a business related field from an accredited institution with a minimum 24 credit hours in accounting, or a Certified Public Accountant; and knowledge of Medicare laws regulations and Government Auditing Standards (GAS); OR 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 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.

Compensation & Benefits

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

Other Compensation: Incentive Plan & Lifestyle Benefit.

Total Rewards Package:

• 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
• Employee Assistance Program
• Financial and Health Wellness Benefits
• Casual Dress
• Open Office Setting
• Online Learning System

CMS Access Compliance and Regulation Contingency Statement

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.

To obtain federal identity credentials and authorized access, employees in this position may be required, as a condition of employment, to successfully 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.