Director Cost Reports DSH - Medicare Bad Debt - UCA

The Director, Cost Reports serves as a senior, clientfacing leader and subjectmatter expert in Medicare cost reporting, with deep specialization in Disproportionate Share Hospital (DSH), Medicare Bad Debt, and Uncompensated Care (UCA). This role blends advanced technical expertise with consultative leadership, team development, and strategic influence across client engagements, internal operations, and product and sales partnerships.

The Director is responsible for leading complex reimbursement engagements, guiding clients through regulatory and audit complexity, and developing the next generation of reimbursement experts through structured training, mentoring, and knowledge sharing.

Impact you will make

• Act as a trusted advisor to hospital and health system clients, providing authoritative guidance on Medicare cost reporting and reimbursement optimization
• Drive consistent, compliant, and highquality delivery across DSH, Bad Debt, and UCA engagements
• Coordinate reimbursement knowledge and best practices across, operations, sales, product, and customer success teams
• Translate regulatory complexity into actionable strategies for clients and internal teams
• Build a highperforming reimbursement team by investing in coaching, mentoring, and formalized training
• Influence organizational strategy through insights derived from regulatory research, client outcomes, and market trends

What you will do

Client Advisory & Consulting Leadership

• Serve as a senior consulting leader for Medicare cost report, DSH, UCA, and Medicare Bad Debt engagements
• Advise clients on regulatory compliance, audit risk, reopening opportunities, and reimbursement optimization strategies
• Lead complex client discussions, including audit preparation, appeal strategy, and executivelevel presentations
• Provide yearoveryear analysis of client results to identify trends, risks, and revenue opportunities
• Leverage industry credibility to deliver trusted, defensible guidance aligned with CMS rules and best practices

Regulatory Expertise & Thought Leadership

• Monitor CMS and industry communications for changes impacting Medicare Bad Debt, DSH, UCA, and cost reporting
• Research and interpret regulatory updates, auditor guidance, and policy changes
• Translate regulatory changes into internal guidance, client advisories, and delivery standards
• Partner with leadership to assess the strategic impact of regulatory changes on service offerings and company direction

Cross-Functional Collaboration

• Work closely with Finance to inform revenue forecasting and financial strategy, leveraging cost report results, audit insights, and regulatory changes to improve forecast accuracy and risk visibility.
• Partner with Sales to support prospect education, opportunity identification, and solution positioning
• Collaborate with Product and Technology teams to ensure reimbursement solutions align with regulatory requirements and market needs
• Work with Customer Success to identify compliance gaps, develop remediation strategies, and improve client outcomes
• Provide strategic insights to leadership to inform roadmap, pricing, and service development decisions

Cost Report Production & Audit Team Management

• Direct and oversee cost report production and audit support teams across multiple concurrent engagements
• Establish delivery standards, timelines, quality controls, and review protocols for Medicare cost reports
• Manage and balance team workloads to ensure timely filings, audit readiness, and sustained performance
• Review and approve complex cost reports, workpapers, and audit submissions prior to filing
• Lead audit preparation, audit response activities, and coordination with CMS, MACs, and state agencies
• Identify and implement process improvements that increase efficiency, accuracy, and scalability
• Directly manage and coach managers, and senior reimbursement professionals
• Establish performance expectations and conduct regular performance reviews and development planning
• Identify staffing needs, participate in hiring and onboarding, and support succession planning
• Design and deliver structured training programs related to DSH, Medicare Bad Debt, UCA, and cost reporting
• Mentor team members to build both technical expertise and consultative leadership skills
• Foster a culture of accountability, continuous improvement, and professional growth

What you will bring

• 15+ years of experience in Medicare reimbursement, cost reporting, or healthcare finance
• Deep expertise in DSH, Medicare Bad Debt, UCA, and Medicare cost report preparation
• Proven ability to interpret and apply CMS regulations in complex, realworld scenarios
• Strong analytical and problemsolving skills with exceptional attention to detail
• Demonstrated success in clientfacing advisory or consulting roles
• Experience training, mentoring, and developing Cost Report
• Ability to explain complex regulatory concepts clearly to both technical and nontechnical audiences
• Executivelevel presentation and facilitation skills
• Confidence operating as a subjectmatter authority and escalation point
• Advanced proficiency in Microsoft Excel and reimbursement analysis tools
• Ability to work independently while collaborating across functions in a fastpaced consulting environment
• Willingness to travel up to 50%, based on client and project needs

What we would like to see

• Bachelor's degree in healthcare administration, Finance, Accounting, or a related field preferred.
• Experience working within a hospital or health system environment
• Exposure to EHR platforms such as Epic, Cerner, Meditech, or McKesson
• Prior experience in consulting, MAC environments, or reimbursement outsourcing models

About FinThrive

FinThrive is advancing the healthcare economy.

For the most recent information on FinThrive's vision for healthcare revenue management visit finthrive.com/why-finthrive.

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Our Perks and Benefits

FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits. For the most up-to-date offerings visit finthrive.com/careers-benefits.

FinThrive's Core Values and Expectations

• Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive's core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities
• Support FinThrive's Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to FinThrive's business practices; this includes becoming familiar with FinThrive's Code of Ethics, attending training as required, notifying management or FinThrive's Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

Physical Demands

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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