Description du poste
VISN 5 is recruiting for two complementary positions. The GS-15 Business Implementation Manager oversees VISN-wide business operations, including billing, revenue, eligibility, enrollment, Community Care, compliance, audits, and process improvement. The GS-14 Access Operations Director/Clinic Practice Management Lead oversees scheduling, clinic templates, consult workflows, capacity, and access improvement. Together, these roles support efficient, coordinated, Veteran-centered care.
PRINCIPALES MISSIONS :
Major duties include, but are not limited to: Oversees billing, revenue, eligibility, enrollment, and other Business Office functions. Coordinates Community Care business processes, compliance, audits, and operational improvements. Supports access and scheduling improvement efforts and supervises business operations staff. Review Business Office performance, revenue, billing, and insurance-data issues across facilities. Work with CPAC and facility leaders to resolve billing, collections, or business-process problems. Check eligibility, enrollment, registration, travel, and Community Care administrative issues. Review audits or compliance concerns, brief executives, and direct business-process improvements. Assign work and address staffing or performance issues for business operations teams. Manage all aspects of VISN Business Office operations, including the accurate capture and verification of veterans' insurance data, pre-registration, pre-admission certifications, and collaboration with VISN CMO on Community Care/CCN activities. Apply analytical, evaluative, developmental and advisory skills toward recommending improvements, action plans, contracts and other vehicles to accomplish work. Lead implementation, monitoring, and performance improvement activities associated with national and VISN initiatives (example, scheduling optimization programs, capacity management projects, and related transformational healthcare delivery models in conjunction with the subject matter experts. Collaborate with facility leadership, Health Service Areas, clinical operations, workforce management officials, and national program offices to identify barriers to access, develop corrective action plans, and implement sustainable process improvements. Collaborate with managers, Chiefs of Staff, physicians, healthcare providers, and compliance officers to ensure adherence to guidelines and requirements Conduct concurrent and retrospective analyses and audits of medical records; report results to appropriate committees with recommendations and follow-up actions. Exercise delegated authority on behalf of senior management to perform investigations, audits, and fact-finding, including actions requested by OIG, OSC, OMI, the Secretary of Veterans Affairs, White House inquiry teams, and Members of Congress. Oversee billing for co-payments and pharmacy co-payments; manage third-party recoveries (including tort and Office of Workers' Compensation Program cases), humanitarian and ineligible claims, personal violence claims, collection bills, and sharing/resource agreements (e.g., CCN, NextGEN CCN, TRICARE). Serve as VISN spokesperson regarding VHA billing/collections with federal departments, agencies, Congressional staff, Veterans Service Organizations, insurers, and other stakeholders; negotiate and coordinate policies and procedures to protect VISN revenue generation. Develop and direct local policies, procedures, and guidelines to achieve revenue collection goals and objectives. Communicate and educate veterans, VSOs, and community organizations regarding Business Office functions and the impact of regulatory/legislative changes; foster cooperation to support legitimate recovery of funds. Resolve work problems presented by site liaisons and team leads; evaluate subordinate positions; hear and resolve group grievances and serious employee complaints. Coordinate multiple types of work requiring distinct bodies of knowledge; provide both technical and ad