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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 diverse 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 recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and 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.

Organization:

Compliance Operations-Billing

Job Summary:

JOB SUMMARY

Provides expert leadership in specialized legal, regulatory, compliance or technological skills and training to analyze and evaluate compliance systems, requirements, data and processes, identify compliance risk, assist in the development and implementation of mechanisms to monitor and reduce risk, and provide timely and effective education and remediation.

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KEY RESPONSIBILITIES

• Evaluates and leads others in the evaluation of external requirements and internal policies, documentation, processes and data to identify patterns, errors and risk factors, assess potential areas of noncompliance and pinpoint institutional vulnerability to audit by health oversight agencies and contractors

• Assists in managing VUMC's Compliance Risk Assessment program. Evaluates and recommends methods to monitor VUMC's compliance risk via data analysis and assists with design, development, and implementation of supporting tools (e.g., metrics, dashboards, reports).

• Recommends and assists in the scoping, planning, and design of subject matter review and clinician focused (structured) review projects. Leads and performs subject matter reviews and analyses related to areas of specialization and assists in the drafting, editing and finalization of OCCI reports resulting from completed reviews. Participates in the planning and attends subject matter review entrance and exit conferences as appropriate.

• Continuously expands compliance related legal, regulatory, and technical expertise related to area(s) of specialization. Keeps abreast of issues and changes within area(s) of expertise that affect services offered by VUMC.

• Researches and analyzes issues in response to requests for assistance from the OCCI team and from other VUMC stakeholders. Provides education and guidance to VUMC clinical and administrative stakeholders. Independently assesses a requested project and provides a complete report/plan by working with stakeholders within desired timeframe.

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

TECHNICAL CAPABILITIES

• Regulatory Compliance (Advanced): 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.

• Improvement Methodology (Advanced): Lead teams in quality and performance improvement methodology, including facilitating opportunity analysis, key driver diagrams, performance measure requirements, and PDSA improvement cycles (EA, FMEA, CTQ)

• Data Procurement (Advanced): Seeking, collecting, transforming, and ensuring quality of data.

• Metadata Analysis (Advanced): Demonstrates the uppermost levels of expertise in data analysis and interpretation. Works with teams and organization stakeholders to identify new, innovative methods and tools for incorporation into data analysis practices. Is able to design a complex logical data or object model. Is knowledgeable of enterprise-wide data and object models and can identify areas of reuse. Possesses expert knowledge in the use of CASE tools. Can recommend extensions to a data dictionary or repository to support data analysis. Can specify how data should be transformed for new uses such as data warehousing.

• Strategic Planning (Advanced): The ability to define a strategy, or direction, and making decisions on allocating its resources.

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: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in. Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others. Breadth of Knowledge: Has in-depth level of knowledge within a professional area and working knowledge of other areas. Team Interaction: May lead mid-sized projects; coaches and guides team members.

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Service: - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them. - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation: - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

7 years

Education:

Bachelor's (Required)

Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled