| Manager Pharmacy Billing Discovery 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 â of culture, thinking, learning and leading â 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. Vanderbiltâs mission is to advance health and wellness through preeminent programs in patient care, education, and research. Department/Unit Summary The Department of Pharmaceutical Services provides comprehensive pharmaceutical care services to Vanderbilt University Hospital (VUH), Monroe Carell Jr. Children's Hospital at Vanderbilt (Children's Hospital), Vanderbilt Psychiatric Hospital (VPH) and The Vanderbilt Medical Group (VMG). This patient-centered service is provided through the Patient Care Center organization and clinic structure. The role of the Pharmacy is to promote safe and effective medication therapy for all patients and to provide oversight and leadership of the medication use system.
JOB SUMMARY:
Manage the retail & specialty pharmacy billing system. Monitor, maintain, & improve the billing systems, processes, databases, and pharmacy employees' performance that impact on charging patients for drugs to ensure that proper charging occurs. Work collaboratively with other VUMC staff to make sure the pharmacy computer system interacts properly with other VUMC computer systems. Is responsible for making sure that pharmacy billing procedures comply with all applicable government regulations. Work with various VUMC staff to ensure proper and adequate payments are received for drug charges.
KEY RESPONSIBILITIES:
Manages the performance of the Pharmacy's billing system for dispensed medications to ensure the accurate and timely billing of drugs to patients. Identify needed system improvements & implement such changes. Work with departmental and VUMC leadership to develop and implement new billing procedures. * Reviews and researches governmental laws, rules, and regulations that relate to billing of dispensed prescriptions on an ongoing basis. Reviews & updates appropriate policies & operating procedures. * Routinely reviews CMS websites and other payor websites to stay updated on new information and rules released on an ongoing basis. * Collaborates with Pharmacy Informatics to determine the need for and to implement software changes to the Pharmacy's computer system to comply with changes in laws, regulations and/or payor contracts. * Communicates professionally and effectively with a very wide range of staff at VUMC, and multiple diverse outside parties including computer vendor support staff, third-party payors, financial institutions and regulatory agencies. * Identifies and discusses continuing patterns of errors in the dispensing workflows with the appropriate manager for resolution. * Monitor reimbursement of Pharmacy charges to help ensure proper cash flow to VUMC. Work collaboratively across departmental lines to diagnose and resolve reimbursement problems. * Ensures that the retail billing operations follow VUMC financial policies related to revenue recognition and posting of payments & adjustments. * Responsible for all personnel management duties related to all team members that report up through the position including hiring, development (onboarding, ongoing training), scheduling (duties, work schedule, PTO, FMLA, etc.), and, when necessary, disciplinary actions. All personnel management duties must comply with VUMC policies. * Ensures that all team members have a functional knowledge of all privacy laws pertinent to the operations of the team including, but not limited to, HIPAA and PCI. * Perform financial analysis in support of departmental and VUMC leadership. Lead and/or attend meetings to present such analysis to leadership * Performs financial analysis as requested by both Pharmacy and VUMC senior leadership, particularly to assist in the budget preparation process.
VUMC Benefits: Healthcare, Dental and Vision Plan 403(B) - Retirement Plan Tuition Reimbursements Flex PTO Flexible Spending Accounts We encourage you to spend some time reviewing our site to see why Vanderbilt University Medical Center is one of the top places to work in Nashville â and the country. 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), 9 adult and 9 pediatric clinical specialties ranked among the nation's best, #15 Education and Training Truven Health Analytics: among the top 100 hospitals in the US 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 American Association for the Advancement of Science: 12 faculty members elected fellows in 2014 Magnet Recognition Program: Vanderbilt nurses are the only group honored in Tennessee Nashville Business Journal: Middle Tennessee's healthiest employer American Hospital Association: among the 100 "Most Wired" medical systems in the US
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Children's Hospital Association