Vanderbilt Univ Medical Center - Nashville, TN

posted 5 months ago

Full-time - Mid Level
Remote - Nashville, TN

About the position

Vanderbilt University Medical Center (VUMC) is seeking a Compliance Operations-Billing expert to provide leadership in specialized legal, regulatory, compliance, or technological skills and training. This role involves analyzing and evaluating compliance systems, requirements, data, and processes to identify compliance risks. The successful candidate will assist in the development and implementation of mechanisms to monitor and reduce these risks while providing timely and effective education and remediation. The position is critical in ensuring that VUMC adheres to external requirements and internal policies, thereby safeguarding the institution against potential vulnerabilities to audits by health oversight agencies and contractors. In this role, the individual will evaluate and lead others in assessing documentation, processes, and data to identify patterns, errors, and risk factors. They will manage VUMC's Compliance Risk Assessment program, recommending methods to monitor compliance risk through data analysis and assisting in the design and implementation of supporting tools such as metrics, dashboards, and reports. The candidate will also be responsible for scoping, planning, and designing subject matter review projects, leading structured review projects, and drafting reports resulting from these reviews. Continuous expansion of compliance-related legal, regulatory, and technical expertise is essential, as is the ability to research and analyze issues in response to requests from the OCCI team and other stakeholders. The position requires a proactive approach to problem-solving and the ability to communicate effectively with clinical and administrative stakeholders. The responsibilities listed are a general overview of the position, and additional duties may be assigned as necessary. This role is integral to the mission of VUMC, which is to advance health and wellness through preeminent programs in patient care, education, and research.

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.
  • Assists in managing VUMC's Compliance Risk Assessment program and recommends methods to monitor compliance risk via data analysis.
  • Recommends and assists in the scoping, planning, and design of subject matter review and clinician focused review projects.
  • Leads and performs subject matter reviews and analyses related to areas of specialization and assists in drafting OCCI reports.
  • Continuously expands compliance related legal, regulatory, and technical expertise related to area(s) of specialization.
  • Researches and analyzes issues in response to requests for assistance from the OCCI team and other VUMC stakeholders.

Requirements

  • Bachelor's degree required.
  • 7 years of relevant work experience in compliance, legal, or regulatory fields.
  • Advanced knowledge of regulatory compliance and ability to apply it in complex situations.
  • Expertise in data procurement and metadata analysis.

Nice-to-haves

  • Experience in healthcare compliance and regulatory frameworks.
  • Familiarity with quality and performance improvement methodologies.

Benefits

  • Professional growth opportunities
  • Comprehensive health insurance
  • Retirement savings plan
  • Paid time off and holidays
  • Supportive work environment
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