Senior Manager Cost Accounting

POSITION SUMMARY:

Reporting to the Senior Director, Decision Support, the Cost Accounting Senior Manager provides strategic financial and analytical leadership for the development, governance, and ongoing application of cost accounting and profitability analytics across Boston Medical Center Health System (BMCHS). This job operates with significant autonomy and general supervision, and is responsible for ensuring that cost, margin, and profitability information is accurate, actionable, and aligned with organizational priorities. The Senior Manager exercises direct supervision over a Cost Accounting Analyst while partnering closely with Finance, Operations, Revenue Cycle, Supply Chain, Pharmacy, Accounting, Reimbursement, Clinical Leadership, and Strategy functions across the enterprise. The work of this role directly supports executive decision-making, financial planning, reimbursement strategy, service line performance management, and long-term organizational sustainability.

Position: Senior Manager Cost Accounting

Department: Perform Mgmt & Decision Support

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Leads enterprise cost accounting activities across hospitals, physician organizations, ambulatory operations, and corporate functions, including the integration of new organizations into the clinical cost accounting framework, ensuring consistency and rigor across all entities. (20% of time)

• Serves as the enterprise subject matter expert in healthcare costing methodologies, profitability analytics, and financial performance measurement; designs and leads costing improvement initiatives that generate deeper insights into margin performance and organizational opportunity areas. (15% of time)

• Conducts root-cause analysis of cost, margin, and profitability variances across service lines, sites, and operational units; translates findings into clear, actionable recommendations for operations and organizational leadership. (15% of time)

• Translates complex financial and operational data into executive-ready insights, briefings, and presentations for senior leadership, Finance Committee, executive leadership, and Board audiences on a recurring and ad hoc basis. (10% of time)

• Develops and maintains service line profitability, contribution margin, and operating margin reporting in partnership with Service Line Finance team members, ensuring timely delivery and analytical accuracy. (10% of time)

• Manages, mentors, and develops Cost Accounting analyst by setting clear performance expectations, providing regular coaching, and fostering a culture of analytical rigor, continuous improvement, accountability, and service orientation. (10% of time)

• Establishes and maintains reporting standards and internal controls that ensure the accuracy, transparency, and consistency of cost and profitability information across the organization; develops benchmarking capabilities to evaluate cost performance against internal and external peers. (10% of time)

• Supports strategic planning efforts in collaboration with Strategy, Finance, and Operations leaders to evaluate growth opportunities, service line expansion, physician recruitment, ROI analyses, business cases, scenario modeling for government advocacy, and capital investment decisions. (5% of time)

• Partners with Revenue Cycle, Reimbursement, and Managed Care teams to assess financial performance by payer, service line, and site of care; provides analytical support for payer contracting, reimbursement initiatives, and strategic pricing scenario development. (5% of time)

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required)

JOB REQUIREMENTS

REQUIRED EDUCATION AND EXPERIENCE:

• Bachelor's degree in Accounting, Finance, Healthcare Administration, Economics, Business Analytics, or a related field, and seven (7) or more years of progressive experience in healthcare finance, cost accounting, reimbursement, decision support, financial analytics, consulting, or a related field; or equivalent combination of education and experience.

PREFERRED EDUCATION AND EXPERIENCE:

• Master's degree in a relevant field. Experience with Strata EPSi Cost Accounting, Tableau, Power BI, SQL, Epic, Workday, Oracle, or similar healthcare analytics platforms preferred.

• Experience leading analytical teams and providing financial decision support in a complex, multi-entity healthcare environment.

KNOWLEDGE, SKILLS & ABILITIES (KSAs):

• Knowledge of healthcare cost accounting methodologies, including standard costing, relative value unit (RVU)-based allocation, and activity-based costing.

• Knowledge of healthcare reimbursement structures, payer contracting mechanics, and service line profitability drivers.

• Skill in applying financial modeling and variance analysis techniques to cost, margin, and profitability data in a healthcare setting.

• Skill in translating complex financial and operational data into structured, audience-appropriate reports and presentations for executive and Board-level stakeholders.

• Skill in leading, developing, and performance-managing analytical staff across multiple levels.

• Ability to manage multiple high-complexity projects concurrently while maintaining accuracy, prioritization, and delivery timelines.

• Ability to partner across Finance, Operations, Revenue Cycle, and Clinical Leadership functions to align cost information with strategic and operational objectives.

Compensation Range:

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. 

NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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