This position is located in the Business Office. The site Business Office Manager is responsible for overseeing the operations for intake, billing and collections, HIMS, revenue, utilization review and claims administration (Fee Section) at the Tennessee Valley Healthcare System (TVHS). The incumbent will provide direct staff support to top management and maintain an expert knowledge of VHA policies in all matters involving this program.

Duties

The incumbent is responsible for the development, implementation, integration, standardization and maintenance of the TVHS Business Office, as well as all aspects of the Systems efforts for maximizing alternative revenue generation from sources to include third party insurance billings, TriCare billings, sharing agreements, first party billings, tort claims, workers' compensation claims, contracting services and other revenue generating services. The core duties of this position include but are not limited to: Plans, organizes, and directs the ongoing development of all functions of the sections within the Business Office. Serves as business manager for TVHS and is involved in the development of overall management objectives and the operating philosophies necessary to attain the ultimate effectiveness in providing medical care for veterans served by TVHS. Prepares extensive analyses and reports on business performance against established parameters. Develops both long and short-range policies and plans for the organization by coordinating the Business Office needs. Directs the utilization of the Business Office financial and staff resources. Provides leadership in all areas of patient administration such as the application process, entitlement issues, admission and discharges, compensation/pension examinations, fee basis activities, transportation, etc. Designs strategies to manage and integrate functions to improve and maximize efficiencies. Designs mechanisms to accurately capture data and obtain maximum reimbursement from first and third parties. Directs efforts to reach collection goals using all available resources and develops programs to effectively manage patient accounts, identify potential billables, maximize collections, and ensure a sound database. Analyzes and aggregates information from various complex data sources both internally and externally to VA. Work Schedule: Monday Friday | 7:30 AM - 4 PM CST Telework: AD-HOC available Virtual: This is not a virtual position. Position Description/PD#: Program Management Officer (Business Office)/PD073130 Relocation/Recruitment Incentives: Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not Required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 01/19/2024. Applicants must meet each of the following requirements: Time-in-Grade and Specialized Experience. These are separate requirements. INTERCHANGE AGREEMENT: Applications will be accepted for this position under the Interchange Agreement as outlined in VA Handbook 5005, Part III, Appendix C. This agreement allows for the movement of Title 38 and Title 38 hybrid personnel, who have at least 1 year of full-time continuous service, to apply for competitive service positions. OPM 90 Day Waiting Period: OPM requires that all current permanent federal employees serve 90 days after their competitive selection in their current Title V position prior to moving to another position. TIME-IN-GRADE REQUIREMENT: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-14 position you must have served 52 weeks at the GS-13. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Examples of appropriate SF-50s include: Within grade increases at the highest grade held; or Promotions with an effective date more than one year old; or SF-50s at the highest grade held with an effective date more than one year old. Award 50s do not provide sufficient information and will not be accepted for the purpose of verifying time-in-grade. In addition to the Time-in-Grade Requirement, applicants must also possess the Specialized Experience as described below. GS-14 SPECIALIZED EXPERIENCE: You must have one year of specialized experience equivalent to at least the next lower grade GS-133 in the normal line of progression for the occupation in the organization. Qualifying specialized experience is defined as: Possessing management experience in the area of healthcare administration for a medical center, experience providing oversight of several program areas that support the mission of the medical center; supervisory healthcare experience interpreting and implementing programs to support patient care services. Using qualitative and/or quantitative methods for improvement of program effectiveness or the documented improvement of complex management processes and systems. Preparing extensive analyses and reports on business performance against established parameters. Developing policies and procedures relative to the various sections of the Business Office, ensuring compliance with VA Headquarters, VA Regional Office and the VISN. Analyzing and aggregating information from various complex data sources both internally and externally to VA. Directing efforts to reach collection goals using all available resources and developing programs to effectively manage patient accounts, identify potential billables, maximize collections, and ensure a sound database. You will be rated on the following Competencies for this position: Administration and ManagementCreativity and InnovationExternal AwarenessLeadershipPlanning and EvaluatingExperience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. PHYSICAL REQUIREMENTS: The work is primarily sedentary. There is walking, bending and reaching required such as for filing or locating material, and carrying items such as reports, documents, and supplies. Entering data and word processing on a personal computer may result in physical problems from the effects of repetitive motion and eyestrain. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

There is no educational substitution at this grade level.

Contacts

• Address Tennessee Valley HCS - Nashville 1310 24th Avenue South Nashville, TN 37212 US
• Name: Caitlin Clabough
• Email: [email protected]