Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jeff Sandman

Director Of Reimbursement- California Association Of Health Facilities
Folsom,CA

Summary

Proven leader in healthcare reimbursement and financial auditing, with a distinguished career at the Department of Health Care Services. Excelled in enhancing statewide operational efficiencies through expert application of Medicare and Medicaid compliance and critical thinking. Demonstrated exceptional teamwork and collaboration, driving significant improvements in provider relations and Medicaid regulations. Results-driven Director of Reimbursement experienced in financial statement review, auditing and reporting, with strong relationships with government officials at both the state and federal levels

Overview

40
40
years of professional experience

Work History

Director of Reimbursement

California Association of Health Facilities
02.2015 - Current


  • Designed and maintained financial models to identify and measure risks.
  • Participated in industry conferences and educational events to stay current on emerging trends affecting healthcare reimbursement strategies.
  • Coordinated with other departments, such as finance and legal, to address cross-functional issues related to healthcare reimbursement.
  • Provided expert guidance on complex reimbursement issues, serving as a valuable resource for internal teams and external partners alike.
  • Enhanced revenue growth by implementing effective reimbursement strategies and streamlining processes.
  • Facilitated strong relationships with payers through ongoing communication efforts, fostering collaboration around common goals.
  • Collaborated with stakeholders to establish departmental goals, driving alignment and revenue optimization across the organization .
  • Reviewed proposed changes in regulations or legislation pertaining to healthcare reimbursement, assessing potential impacts on organizational operations.
  • Collaborated with C-level executives and stakeholders to develop long-term financial plans.
  • Analyzed business processes to identify cost savings and operational efficiencies.

Chief Financial Audits Branch DHCS

Department of Health Care Services
01.2011 - 02.2015
  • Self-motivated, with a strong sense of personal responsibility.
  • Excellent communication skills, both verbal and written.
  • Proven ability to learn quickly and adapt to new situations.
  • Skilled at working independently and collaboratively in a team environment.
  • Passionate about learning and committed to continual improvement.
  • Managed time efficiently in order to complete all tasks within deadlines.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Worked effectively in fast-paced environments.
  • Worked flexible hours across night, weekend, and holiday shifts.
  • Adaptable and proficient in learning new concepts quickly and efficiently.
  • Resolved problems, improved operations and provided exceptional service.
  • Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
  • Participated in team projects, demonstrating an ability to work collaboratively and effectively.

Health Program Audit Manager

Department of Health Care Services
01.2000 - 01.2011

Facilitated internal audits and prepared detailed reports on findings.

  • Improved client relations by maintaining open lines of communication and addressing concerns promptly.
  • Managed a team of auditors, ensuring accurate and timely completion of audit projects.
  • Provided valuable insights to senior management on potential business risks identified during audits.
  • Conducted regular training sessions for audit staff, increasing their knowledge and skillset in the field.
  • Evaluated effectiveness of internal controls by testing key controls across various business units within the organization.
  • Implemented risk-based auditing strategies, resulting in better identification of potential issues.
  • Consistently met deadlines for audit reports, helping maintain company reputation for reliability and professionalism.
  • Mentored junior auditors, aiding in their professional development and fostering a positive work environment.
  • Coordinated, managed and implemented auditing projects and prepared for evaluation.
  • Developed comprehensive audit plans outlining scope, goals, timelines, and resource requirements for each project.
  • Participated in fraud investigations, gathering evidence to support legal proceedings when necessary.
  • Led cross-functional teams in complex audits, ensuring seamless collaboration between departments.
  • Cultivated mutually beneficial relationships with clients and company financial officers to facilitate improved business operations.
  • Developed and maintained productive relationships with clients to facilitate smooth audit processes and ensure compliance.
  • Facilitated knowledge sharing sessions on best practices in auditing, raising overall competency of audit department.
  • Spearheaded initiatives to stay ahead of regulatory changes, ensuring organization remained compliant with new standards.
  • Negotiated with clients to define audit scopes and objectives, ensuring clear expectations and deliverables.
  • Led team of junior auditors, fostering their professional growth and ensuring high standards of audit performance.
  • Oversaw successful completion of numerous audit projects, consistently meeting deadlines and quality benchmarks.
  • Contributed to development of audit software tools, significantly improving audit process.
  • Delivered comprehensive audit reports that clearly communicated findings and recommendations to senior management.
  • Pioneered use of data analytics in audits, enhancing detection of irregularities and fraud.
  • Cooperated with senior leaders to create operating budgets and initiate financial planning.
  • Developed financial models to assess and analyze financial performance of clients.

Health Program Auditor IV

Department of Health Care Services
01.1992 - 01.2000
  • Supported continuous improvement initiatives, monitoring progress on implemented audit recommendations over time.
  • Streamlined internal processes for increased productivity by implementing effective audit recommendations.
  • Assisted in the development of more efficient internal controls through thorough evaluation of existing procedures.
  • Developed customized audit plans tailored to each organization''s unique needs, taking into consideration industry-specific requirements and best practices.
  • Collaborated with cross-functional teams to ensure seamless integration between different departments throughout the auditing process.
  • Boosted overall program performance with targeted audits focused on specific areas of concern.
  • Facilitated timely corrective actions, promptly reporting significant audit findings to relevant stakeholders.
  • Maintained up-to-date knowledge on changes in regulatory frameworks and industry standards, ensuring that audit methodologies remained current and effective in addressing emerging risks.
  • Improved program efficiency by conducting comprehensive audits and identifying areas for improvement.
  • Strengthened interdepartmental collaboration, sharing audit findings and best practices across multiple teams.
  • Increased transparency in program operations, establishing a clear audit trail for future reference and analysis.
  • Optimized resource allocation, evaluating programs'' effectiveness in meeting strategic goals and objectives.
  • Delivered high-quality audit reports, presenting complex information in a clear and concise manner for easy interpretation by non-auditor stakeholders.
  • Communicated with auditee staff to obtain necessary information for audits.
  • Planned and executed follow-up audits at appropriate intervals.
  • Identified control gaps in processes, procedures and systems through in-depth research and assessment and suggested methods for improvement.
  • Interviewed auditees to gather data needed to conduct audits.
  • Interpreted state and federal laws, accepted auditing principles and procedures and program standards to audited materials and data to detect non-compliance and facilitate recommendations.
  • Prepared working papers, reports and supporting documentation for audit findings.
  • Developed financial models to assess and analyze financial performance of clients.

Health Program Auditor 3

Department of Health Care Services
06.1984 - 01.1990
  • Collaborated with cross-functional teams to ensure seamless integration between different departments throughout the auditing process.
  • Assisted in the development of more efficient internal controls through thorough evaluation of existing procedures.
  • Mitigated financial risks by thoroughly reviewing program expenditures and budget allocations.
  • Reduced operational costs by identifying inefficiencies in program management and suggesting cost-saving measures during audits.

Education

Bachelor of Science - Professional Accountancy

California State University Long Beach
Long Beach, CA
05.2001 -

Skills

Provider Relations

Medicare Compliance

Medicaid Regulations

Managed care contracting

Healthcare Reimbursement

Teamwork and Collaboration

Customer Service

Problem-Solving

Multitasking

Financial analysis and reporting

Relationship building and management

Critical Thinking

Timeline

Director of Reimbursement

California Association of Health Facilities
02.2015 - Current

Chief Financial Audits Branch DHCS

Department of Health Care Services
01.2011 - 02.2015

Bachelor of Science - Professional Accountancy

California State University Long Beach
05.2001 -

Health Program Audit Manager

Department of Health Care Services
01.2000 - 01.2011

Health Program Auditor IV

Department of Health Care Services
01.1992 - 01.2000

Health Program Auditor 3

Department of Health Care Services
06.1984 - 01.1990
Jeff SandmanDirector Of Reimbursement- California Association Of Health Facilities