Senior Director – Financial Planning

Time: 5%

1. Assist the Senior Vice President in the formulation of corporate policy and strategy with respect to third party hospital reimbursement and reporting requirements.
a. Review and evaluate internal and third party reimbursement systems and procedures; with respect to the maximization of revenue and utilization by the department.
b. Review and evaluate proposed and existing reimbursement related regulations; and perform financial analysis to determine institutional operational and financial impact.

Time: 20%

1. Supervise the development of the annual inpatient and outpatient revenue budgets. Collaborate with the Financial Analysis Manager, Regulatory Reimbursement Manager, patient accounts staff and Hospital Administration to ensure the projections are prepared timely, accurately and reflect appropriate estimates of volume and current reimbursement methodologies.
2. Review any refinements made to the revenue budget models by the Financial Analysis Manager or Regulatory Reimbursement Manager to ensure they properly address current operations and reimbursement methodologies.
3. Monitor revenue and third party reimbursement monthly to ensure inpatient and outpatient hospital revenue is recorded appropriately. Oversee the team’s activity to ensure that all monthly analyses are prepared timely and distributed to users. Evaluate and adjust the accruals as needed to reflect current information regarding corporate revenue policies, reimbursement, government filings, audit results, and contingencies. Report on the revenue variances at the monthly financial statement meetings.
4. Review and analyze governmental reimbursement rates and communicate with the respective agencies of errors and methodological alternatives.
5. Prepare year end analyses of rate accounts and hospital technical revenue used by external auditors during their audit procedures. Discuss and understand any noted issues. Evaluate the financial impact of any audit adjustments. Follow-up as necessary and summarize and discuss all issue with VP. Prepare financial statement disclosures regarding third party revenue and rate accounts.
6. Interact extensively with colleagues throughout the hospital to ensure information needed to monitor revenue operations is both provided and obtained as needed. Oversee needed refinements to the revenue variance and metrics reports to be responsive to the changing needs of department administrators and Hospital Administration.
7. Oversee the monitoring of the financial aspects of the hospital’s charge description master (CDM). This work is performed in collaboration with the managed care team to ensure the prices on the CDM are in line with the terms of the contract. Review analyses prepared to determine the impact of billing changes on Hospital finances for reasonableness and accuracy. Oversee the annual charge increase approval process.

Time: 20%

1. Evaluate the financial feasibility of new hospital programs and facilities through the development of financial projection models that are easily adaptable when plans and assumptions are changed. Oversee the work on these models as they are revised for new data. Work with Hospital Administration and Facilities in the preparation of presentations to the Joint Finance and Funding Committee on new hospital related projects.
2. Oversee the preparation of the financial sections of the Certificate of Need applications which consist of revenue and expense projections, funding projections, cash flow projections and statistical information. Coordinate efforts with the Regulatory Affairs department to ensure applications contain all necessary financial information. Respond as needed to financial questions from the New York State Department of Health. Attend meetings with representatives of the Department of Health when needed to address concerns related to projects.
3. Oversee the hospital portion of the cash flow projections which incorporate existing facilities and projections for all new programs and facilities. Ensure the models reflect current assumptions and data. Evaluate the reasonableness of the results and revisit assumptions when needed. Participate in the presentation of the hospital cash flow projections to senior management and individual members of the Joint Finance and Funding Committee.

Time: 25%

1. Supervise the annual preparation of the Medicare Cost Report and the New York State Institutional Cost Report. Complete the financial sections of the reports. Review all aspects of the final reports for reasonableness and accuracy. Oversee final filings to ensure complete and timely. Review tentative settlements received for accuracy.
2. Oversee the filing of the Medicare enrollment and provider based attestation packages for all existing and new locations. Review packages for accuracy and completeness. Formulate responses to subsequent questions and requests received.
3. Oversee the annual filing of the patient care research rate agreement with the Department of Health and Human Services. Work with the Office of Clinical Trials and department administrators to ensure the agreement is properly implemented.
4. Coordinate the responses to surveys received directly from outside agencies or the providing of requested data to others within the Institution preparing survey responses. Supervise staff to ensure that responses are made within the appropriate time frame such as quarterly (bond disclosure) and annually (AHA, NYS Community Service Plan, and NYS Dept. of Health). Monitor and evaluate staff’s work on these surveys to ensure that data is properly disseminated.

Time: 20%

1. Oversee the audit of the Medicare Cost Report. Interact with audit team throughout the audit to ensure that the audit progresses to completion. Coordinate the work of team and other departments (Accounting, GME office, Hospital Administration) within the Hospital, as needed, to obtained needed information for the auditors. Review responses with team to audit requests for accuracy and reasonableness before submission. Provide updates to VP on status of audit and arising issues. Formulate responses to key issues and confer with legal counsel when needed. Review final proposed audit adjustments and exceptions with VP. Evaluate final settlements received for accuracy.
2. Manage the preparation of the Medicare TEFRA appeals and the appeals of protested audit adjustments which could generate $5 to $20 million in additional revenue each rate year once settlements are reached. Participate in meetings with Hospital Administration to obtain support for clinical reasons for changes from base year costs. Collaborate with the legal specialist preparing the draft of the appeals to ensure all areas differing from the base period have been addressed and include the appropriate supporting data. Supervise team members preparing the supporting financial analyses for both the TEFRA appeals and the protested audit adjustment amounts. Work with external legal counsel in the preparation of the final drafts of the appeal documents. Review documents before submission for accuracy and reasonableness. Monitor the status of all open rate appeals, which can total over $150 million at any given time, and applications. Work with legal counsel as needed to prepare follow-up documents needed to advance the appeals through the regulatory process. When needed, develop proposals for potential settlements of open appeal issues. Provide VP with financial evaluation of proposed settlements. When needed, participate in the preparation for hearings related to TEFRA appeals. Attend meetings with internal clinical staff and legal counsel in preparing for testimony before the Provider Reimbursement Review Board.
3. Supervise the audits performed by the New York State Department of Health. Audits are performed on the New York State Institutional Cost Report and Medicaid Disproportionate Share Hospital Payments. Review the input prepared by the team into the online tool utilized by the state to complete the audits. Evaluate responses to follow-up audit questions and requests depending on whether the audit is a desk audit or site audit. Coordinate parties needed to attend meetings for site audits. Provide updates to VP on status of audits and findings. Formulate responses to findings.
4. Represent the Finance Department during the New York State Healthcare Reform Act Performance audit. Prepare reconciliation of data being used for audit to the audited financial statements. Participate in audit status meetings. Collaborate with the patient accounts team and other departments as needed to address auditors’ requests and findings. Keep senior management informed of significant issues and findings.

Time: 5%

1.Participate in the Business Analytics committee of the Alliance for Dedicated Cancer Centers. The ADCC works extensively to preserve and enhance the PPS-Exemption which ensures the hospital receives comparable reimbursement when compared to PPS hospitals. Without the exemption, hospital reimbursement would decrease by over $150 million. Prepare financial analyses to support the work of the Legislative and Executive committees.
2.Chair the cost report subcommittee which involves coordinating monthly meetings and the activities of the group. The group provides data analysis related to Medicare reimbursement and shares best practices. The committee is responsible for the financial analysis of the impact of proposed legislation on hospital reimbursement.
3.Function as the bookkeeper for the Alliance of Dedicated Cancer Centers. Process all invoices for payment and track receivable balances from other members. Bill other members semi-annually for their share of the costs of operating the group.

Time: 5%

1. Attend meetings of the Joint Finance and Funding Committee. Prepare the performance metric report presented at the meeting. Share the responsibility of preparation of the minutes of the meeting with the Director, Cost and Budgets. Attended other board committee meetings, when requested, including the Joint Audit committee.
2. Provide assistance to the Decision Support Department, Compliance Office, the Strategic Planning Department and other departments, as needed. Ensure that the requests for data and analyses are prepared in a timely manner. Delegate the work to the appropriate staff member of the Financial Planning Department.
3. Perform all other duties and responsibilities as established by the Vice President. This includes but is not limited to assuming administrative responsibility for staff of the financial analysis group. Advise the Vice President of the status of all departmental activities and issues. Initiate or recommend action as to hiring, transfers, promotions, terminations and other personnel actions. Advise subordinate staff of hospital and departmental policies and procedures. Discuss grievances and job problems with departmental staff, and coordinate referrals when appropriate.