Associate Director, Chargemaster Management

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

Charge Master Spvr

Job Summary:

The Associate Director for Chargemaster Management is responsible for maintaining an accurate and complete charge description master, for both hospital and professional billing, and reports to the Associate Vice President of Finance. The position will require supervision of staff in performing data analysis, periodic audits, information queries, external audits and other special projects necessary to optimize revenue generation and maintain compliance with governmental and third-party payer requirements.

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KEY RESPONSIBILITIES

• Supervises the work of staff to implement changes in the CDM

• Works with the VUMC Health IT staff to ensure all subsystems and charge capture applications are updated

• Works with Managed Care Contracting, Revenue Integrity, Revenue Cycle, and Clinical Departments to research, design and implement charge code and charge structure improvements and participate in ongoing coordination and resolution of revenue issues

• Conducts billing audits as considered necessary to rectify any potential issues with charging

• Assists Revenue Cycle in CDM related and claim problem resolutions

• Implements and maintains the EPIC EAP HB file and PB chargemaster for VUMC including annual coding updates, fee schedule adjustments and shell code designs for supplies and pharmacy

• Follows instructions provided by senior leadership by carrying out assigned activities to promote an updated and compliant CDM for the capture of services, pharmaceuticals and supplies

• Performs queries of data to assist in the resolution of billing and coding questions

• Provides education on procedures to maintain charge and reconciliation processes that are compliant

• Performs timely updates of the chargemaster in alignment with regulatory guidance

• Mentors and trains new staff on learning clinical and billing system workflows and daily tasks related to the management of the chargemaster

• Manages and performs all daily activities performed by the chargemaster specialist role to ensure requests for new charges and regulatory updates are completed accurately and timely

• Supervises and monitors changes to regulatory requirements for the entire patient revenue cycle (i.e., CMS bulletins, transmittals, etc.) and updates the chargemaster timely

• Performs queries of data to assist in the resolution of CDM related billing and coding questions

• The responsibilities listed are a general overview of the position and additional duties may be assigned

TECHNICAL CAPABILITIES

• REVENUE CYCLE (INTERMEDIATE): Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

• REGULATORY COMPLIANCE (INTERMEDIATE): Demonstrates knowledge of the appropriate rules and regulations and apply them in difficult, stressful and complex situations. Able to interpret and explain rules and regulations that are ambiguous or unclear. Directs others in interpreting rules and regulations on the job and trains others in them.

• PROBLEM SOLVING (EXPERT): Uses critical thinking and process improvement i.e. coaches and mentors development of problem statement, describes current state, identifies root causes, creates future state, coaches and mentors development of solutions and action plans with a sustainability plan. Applies appropriate tools to address issues.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

* Organizational Impact: Establishes key tactical and operational plans of a sub-function or multiple departments that has longer-term effect on results of the sub-function. * Problem Solving/ Complexity of work: Integrate knowledge and in-depth analysis from several areas to resolve complex problems that are both technical and operational. * Breadth of Knowledge: Applies comprehensive knowledge of professional/technical area and broad management knowledge of other professional areas to carry out objectives. * Team Interaction: Leads multiple departments with a function.

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Acts upon constructive feedback from all levels of the organization and initiates strategies to develop talent in others. - Builds and Maintains Relationships: Leverages relationships and insight to forecast potential future needs and influence delivery of work to exceed expectations. - Communicates Effectively: Anticipates difference audience concerns, styles and finds mutually beneficial solutions across conflicting and sensitive issues. Delivering Excellent Services: - Serves Others with Compassion: Demonstrates in-depth knowledge of broad-based issues and considers the interests of others to improve satisfaction of services. - Solves Complex Problems: Critically evaluates complex information and identifies trends/risks to make recommendations to improve processes across areas. - Offers Meaningful Advice and Support: Provides ongoing feedback and development discussions to motivate and support team members to maximize performance.Ensuring High Quality: - Performs Excellent Work: Anticipates problems or obstacles which may interfere with quality standards and develops plants to ensure area's quality standards are met. - Ensures Continuous Improvement: Routinely draws upon valuable learning from others, past experiences, and new information to determine key opportunities. - Fulfills Safety and Regulatory Requirements: Develops appropriate corrective actions for unsafe environments in order to ensure operational and safety compliance. Managing Resources Effectively: - Demonstrates Accountability: Identifies potential obstacles to goal achievement and develops solutions to address those obstacles. - Stewards Organizational Resources: Creates the appropriate systems and processes to effectively manage resources. - Makes Data Driven Decisions: Applies in-depth knowledge of data to recommend and implement new approaches to improve decision making capabilities. Fostering Innovation: - Generates New Ideas: Identifies opportunities and leads development of new initiatives that create value across areas. - Applies Technology: Creates the energy and drive for self/others to identify and leverage technology in new, innovative ways to drive greater efficiencies. - Adapts to Change: Anticipates the change process and clearly communicates impact on others/own team(s), assisting them in embracing the change.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

5 years

Education:

Bachelor's (Required)

This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth.

Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity.  EOE/Vets/Disabled.