Manager Reimbursement

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

The Manager, Reimbursement role is ideal for a leader with deep expertise in Medicare, Medicaid, OPPS, and reimbursement methodologies. We're looking for someone with strong knowledge of claims processing, CPT/HCPCS, and revenue codes, and how these components interact with pricing and reimbursement strategies.

Candidates with health plan experience across multiple lines of business-Commercial, SelfFunded, Medicare, and Medicaid-will thrive in this role. Strong leadership and teammanagement skills are essential, along with the ability to translate complex reimbursement structures into clear operational and financial strategies.

Some key responsibilities include:

• Monitors project work plan progress to ensure projected timelines, resources and budget guidelines are on schedule and within budget.

• Provides communications to the appropriate governance process.

• Creates, monitors, and provides required specifications to maintain service level agreements for production systems in order to meet IT standards and customer needs.

• Defines project leadership accountabilities involving clinical or financial management systems

Qualifications:

• High School and five to eight years combined experience in management of IT or equivalent experience.

• Bachelor s Degree preferred with 2-3 years of experience in management of IT or equivalent experience.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.