Director, Business Office Services - Revenue Cycle
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. It is a place where your diversity — of culture, thinking, learning and leading — 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.
This position is responsible for providing management and oversight for the Central Business Office within the VUMC Revenue Cycle (departments listed below). Responsibilities include planning, developing, implementing, and operating a structure of centralized and consolidated management of accounts receivable for the system. This includes the revenue cycle activities of all technical and professional billing, billing follow-up and collection functions, for all payers. This position works to appropriately integrate, facilitate best practices, achieve efficiencies and align with the revenue cycle's finance key performing indicators (KPIs) with the organization's financial service and human resources goals while maintaining compliance and regulatory standards are operating within the rules and regulations applicable to the Departments.
Key Functions and Expected Performances:
Responsible for management and oversight of the following Departments/functions/processes:
Billing (Hospital Billing-HB and Professional Billing-PB)
Billing Follow-up (HB and PB)
Cash posting and reconciliation
Transplant Billing/Follow-up (HB and PB)
Transplant Financial Counseling
Vendor Management for CBO vendors
Productivity, Quality and Budget Management
CBO Employee Engagement
Success in managing responsible functions will be measured by the following metrics:
Accounts Receivable quality/compliance
Accounts Receivable Days
Accounts Receivable Days >90
Recover Workqueue Inventory
Vendor Performance per contract
Partner with Associate Vice President of Revenue Cycle to develop strategic direction and goals for areas of responsibility to help achieve Vanderbilt's strategic and Pillar goals
Work collaboratively with other Patient Access Revenue Cycle management areas (Patient Financial Services, CHIM, Patient Access) to ensure needs of the organization are being met. May require traveling to the respective locations on a periodic basis to provide visibility of the CBO.
Develop, implement, and monitor appropriate and measurable CBO performance metrics and goals along with comparison to industry benchmarks including EPIC top performers. Identify opportunities for improvement and develop, plan, and implement strategies for successful execution
Communicate proactively, appropriately and effectively to AVP, Revenue Cycle Executive, Administration, Medical Staff, and others the pertinent information related to areas managed
Work collaboratively with the Office of Healthcare Compliance (OHC) and the Office of Legal Affairs (OLA) to ensure that the organization maintains compliance with all relevant regulatory requirements; participate in Compliance/OLA meetings and projects as requested and be visible and responsible to the OHC and OLA with respect to CBO matters
Work collaboratively with the Office of Internal Audit on audits of CBO functions, and be responsible for implementing any approved management action plans applicable to the CBO
Ensure that the organization maintains a high level of integrity through comprehensive understanding of regulatory and accreditation standards including Medicare, Medicaid, and commercial and contracted insurance billing procedures, regulations, and contracts
Stay abreast of new developments in areas of responsibility and proposes use of new processes or use of technology when appropriate and cost effective
Contribute to Epic stabilization and optimization to enhance system performance Create, maintain, and enforce written CBO related policies and procedures
Assist with preparations for the Joint Commission survey process
Ensure there are internal controls for areas managed
Manage contractual relationships with third party vendors that are integral to the success of the CBO including negotiate new vendor statements of work (SOWs), monitor vendor productivity and quality performance, communicate with vendors
Develop departmental budgets for staffing, operations, and capital resources; manage actual costs to budget; proactively address any unfavorable budget variances;
Work collaboratively with the Revenue Integrity and Reimbursement departments on issues pertaining to provider payer enrollment and any Medicare Administrative Contractor and CMS notifications and reporting required
Represent Vanderbilt University Medical Center, if needed, in a matter of patient account litigation
Contribute prior academic medical center experience towards continually improving the Vanderbilt experience
VUMC Recent Accomplishments:
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
US News & World Report: #1 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center ), 12 adult and 10 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
Truven Health Analytics: among the top 50 cardiovascular hospitals in the U.S.
Becker's Hospital Review: one of the "100 Greatest Hospitals in America"
The Leapfrog Group: grade "A" in Hospital Safety Score
National Institutes of Health: among the top 10 grant awardees for medical research in the US
Magnet Recognition Program: Vanderbilt nurses are the only group honored in Middle Tennessee
Nashville Business Journal: Middle Tennessee's healthiest employer
American Hospital Association: among the 100 "Most Wired" medical systems in the US
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.
Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties.
Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disea...se.
As the largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.
Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.