Remote Program Evaluation Jobs in Milwaukee, WI (NOW HIRING)

Remote Reimbursement Manager

Location: Remote — Must reside in an eligible state

Employment Type: Permanent, Full-Time

Schedule: Monday–Friday, 8:00 AM–4:30 PM

Salary Range: $100,000–$145,000 annually, based on experience

Position Overview

We are seeking an experienced Remote Reimbursement Manager to join the Corporate Finance team of a large healthcare organization. This position is responsible for overseeing Medicare and Medicaid cost reporting, government reimbursement analysis, regulatory compliance, forecasting, audits, and reimbursement strategy across a multi-hospital health system.

The ideal candidate brings significant healthcare finance and reimbursement experience, strong knowledge of Medicare and Medicaid regulations, and proven leadership experience managing teams and complex reimbursement initiatives.

Required Qualifications

• 8+ years of experience in healthcare accounting and/or finance
• 8+ years of experience with Medicare and Medicaid cost reporting
• 3+ years of supervisory or management experience
• Advanced proficiency with Microsoft Excel
• Strong knowledge of healthcare reimbursement regulations and reporting requirements
• Ability to work effectively both independently and collaboratively in a remote environment

Preferred Qualifications

• Experience in healthcare reimbursement consulting
• Reimbursement experience within a multi-hospital health system
• CPA and/or MBA
• Experience managing reimbursement audits, appeals, forecasting, and regulatory changes

Key Responsibilities

Medicare & Medicaid Reimbursement

• Prepare, analyze, and review annual Medicare and Medicaid cost reports for accuracy and regulatory compliance.
• Identify opportunities to optimize reimbursement under applicable Medicare and Medicaid regulations.
• Coordinate with internal departments to ensure accurate and timely completion of Medicare and Medicaid filings.
• Maintain schedules, supporting documentation, and analysis related to cost reporting.

Regulatory Compliance & Analysis

• Monitor Medicare and Medicaid regulatory changes affecting reimbursement and cost reporting.
• Monitor changes in DRG reimbursement, including rates, weightings, indexes, cost outliers, and capital reimbursement.
• Update reimbursement models and DRG profiles as necessary.
• Identify and pursue appropriate reimbursement appeal opportunities.

Cost Reporting & Financial Analysis

• Ensure cost reports are prepared in accordance with federal and state regulations.
• Develop system-wide reimbursement and cost reports for executive leadership.
• Prepare and review Medicaid disproportionate share and other third-party reimbursement filings.
• Prepare quarterly social accountability calculations and supporting analysis.
• Perform monthly account analysis to ensure accuracy and appropriateness.

Forecasting & Strategic Planning

• Develop multi-year forecasts for government reimbursement programs.
• Analyze reimbursement trends and their potential financial impact on the organization.
• Identify opportunities to improve and streamline reimbursement processes and reporting.

Audit & Project Management

• Participate in internal and external reimbursement audits.
• Prepare documentation and analysis supporting audit activities.
• Manage reimbursement-related projects to ensure timely completion and adherence to budget.

Team Leadership

• Lead and manage reimbursement team members.
• Provide ongoing coaching, feedback, development, and performance management.
• Conduct performance evaluations and participate in hiring and workforce planning.
• Develop and implement departmental policies and procedures.
• Manage departmental expenses and ensure alignment with established budgets.

Remote Work Requirements

This position is fully remote; however, candidates must currently reside in one of the following states:

Alabama, Florida, Georgia, Iowa, Illinois, Indiana, Kentucky, Louisiana, Maine, Michigan, Missouri, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, or Wisconsin.

Company-issued laptop and necessary equipment will be provided.

Ideal Candidate

The successful candidate will be a seasoned healthcare reimbursement professional who understands the complexities of Medicare and Medicaid cost reporting and can operate effectively within a large healthcare system. This individual should be analytical, detail-oriented, organized, and comfortable managing multiple priorities while also providing strong leadership to the reimbursement team.

This is an excellent opportunity for an experienced healthcare finance professional looking for a fully remote leadership role with significant responsibility across reimbursement, regulatory compliance, forecasting, and financial strategy.