Under the supervision and direction of the Chief Financial Officer, the incumbent prepares, submits, and monitors the operating budget, cost reports, and monthly financial analysis reports, assists in budget preparation, and apprises the Chief Financial Officer (CFO) of the current and projected financial status of the regional centers. In a multi-facility skilled nursing organization, the Budget and Cost Manager often serves as the financial partner to regional and facility leadership, helping balance quality care, regulatory compliance, and profitability. This position may require working beyond normal working hours and on weekends and holidays when necessary. 

• Oversees and directs staff in the review of invoices for ancillary services, to assure invoice accuracy and that billing reflects costs being incurred.
• Supervises a variety of personnel, including but not limited to Accounts Payable and Payroll Department, Purchasing, Receiving, Billing, and Accounts Receivable Departments.
• Advises the CFO of the current and projected costs status of the Regional Centers and prepares a quarterly financial statement covering all the Regional Centers' accounts; assists with audits and financial reviews.
• Serves as chief of staff in organizing and coordinating staff meetings and work projects within the fiscal department, and monitors assignments delegated by the CFO to Accounts Payable, Payroll, Purchasing, Billing, and other fiscal activities.
• Assists in preparation of annual operating and capital budget; analyzes and reviews operational and capital budget requests.
• Develops census, revenue, labor, and expense forecasts.
• Monitors budget performance and identifies variances.
• Delivers financial reports to executive leadership (CFO).
• Analyzes staffing patterns against census and acuity levels
• Tracks Medicare, Medicaid, Managed Care, and Private Pay reimbursement trends
• Supports CFO with Payroll Base Journal (PBJ) reporting as needed.
• Reviews purchasing practices and vendor contracts.
• Supports supply chain and procurement efforts to reduce expenses.
• Ensures budgeting processes align with company policies and accounting standards.
• Monitors adherence to spending policies and approval processes
• Assists in the preparation of compliance critical to Medicare/Medicaid cost reports.
• Prepares and analyzes expense accruals; prepares quarterly Fixed Assets Cost Reconciliation and maintains fixed asset and depreciation ledger.
• Performs other related duties as assigned by the CFO. 

• Principles and practices of financial analysis and budgeting.
• Medicare and Medicaid reimbursement. 

• Microsoft Office Suite
• Accounting and budgeting platforms.  

• Demonstrate strong communication and leadership skills.
• Work collaboratively with facility Administrators, Regional Leaders, and Executive teams.
• Make independent decisions when circumstances warrant such action.
• Move intermittently throughout the day.
• Work beyond normal working hours and on weekends and holidays when necessary.
• Communicate effectively, both orally and in writing.
• Maintain composure and maintain a positive attitude in stressful situations.
• Coordinate organized, efficient meetings and set and achieve goals.