Manager of Reimbursement
Formed in February 2015, AMITA Health is a new beginning in healthcare that was created by the merger of Adventist Midwest Health and Alexian Brothers Health System. Together, we will provide quality care that is open, inclusive and compassionate, delivered with dignity and empathy for all. What makes our opportunities so special is our holistic approach to healthcare and to life. We care for patients in body, mind, and spirit - and encourage a work-life balance that really works for our employees.
Provide advisory services and manage client work-streams during operational readiness, technical releases, and system migrations from start to finish. (Business Requirements, Technical Requirements, Design, Construction, SIT, UAT, Implementation, and Warranty Period). Platform Migration Planning Lead – Established and analyzed the scope of the migration and identified the business process impacts of the migration to understand required process changes and scope for improvement. Responsibilities included defining an approach for all phases of the project and account for internal and external dependencies. Document current processes and identified any gaps between the migrating platforms and develop change architecture in the form of process flows to demonstrate the gaps between processes. Develop an initial approach through business models, frameworks and produce a high-level plan to execute the migration strategy along with an initial high level resource plan along accompanied by a data driven dashboard analysis using the Agile methodology. Provide advisory services for healthcare providers and 3rd party audit support for large university hospitals during financial audits and review the current year estimated due to/from balances for Medicare, specifically reviewing the current year rates and support used to calculate entitlements and interim payments for inpatient services, capital payments, disproportionate share, interns and residents, organ transplants, and bad debts. Review the hospitals outstanding balances for reasonableness for open cost reporting periods. Provide advisory services to healthcare providers, including preparation of Medicare and Medicaid cost reports. Prepare Medicare Disproportionate Share (DSH) reviews and Wage Index Reviews. Specialties: Project Management, Operational Readiness, Medicare Cost Reports, 3rd Party Audit, Client Billing, Maintaining Budgets, Presentation Deck Building, Developing Milestones.