Cost Report Audit Director

Role Snapshot
Our Cost Report Director leads a team of several direct reports with 60 or so indirect reports in our Government Health Administrator line of business which focuses on Medicare contracts. In this critical management role, they will be leading teams to ensure all contractual requirements are met for Medicare provider cost report audit and reimbursement activities within approved Centers for Medicare & Medicaid Services (CMS) funding levels. They are accountable to ensure the appropriate amount of reimbursement to approved providers of health care under the Medicare Program through the cost report settlement processes. This Director is responsible for reporting monthly metrics to CMS and coordinating all external reviews of the business area.

Salary Range
$125,000 ~ $145,000

The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.

We are open to remote work in the following approved states:
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin

How do I know this opportunity is right for me? If you:

• Possess strong leadership skills and ability to recognize and develop strong leadership skills in others.
• Enjoy leading, motivating, and inspiring high-performing teams, fostering an environment of trust, collaboration, and accountability.
• Have planned, directed, and controlled the Audit & Reimbursement activities within an identified MAC jurisdiction.
• Can develop the annual Audit Plan (CMS deliverable) for the applicable MAC jurisdiction.
• Can coordinate department hospital workload by assigning cost reports based on risk factors.
• Enjoy monitoring the completion of audits, desk reviews, cost report accepts, tentative settlements, final settlements, and interim rate reviews.
• Would like to complete Audit Monthly Status Reports, IER and metric reporting for the applicable CMS jurisdiction.
• Like to coordinate with external reviews including CMS QASP and QCP, SSAE 18, ISO, and Internal Audit and implement corrective action plans as necessary.
• Can monitor department productivity measurements, desktop analytics and workload/process efficiencies.
• Have maintained awareness of constantly changing Medicare regulations.

What will I gain from this role?

• Working for a MAC that is viewed by its customer as a thought leader.
• Ability to impact the Medicare program through innovations and process improvements.
• Working in a continuous performance feedback environment.
• Experience working for a government contractor that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries.

Minimum Qualifications

• Bachelor's Degree in Accounting or related field or equivalent experience.
• 5 or more years of progressively responsible Medicare Cost Report Audit and Reimbursement experience.
• 3 or more years of experience in a leadership role directing Medicare Cost Report Audit or Reimbursement activities.
• Extensive knowledge and understanding of Medicare laws, regulations and Government Auditing Standards (GAS).
• Strong leadership and team-building capabilities.
• Ability to identify, prioritize and drive work efforts that result in more efficient operations through innovation or process improvement.
• Proficiency in Microsoft Office (i.e., Teams, Outlook, Word, Excel)

Preferred Qualifications

• 10 or more years of cost report audit and reimbursement experience.
• 5 or more years as a supervisor/manager of Medicare Cost Report Audit or Reimbursement.
• Experience working for a Medicare Administrative Contractor (MAC).
• Proven experience in building strong collaborative teams in a dynamic culture.
• Experience in identifying efficiency gaps and implementing process improvement solutions to correct those gaps.

Remote Work Requirements

• Wired (ethernet cable) internet connection from your router to your computer
• High speed cable or fiber internet
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)
• Please review Remote Worker FAQs for additional information

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional benefits: (https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml)

Who We Are

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture Drives Our Success

WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.

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*This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.