Manager of Reimbursement Strategy, Analysis and Forecasting

Job Description

Job Description

Manager of Reimbursement Strategy, Analysis and Forecasting

• Salary Range: $89,648 - $107578 based on relevant years of experience
• Location: Larimer county, Colorado
• Status: (example full time, 40 hours per week)
• Hours: Monday-Friday

Role Overview:

The Manager of Reimbursement Strategy, Analysis, and Forecasting is a strategic leadership role responsible for data-driven insight, aligning the organization’s operational oversight related to payer reimbursement, revenue modeling, and financial performance. This role is essential to maximizing the organization’s understanding of and responsiveness to evolving reimbursement models, including Medicaid, commercial, grant-funded, and value-based arrangements, and ensures effective participation in risk-based and prospective payment systems. This position plays a key role in analyzing payment methodologies, forecasting revenue, and developing financial strategies that ensure sustainability and support the mission of delivering high-quality behavioral health services. The position works closely with Finance, Clinical Operations, Revenue Cycle, and Executive Leadership to integrate reimbursement intelligence into budgeting, forecasting, and decision-making processes.

Essential Duties:

• Reimbursement Strategy and Analysis
  • Serve as the organization’s lead expert on payer reimbursement, including prospective payment systems (PPS), capitation, fee-for-service, and value-based care models.
  • Monitor regulatory and legislative activity affecting Medicaid policy and analyze the financial impact of current and proposed payment methodologies and recommend organizational responses.
  • Support contract negotiation and program development with reimbursement modeling and revenue projections.

• Financial Planning and Forecasting

  • Lead multi-year revenue forecasting and financial planning processes, incorporating reimbursement trends and payer dynamics.
  • Integrate cost, volume, and payment data into comprehensive program financial plans.

• Decision Support and Revenue Modeling

  • Design and maintain financial models and dashboards to inform leadership on the financial impact of reimbursement policies, service mix, and operational performance.
  • Provide scenario planning for new payer models, rate changes, or policy shifts.
  • Evaluate financial risk and return associated with entering into new reimbursement arrangements, pilots, or strategic partnerships.

• Cross-Functional Collaboration and Leadership

  • Work closely with the CFO, Executive and Senior Leadership Teams to align financial planning with organizational goals and funding environment.
  • Communicate complex financial information and reimbursement issues clearly to non-financial stakeholders.

• Stakeholder Engagement and Advocacy

  • Liaise with state Medicaid agencies, managed care organizations, associations (e.g., CBHC), and external consultants on payment model developments.
  • Monitor regulatory and legislative activity affecting behavioral health reimbursement and recommend organizational responses.

Required:

• Bachelor’s degree in accounting, Finance, Analytics, Economics, or a related field (or equivalent experience); master’s degree or CHFP certification preferred.
• Minimum 7 years of progressive experience in healthcare finance, reimbursement analysis, or payer contracting; behavioral health or Medicaid focus preferred.
• Strong knowledge of healthcare reimbursement models, financial forecasting, and planning tools.
• Proficient in financial modeling, Excel, and business intelligence platforms (e.g., Power BI).
• Exceptional analytical, communication, and leadership skills.

Preferred Qualifications:

• Experience in community mental health, FQHCs, or safety-net healthcare systems; familiarity with Colorado Medicaid and behavioral health integration strongly preferred.
• Proven ability to communicate complex financial concepts to executives and external stakeholders.
• Demonstrated success in strategic planning, project management, and cross-functional collaboration.
• Skilled in proactive problem-solving, service-oriented communication, and driving continuous improvement.
• Experience in fast-paced, policy-driven environments; consulting or multi-site healthcare systems experience a plus.
• Bilingual/bi-cultural preferred

Total Rewards

At SummitStone Health Partners we are proud to offer a competitive and competitive benefit package to support the wellbeing of our teams. Visit our website for more information about Total Rewards.

Reach Out

SummitStone will provide persons with disabilities with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or selection process, please let your recruiter know.

Questions? Please email us at hiring@summitstonehealth.org.

This position will be open for a minimum of three days and/or until a top candidate is identified.