Senior Director of Reimbursement & Policy Analysis - TAL Healthcare : Job Details

Our client, a world-class, patient-centered, integrated academic medical center, is seeking a Senior Director of Reimbursement & Policy Analysis to join their high-performing finance leadership team. This is a mission-critical role responsible for leading the strategic and operational oversight of Medicare and Medicaid cost reporting, reimbursement optimization, and health policy analysis. This leader will evaluate current and proposed CMS policies, assess their financial and operational impacts, and provide data-driven recommendations to support the financial strength of the organization. The Senior Director will manage a team of experienced professionals, ensure regulatory compliance, and serve as a key liaison with both internal stakeholders and external agencies.Responsibilities:

• Lead enterprise-wide reimbursement strategy, government policy analysis, and financial planning initiatives.
• Manage the full lifecycle of Medicare and Medicaid cost reports—including preparation, submission, audit response, and appeals.
• Serve as the organization's subject matter expert on federal and state reimbursement policies; provide timely impact assessments and strategic recommendations.
• Partner with Government Affairs to monitor legislative developments and advocate for favorable reimbursement positions.
• Ensure compliance with regulatory reporting, including ICRs, cost reports, capital budgets, IME and occupational mix surveys, and other governmental submissions.
• Collaborate with departments across Financial Operations, Budget & Planning, Managed Care, and Revenue Cycle to align financial strategies and improve data transparency.
• Represent the organization in external industry forums and discussions with regulatory agencies and healthcare associations.
• Manage internal and external audits related to reimbursement and policy compliance.
• Develop and implement team policies, procedures, and performance metrics; oversee hiring, training, and career development of reimbursement staff.
• Conduct revenue impact analyses for new programs and strategic initiatives; guide leadership in decision-making through predictive modeling and data storytelling.
• Support financial reporting accuracy through revenue budget development, rate setting, and accrual review.
• Continuously identify opportunities to enhance systems and processes through automation and cross-functional collaboration.
• Deliver executive-level communications and presentations related to financial health, policy shifts, and reimbursement projections.
• Oversee departmental planning and resource allocation, ensuring alignment with institutional goals.
• Drive process redesign and technology integration to improve efficiency and timeliness of deliverables.

Requirements:

• Bachelor's degree in Finance, Accounting, Economics, Healthcare Administration, or a related field.
• Master's degree in Health Administration (MHA), Public Health (MPH), Business Administration (MBA), Public Policy (MPP), or related field. preferred
• Demonstrated expertise in Medicare/Medicaid reimbursement methodologies and CMS regulatory frameworks.
• Strong analytical capabilities with proficiency in financial modeling, revenue forecasting, and large-scale data management.
• Exceptional written and verbal communication skills, with experience preparing materials for executive and board-level audiences.
• Proven ability to lead, mentor, and manage multidisciplinary teams.
• CPA designation strongly preferred.
• 10+ years of experience with a strong track record in reimbursement strategy and financial impact modeling.
• Deep familiarity with managed care contracting, value-based payment models, and commercial payer methodologies.
• Experience working in a large integrated health system, payer organization, or healthcare consulting firm.
• Advanced proficiency in data visualization tools and financial planning software.