A place that gives you opportunity and takes your breath away.

Job Summary

Provides enterprise-wide strategic and operational leadership for reimbursement and patient service revenue recognition ensuring alignment with regulatory requirements.

Job Duties

• Ensures the integrity, completeness, and accuracy of net patient service revenue, and third-party settlement estimates, in accordance with GAAP. Oversees methodologies supporting financial estimates and continuously monitors variance, hindsight analysis, and emerging trends.
• Leads the development of advanced analytics and tools (e.g., dashboards, predictive models) that provide actionable insights into reimbursement trends, denial drivers, and the financial impact of value-based and quality reimbursement programs.
• Proactively monitors and interprets evolving federal and state reimbursement regulations and payer methodologies, translating changes into actionable strategies that maintain full regulatory compliance.
• Synthesizes complex regulatory changes and reimbursement dynamics into clear, executive-level insights, including quantified financial impacts, risks, and recommended strategic responses for senior leadership and governance committees.
• Oversees the timely and accurate completion and submission of all third-party cost reports and other reimbursement reports or correspondence which may be required by third-party payors and/or government agencies.
• Oversees all interactions with Medicare Administrative Contractors and other payors, including audit management, settlement reviews, and appeal strategies, ensuring optimal financial outcomes and defensible positions.
• Directs the research and accumulation of data for filing of formal appeals, re-opening requests, exception requests to rates or payment methodologies to support the Geisinger's position on governmental and third-party regulations.
• Ensures compliance with all applicable federal and state reimbursement regulations, including CMS rules, Medicare/Medicaid payment methodologies, and related billing and documentation requirements across hospital, professional, and academic entities.
• Provides strategic and technical guidance on graduate medical education reimbursement, including modeling, affiliation agreements, and compliance with CMS resident cap regulations.
• Serves as a strategic advisor in evaluating proposed regulatory and legislative changes, partnering with Government Relations to influence policy through data-driven analysis, formal comment letters, and industry engagement.
• Builds and develops a high-performing team through strategic talent management, succession planning, and a culture of accountability, continuous improvement, and cross-functional collaboration.
• Champions the adoption and optimization of reimbursement and revenue analytics technologies, including automation tools and advanced modeling platforms, to improve accuracy, efficiency, and scalability.
• Provides subject matter expertise on reimbursement and revenue recognition implications for mergers, acquisitions, affiliations, and new business models, including due diligence, integration planning, and pro forma financial impact analysis.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Education

Bachelor's Degree- (Required), Master's Degree- (Preferred)

Experience

Minimum of 8 years-Finance (Required), Minimum of 5 years-Managerial/Supervisory (Required)

Skills

Teamwork; Organizing; Healthcare Industry; Computer Literacy; Communication; Analytical Thinking

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Our Vision & Values

Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.

KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.

EXCELLENCE: We treasure colleagues who humbly strive for excellence.

LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.

INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.

SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.