Supervisor, CMS Programs - Remote - Nationwide at Vituity in Sacramento, California

Job Description:

Remote, Nationwide - Seeking Supervisor, CMS Programs

Everybody Has A Role To Play In Transforming Healthcare

At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare's most pressing challenges from the inside.

Join the Vituity Team. At Vituity we've cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call "culture of brilliance." Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.

Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

The Opportunity

• With support from the Director of Coding Compliance & Revenue Integrity, responsible for scheduling, monitoring, and reviewing production of the Revenue Integrity & CMS Programs Department.
• Conduct routing and/or focused internal audits of policy/procedure adherence as well as coordinating audits generated by external sources (CMS).
• Coordinate evaluations for measure specific coding application and make recommendations as needed.
• Complete analysis and communicate trends in errors or documentation concerns to the Director of Coding Compliance & Revenue Integrity.
• Participate in industry-related webinars and/or other conference calls as needed and summarize information for team and for education awareness messaging.
• Offer recommendations for CMS programs enhancement.
• Monitor activities of team members; provide feedback and counsel team members regarding performance.
• Ensure compliance with local, state, and federal government requirements.
• Assist with department tasks as needed.
• Research and develop Merit-Based Incentive Payment System (MIPS)/Qualified Clinical Data Registry (QCDR) guidelines and methodology, including coder and client reference materials:


• New practice lines and/or services.
• New MIPS/QCDR codes.
• Assist in evaluating MIPS/QCDR measure information and applying periodic updates to reference materials.
• Clarify current code application and methodology of MIPS/QCDR measures as needed.
• Evaluate application and/or assist in development of MIPS/QCDR measures.
• Evaluate payor guidelines or manual changes and make recommended policy changes.
• Participate in operational calls on behalf of Coding Compliance & Revenue Integrity as assigned.
• Assist with development of guidelines and methodology for capturing other quality measure data.
• Act as a steward by exhibiting sound ethical standards and consistently promoting a compliant culture.
• Lead and participate in Compliance Team Projects and initiatives when requested.
• Participate in enterprise activities and industry meetings or conferences to help foster relationships with other departments and industry colleagues and network amongst peers.
• Develop expertise and perform research in coding or compliance subjects and issues when requested.
• May be asked to travel for business purposes, not exceeding 5%.

Required Experience and Competencies

• High school diploma or GED equivalent required.
• Four (4) years' minimum coding experience, or equivalent, to be able to apply correct CPT and ICD-10-CM codes in accordance with Federal, State, and private payer statute and regulations required.
• Certified Procedural Coder (CPC) certification, or equivalent, and/or Certified in Healthcare Compliance (CHC) certification highly desired.
• Experience in the application of CMS Quality Program measures highly desired.
• Basic knowledge of pathology and etiology of disease, body areas, and organ systems.
• Knowledge of CPT and ICD-10-CM coding practices and/or knowledge of Medicare/Medicaid billing practices and appeal process.
• Excellent communication and interpersonal skills, including conflict resolution.
• Ability to communicate effectively in writing and verbally.
• Computer skills including Microsoft Office Suite (Word, Excel, Outlook), with intermediate Excel and Word knowledge.
• Ability to review literature and come to conclusions and make recommendations to management.
• Ability to analyze new or ambiguous information, define the issue or problem and propose resolution.
• Strong organizational skills and ability to meet deadlines.
• Ability to handle a fast-paced, high production environment.
• Strong consultation skills and the ability to seek out information and provide quality advice.
• Strong research skills with ability to apply complex reasoning and analysis to identify best policy proposal or interpretation.
• Ability to work independently, accomplish responsibilities timely, monitor the team's productivity requirements to ensure appropriate workflow.
• Ability to maintain effective working relationships with all staff.
  Ability to react to change productively.

The Community

Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.

• Monthly wellness events and programs such as yoga, HIIT classes, and more
• Trainings to help support and advance your professional growth
• Team building activities such as virtual scavenger hunts and holiday celebrations
• Flexible work hours
• Opportunities to attend Vituity community events including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more

Benefits & Beyond*

Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
• Outstanding Paid Time Off: 3-4 weeks' vacation, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP, travel assistance, and identify theft included
• Wellness program
• Vituity community initiatives including LGBTQ+ History, Dia de los Muertos Celebration, Money Management/Money Relationship, and more
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees

We are excited to share the base salary range for this position is $69,520 - $86,900, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company's annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details.

We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.

Vituity appreciates differences; our dedication to diversity, equity and inclusion is at the heart of our organization. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.

*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.

Applicants only. No agencies please.