Sr. Cost Accountant

Sr. Cost Accountant – Confluence Health

Overview

Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members.

Salary Range: $39.33 - $61.57

Benefits

• Medical, Dental & Vision Insurance
• Flexible Spending Accounts & Health Saving Accounts
• CH Wellness Program
• Paid Time Off
• Generous Retirement Plans
• Life Insurance
• Long-Term Disability
• Gym Membership Discount
• Tuition Reimbursement
• Employee Assistance Program
• Adoption Assistance
• Shift Differential

Summary

The Sr Cost Accountant is responsible for supporting the CFO, VP of Finance, and Director of Finance analyzing and managing cost structures across clinical services, departments, and facilities. The ideal candidate will bring deep knowledge of healthcare cost accounting, regulatory requirements, and financial reporting to support strategic decision-making and operational efficiency.

Position

Reports To:

Accounting Supervisor

Essential Functions

• Develop and maintain cost accounting models for healthcare services, procedures, and departments.
• Analyze cost trends and variances across inpatient, outpatient, and ancillary services.
• Collaborate with clinical and operational leaders to identify cost‑saving opportunities and improve resource utilization.
• Support service line profitability analysis and cost benchmarking.
• Ensure compliance with healthcare regulations, reimbursement policies, and internal controls.
• Assist in the preparation of Medicare and Medicaid cost reports and other regulatory filings.
• Participate in budgeting and forecasting processes, providing cost insights and recommendations.
• Maintain accurate records of inventory, supplies, and capital expenditures.
• Prepare detailed reports and presentations for senior leadership.
• Performs other duties as assigned

Demonstrate standards of behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Qualifications – Required

• Bachelor’s Degree in Accounting, Finance or related field.
• 5+ years of cost accounting experience in a healthcare environment (hospital, clinic, or health system).
• Strong understanding of GAAP and cost accounting principles.
• Strong understanding of healthcare reimbursement models, cost reporting, and regulatory compliance.
• Ability to work cross‑functionally and manage multiple priorities in a fast‑paced environment.
• Excellent analytical, communication, and problem‑solving skills.
• Proficiency in ERP systems and advanced Excel skills.
• Familiarity with DRG, RVU, and other healthcare costing methodologies.
• Knowledge of value‑based care and population health financial models.
• Ability to work independently and manage multiple priorities

Desired Qualifications

• Experience with Axiom software and healthcare financial systems.
• CPA/CPA Candidate/CMA/CHFP.

Physical/Sensory Demands

O = Occasional, represents 1 to 25% or up to 30 minutes in a 2 hour workday.

F = Frequent, represents 26 to 50% or up to 1 hour of a 2 hour workday.

C = Continuous, represents 51% to 100% or up to 2 hours of a 2 hour workday.

Physical/Sensory Demands for This Position

• Walking - F
• Sitting/Standing - F
• Reaching:
  Shoulder Height - F
• Reaching:
  Above shoulder height - O
• Reaching:
  Below shoulder height - F
• Climbing - O
• Pulling/Pushing: 25 pounds or less - O
• Pulling/Pushing: 25 pounds to 50 pounds - O
• Pulling/Pushing:
  Over 50 pounds - O
• Lifting: 25 pounds or less - O
• Lifting: 25 pounds to 50 pounds - O
• Lifting:
  Over 50 pounds - O
• Carrying: 25 pounds or less - O
• Carrying: 25 pounds to 50 pounds - O
• Carrying:
  Over 50 pounds - O
• Crawling/Kneeling - O
• Bending/Stooping/Crouching - O
• Twisting/Turning - F
• Repetitive Movements - F

Working Conditions

• Not Specified.

Job Classification

• FLSA:
  Exempt
• Hourly/Salary:
  Salary

Physical Exposures for This Position

• Unprotected Heights - No
• Heat - No
• Cold - No
• Mechanical Hazards - No
• Hazardous Substances - No
• Blood Borne Pathogens Exposure Potential - No
• Lighting - No
• Noise - No
• Ionizing/Non-Ionizing Radiation - No
• Infectious Diseases - No

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