Manager of Cost Accounting

Overview

The Manager, Cost Accounting is responsible for overseeing the organization's healthcare cost accounting function and maintaining the integrity of the cost accounting model used to support financial, strategic, and regulatory decision-making. This role leads the monthly costing processes, develops and maintains cost allocation methodologies, and ensures the accurate assignment of costs across hospitals, departments, service lines, physicians, and patient populations.

The Manager, Cost Accounting serves as the organization's subject matter expert for healthcare cost accounting and is responsible for the governance, maintenance, and continuous improvement of the health system's cost accounting methodologies and systems. Reporting to the Director of Decision Support, this role collaborates closely with Financial Planning & Analysis, Revenue Cycle, Supply Chain, Operations, and Information Systems to ensure cost data accurately reflects resource utilization and organizational operations.

A key responsibility of this role is partnering with operational and clinical leaders to conduct and maintain departmental time studies and workload assessments that support RVU weighting methodologies and cost allocation models.
Job Responsibilities and Essential Functions

Cost Accounting Leadership

• Oversee the integrity, maintenance, and continuous improvement of the organization's healthcare cost accounting model.
• Manage the monthly and quarterly costing processes, including data validation, reconciliations, cost assignments, and balancing procedures.
• Develop, maintain, and document methodologies that appropriately assign direct and indirect costs across departments, patient services, physicians, procedures, and service lines.
• Establish and maintain cost allocation methodologies that reflect resource utilization and operational workflows.
• Ensure consistency with organizational accounting standards, regulatory requirements, and healthcare industry best practices.
• Lead periodic reviews and refinement of costing methodologies to reflect organizational, operational, and reimbursement changes.
• Maintain documentation of cost accounting assumptions, methodologies, controls, and governance processes.

RVU Weighting and Cost Methodology Management

• Serve as the organizational leader for Relative Value Unit (RVU) and workload-based costing methodologies.
• Partner with clinical, operational, and departmental leaders to conduct periodic time studies and workload assessments.
• Evaluate staffing models, workflow changes, and operational practices to ensure appropriate assignment of labor and indirect costs.
• Develop and maintain departmental RVU weighting methodologies used within the cost accounting system.
• Review and validate workload statistics, labor drivers, and allocation bases to ensure accurate costing outputs.
• Recommend methodology enhancements to improve the accuracy and credibility of cost information across the organization.

Cost Data Integrity and System Administration

• Serve as the primary business owner and subject matter expert for healthcare cost accounting systems and associated data structures.
• Ensure the integrity and accuracy of financial, clinical, operational, payroll, supply chain, and billing data utilized in cost accounting processes.
• Collaborate with Information Systems, Revenue Cycle, Supply Chain, and Finance teams to develop, test, and implement new data feeds and system enhancements.
• Lead quality assurance reviews and data validation processes to ensure accuracy of costing results and allocation methodologies.
• Oversee periodic audits of cost accounting data, mappings, statistics, and allocation drivers.
• Maintain system tables, departmental mappings, cost-center relationships, charge master assignments, and statistical drivers within the cost accounting platform.

Cost Analysis 

• Produce and distribute standard cost accounting outputs, including unit cost files and costing validation reports.
• Conduct analyses to identify anomalies, inaccuracies, or shifts in cost trends requiring methodology review.
• Provide technical expertise regarding costing methodologies and cost data interpretation to finance and operational stakeholders.

Leadership and Staff Management

• Manage and develop cost accounting analysts and other assigned financial staff.
• Establish clear goals, expectations, work procedures, and performance standards.
• Conduct performance evaluations and provide ongoing coaching and professional development.
• Foster a culture of accountability, continuous improvement, and technical excellence.
• Lead departmental initiatives and special projects related to cost accounting, costing methodologies, and system optimization.

Education

• Bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, Economics, or related field required.
• CPA, CMA, HFMA certification, or other relevant professional credential preferred.

Experience

• Minimum of 5-10 years of progressive healthcare finance or cost accounting experience.
• Minimum of 3 years of direct healthcare cost accounting experience required.
• Experience within a hospital, integrated health system, academic medical center, or large physician enterprise strongly preferred.
• Prior leadership or supervisory experience preferred.
• Experience administering healthcare cost accounting systems such as Strata, EPSi, HPM, or similar platforms required.
• Experience developing and maintaining RVU-based costing methodologies, time studies, and allocation statistics preferred.

Knowledge, Skills, and Abilities

• Extensive knowledge of healthcare cost accounting principles, cost allocation methodologies, and RVU-based costing models.
• Strong understanding of departmental costing, labor allocation methodologies, and overhead distribution techniques.
• Knowledge of hospital operations, physician enterprise structures, reimbursement methodologies, and healthcare financial practices.
• Experience conducting and interpreting departmental time studies and workload assessments.
• Strong understanding of healthcare data sources, including financial, payroll, supply chain, operational, clinical, and billing systems.
• Advanced analytical and problem-solving skills with the ability to evaluate large and complex datasets.
• Advanced proficiency in Microsoft Excel and database analysis tools.
• Excellent verbal and written communication skills with the ability to explain complex costing methodologies to operational and finance stakeholders.
• Demonstrated ability to build collaborative relationships with clinical leaders, operational departments, and executive leadership.
• Ability to manage multiple priorities and deadlines in a complex healthcare environment.

Preferred Healthcare Experience

• Relative Value Unit (RVU), physician practice costing, ambulatory cost accounting, and hospital service costing experience.
• Experience with labor productivity statistics, workload measurement systems, and departmental benchmarking methodologies.