Hospice CAP Consultant
At Maxwell TEC, we design technology that adapts to the real world of care at home—streamlining workflows, supporting clinicians, and keeping patients at the center.
Our team boasts unparalleled expertise in all facets of EMR systems, analytical software, and tech-enabled care solutions. Maxwell TEC applies this knowledge to guide home health, hospice, and home care providers through every phase of their technology journey—from selecting the right tools to ensuring successful implementation, adoption, and ongoing support.
OUR VALUES
Empathy
We leverage our care-at-home expertise to develop technology that enhances connection, support, and quality of care — enabling organizations with compassionate and efficient patient-centric solutions.
Collaboration
We believe in working closely with our partners, clients, and team members to create customized solutions that deliver meaningful results.
Empowerment
We harness the power of innovation to enable care-at-home organizations to thrive, focusing on tools that simplify processes and improve outcomes.
Ingenuity
We cultivate forward-thinking solutions that redefine care at home, leveraging technology and creativity to drive customer-centric progress.
Agility
We embrace change and proactively adapt to industry shifts, ensuring our clients stay ahead in delivering exceptional care.
DESCRIPTION
Maxwell TEC is seeking an experienced Hospice CAP Consultant to support hospice clients with Medicare hospice aggregate CAP calculations, projections, financial analysis, and ongoing CAP management.
This independent contractor role is ideal for a hospice financial analyst, revenue cycle analyst, CFO/controller, reimbursement specialist, or compliance leader with strong financial depth and hands-on hospice operations knowledge. The consultant will partner with client leadership teams to review CAP exposure, analyze PS&R reports and related financial data, evaluate billing and census trends, and provide practical recommendations to support real-time decision-making.
This role requires more than historical Medicare reporting knowledge. The ideal consultant understands that hospice CAP is an active financial and operational management issue that requires accurate projections, reliable data, strong reconciliation processes, and timely communication with leadership.
Key Responsibilities
The Hospice CAP Consultant may assist with:
- Reviewing and assessing current hospice CAP calculation, tracking, reporting, and monitoring processes.
- Analyzing Medicare hospice aggregate CAP exposure using PS&R reports, beneficiary count reports, billing data, claims activity, census trends, remittance data, EMR data, and other client-provided financial reports.
- Building, reviewing, or validating Excel-based CAP projection models.
- Supporting monthly or periodic CAP forecasting, variance analysis, and financial reporting.
- Identifying key drivers of CAP risk, including admission trends, length of stay, billing lag, claims adjustments, revenue patterns, high-risk patient mix, and beneficiary count methodology.
- Reconciling PS&R data against internal billing, claims, remittance, census, revenue cycle, and general ledger data when applicable.
- Reviewing claims, revenue, and reimbursement trends to help clients understand current and projected CAP position.
- Providing financial planning and analysis support related to hospice CAP exposure, reimbursement risk, and operational decision-making.
- Supporting preparation, review, and documentation for self-determined hospice aggregate CAP reporting.
- Reviewing internal controls, reporting processes, and data workflows related to CAP monitoring and financial reporting.
- Identifying opportunities to improve reporting accuracy, timeliness, documentation, compliance readiness, and leadership visibility.
- Collaborating with finance, accounting, billing, revenue cycle, compliance, clinical operations, and executive leadership teams.
- Translating complex financial, reimbursement, and regulatory data into clear summaries, dashboards, reports, and actionable recommendations.
- Supporting audit, survey, MAC, or other documentation needs related to hospice CAP and Medicare reimbursement.
- Serving as a subject matter resource on hospice CAP, PS&R reports, Medicare hospice billing, reimbursement trends, and related regulatory considerations.
REQUIRED
- Minimum of 5+ years of hospice experience with meaningful exposure to finance, revenue cycle, reimbursement, compliance, or operations.
- Demonstrated expertise in Medicare hospice aggregate CAP calculations and CAP management.
- Strong working knowledge of PS&R reports, including how PS&R data is used in hospice CAP reporting, reconciliation, and projection analysis.
- Advanced Excel skills, including financial modeling, formulas, pivot tables, lookups, data validation, variance analysis, and scenario planning.
- Strong financial analysis skills with the ability to evaluate trends, identify drivers, and forecast potential risk.
- Strong understanding of hospice Medicare billing, claims processing, remittance activity, revenue cycle workflows, and reimbursement-related reporting.
- Familiarity with CMS regulations, MAC requirements, hospice CAP deadlines, Medicare hospice billing rules, and hospice compliance expectations.
- Ability to evaluate financial and operational data, identify risk areas, and provide practical recommendations.
- Ability to review reporting processes and identify gaps in data accuracy, internal controls, or system workflows.
- Strong communication skills with the ability to explain complex financial and reimbursement concepts clearly to executive, finance, billing, compliance, and operations teams.
- High attention to detail and ability to work independently in a project-based consulting environment.
- Ability to maintain confidentiality and handle sensitive financial, operational, and patient-related information appropriately.
- Ability to operate as an independent contractor and meet Maxwell TEC contractor requirements, which may include maintaining an active business entity and appropriate insurance coverage.
PREFERRED
- Prior experience as a hospice financial analyst, revenue cycle analyst, reimbursement analyst, CFO, controller, compliance director, finance manager, or hospice CAP consultant.
- Experience preparing, reviewing, or supporting self-determined hospice aggregate CAP reports.
- Experience with hospice cost reporting, MCReF, PEPPER, MAC audits, reimbursement reviews, or claims-based financial reporting.
- Experience with claims forecasting, financial projections, accrual review, month-end reporting, or reimbursement variance analysis.
- Familiarity with hospice EMR and billing platforms such as Homecare Homebase, WellSky, MatrixCare, Netsmart, or similar systems.
- Experience creating dashboards, financial reports, CAP monitoring tools, or recurring leadership reporting packages.
- Experience reviewing system changes, reporting logic, or data workflows that impact reimbursement, claims reporting, or financial projections.
- CPA, MBA, accounting, finance, healthcare administration, or related degree preferred but not required.
- Prior consulting or project-based experience.
Ideal Candidate Profile
The ideal candidate is a rare blend of hospice financial analyst, reimbursement expert, operator, and compliance-minded advisor. This person understands Medicare hospice CAP not just as an annual report, but as a real-time financial and operational management issue.
They are comfortable reviewing detailed data, working through PS&R reports, building Excel models, identifying reimbursement risk, analyzing financial trends, and helping client teams understand what the numbers mean. They can communicate clearly with finance, accounting, billing, revenue cycle, compliance, operations, and executive leaders while keeping recommendations practical and grounded in hospice operations.
This person is analytical, detail-oriented, collaborative, and able to turn complex Medicare reimbursement data into clear next steps for clients.
JOB TYPE: Independent Contractor
WORK STRUCTURE: Project-based; hours may vary based on client needs
LOCATION: Remote, with potential travel depending on client engagement needs
Pay: $65.00 - $85.00 per hour
Benefits:
Work Location: Remote
