Program Manager - Director - CPAC

Cpac Director

* THIS IS NOT A VIRTUAL OR REMOTE POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*

This position is the CPAC Director, responsible for overseeing and implementing the Consolidated Patient Account Center (CPAC) in a VISN or VISNs. CPACs cover several VISNs in providing oversight of a full spectrum of complex billing and collection processes that has a critical impact on the revenue management operating programs. This position is responsible for managing the Pre-Registration, Insurance Verification, Billing and Collections, Revenue, Utilization Review, First iteration appeals and precertification requirements for the CPAC Customer Service Program.

This position also coordinates responsibility and training for intake of patients, coding, fee, and 2nd and 3rd iteration appeals with facility management. In addition to the business functions mentioned above, this position will provide CPAC staff leadership in the management of program information technology, human resource management, third party payer compliance, staff training and education. The incumbent is responsible for the development, implementation, integration, standardization and maintenance of the Business Office, as well as all aspects of the network's efforts for maximizing revenue from sources to include third party insurance billings, Tri Care billings, sharing agreements, first party billings, Tort Feasor, and Workers Compensation Claims from veteran patients.

Revenue generated is critical to providing quality health care for Veterans served and is expected to be around 10% of the total operating budget annually. The position provides direct staff support to top management, CPAC staff, and staff within all facilities and maintains an expert knowledge of VHA policies in all matters involving this program. The CPAC Director is responsible for the overall management and oversight responsibilities for managing a consolidated business unit consisting of capturing insurance information, pre-registration, verification of insurance data with Veterans and private sector insurers, pre-admission certifications, utilization review, billing, collections, customer service, cash management and performance reporting.

This position also encompasses pharmacy copayments, and first and third party billings, Tort Feasors, Workers Compensation cases for veteran patients, Humanitarian, Ineligible Claims, Personal Violence Claims; and Sharing Resource Agreements, such as CHAMPVA and Tri Care. The CPAC Director manages and reviews all activities for billing, auditing, collecting and follow-up for all of the above. The incumbent works, in conjunction with medical center management to establish procedures and accountability for the intake of patients.

• Evaluate the performance of senior managers and supervisors in a health care revenue organization.
• Presents statistical reports and special analysis to management committees for recommendations and follow-up action.
• Establish clear accounting and administrative procedures for the operation of the health care revenue program.
• Serves as primary strategist, resolving conflicts or disputes with insurance companies or beneficiaries, which may jeopardize revenue generation.
• Establish and modify performance measures for both programs and employees.
• Consult with executive managers of health care programs internally & externally to resolve complex issues.
• Other related duties as assigned.

Work Schedule:

Monday
- Friday; 8:00 am - 4:30 pm

Compressed/Flexible:
May be available at supervisor's discretion

Telework:
This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Virtual:
This is not a virtual position.

Position Description/PD#:
Program Manager
- Director - CPAC/ PD98057A and PD98057A

Relocation/Recruitment

Incentives:

Not authorized

Critical Skills Incentive (CSI):
Not approved

Permanent Change of Station (PCS):
Not authorized