Vice President, Research & Reimbursement

Tennessee Hospital Association

Brentwood, TN

Finance & Accounting , Health Care , Legal


Position Description / Responsibilities

JOB SUMMARY:

Coordinates a network of hospital and health system reimbursement specialists and provides in-depth research, support, education and advocacy around issues of healthcare reimbursement and compliance, including managed care (commercial, Medicaid, and Medicare Advantage), TennCare, workers’ compensation, payment innovations, changes and methodologies and program integrity. Creates regular educational and professional development opportunities for member hospitals related to current and emerging topics in hospital reimbursement and compliance.

ESSENTIAL FUNCTIONS OF THE JOB:

  1. Provide in-depth research, support, education and advocacy for members around issues of healthcare financing and reimbursement. Serve as a resource and respond to member queries on these issues in a timely and effective manner.
  2. Provide in-depth research, support, education and advocacy for members around healthcare compliance issues and program integrity. Provide a statewide focal point for compliance education and compliance officers. Respond to member queries on these issues.
  3. Provide analysis of hospital financial and operational impact of proposed program or regulatory changes.
  4. Must have the ability to adapt to a changing work environment and meet challenges presented throughout the day.
  5. Must be available for out-of-town travel approximately 10 percent of the time, be able to drive an automobile and maintain a valid driver’s license. Must travel both within and out of the state for various meetings as needed.


Position Requirements

Educational and Experience Requirements Needed to Perform the Duties of the Job:

Bachelor’s degree in accounting, finance or other related field required. Graduate degree in related field preferred.

-Detailed knowledge of hospital managed care—commercial, Medicare, Medicaid and workers’ compensation, including:

Reimbursement methodologies

Financial analysis

Legal/contractual issues

Reimbursement audits

Investigation and resolution of payment errors

Operational issues

Measuring contract performance

-Hospital & system operations experience desired

-General knowledge of the following as it relates to hospitals:

Accounting/auditing

Billing and collections

Healthcare compliance

Health information management

Utilization management

Quality & accrediting bodies

Managing reimbursement analysis/negotiation

Contractual language

Operationalizing financial arrangements

Identifying and resolving issues involving reimbursement, hospital operations and healthcare compliance

Building and managing relationships with managed care payers/outside entities

Licensing or Other Special Certifications Required:

Healthcare compliance certification desired

Skills Required to Perform the Duties of the Job:


Application Instructions

Please submit your resume and apply here.

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