Dir Provider Audit & Reimbursement

The Director of Provider Audit & Reimbursement will lead strategic planning, operational performance, and team development across provider audit and reimbursement functions. This senior leadership role focuses on ensuring compliance with Medicare requirements, meeting contractual obligations, and delivering accurate, efficient, and high-quality services. You will guide experienced teams, oversee budgets and resources, and translate organizational priorities into actionable plans that drive performance and continuous improvement. Working closely with internal leaders, government agencies, healthcare institutions, and other stakeholders, you will help strengthen operational effectiveness and support evolving customer needs. This remote-eligible opportunity is ideal for an experienced Medicare audit and reimbursement professional who combines technical expertise with strong leadership, analytical thinking, and a commitment to accountability.

• Bachelor’s degree in accounting or a business-related field from an accredited institution, including at least 24 credit hours in accounting, or a Certified Public Accountant (CPA) credential, together with knowledge of Medicare laws, regulations, and Government Auditing Standards; alternatively, 15 or more years of significant management experience in Medicare audit and reimbursement.

• At least five years of Medicare Cost Report audit and reimbursement experience, including three years managing Medicare Cost Report audit or reimbursement functions, or in an equivalent role.

• Demonstrated experience building and leading teams, achieving operational goals, and maintaining efficiency and service quality.

• Strong knowledge of Medicare Cost Reporting, provider audit and reimbursement operations, and applicable regulatory and compliance requirements.

• Proven leadership, interpersonal, communication, organizational, and staff-development skills.

• Strong analytical capabilities, including the ability to interpret data, assess performance, and make informed operational decisions.

• Excellent problem-solving skills and the ability to identify risks, address audit findings, and implement effective improvements.

• Experience with strategic planning, budget oversight, resource allocation, and performance management.

• Ability to collaborate effectively with senior leaders, government agencies, healthcare organizations, and cross-functional teams.

• Understanding of HIPAA and other applicable privacy, security, and regulatory obligations.

• Preferred qualifications: CPA certification, a Master of Business Administration (MBA), and at least five years of management experience overseeing complex systems and workflows.

• Ability to work remotely from a location within one of the 50 U.S. states or the District of Columbia.

• Willingness to travel periodically for in-person management meetings, with travel of up to 25%.

• Ability to meet the role’s office-related requirements, including prolonged sitting, computer and telephone use, effective communication, and occasional lifting of up to 15 pounds.

• Depending on the position’s federal access requirements, eligibility to complete applicable identity verification, background investigation, credentialing, and access authorization processes. Federal credentials may require at least three years of U.S. residency within the previous five years.