Dir Administrative Simplification Policy

Job Details

Description

The American Hospital Association (AHA) is a national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. We are currently seeking a Director, Administrative Simplification for our Policy department in Washington, DC or our Chicago office.

POSITION PURPOSE
The Director, Administrative Simplification Policy, provides strategic direction, guidance, and oversight for the AHA on administrative simplification policy issues associated with the transaction standards enumerated in the Health Insurance Portability and Accountability Act (HIPAA) and related administrative simplification efforts. The Director also serves as chair of the National Uniform Billing Committee (NUBC), a multi-stakeholder group whose purpose is to review and approve a billing data set capable of supporting the HIPAA administrative transaction standard for billing (the UB-04 Data Set). AHA holds a permanent role as chair of the NUBC. This role also entails providing expert testimony before the National Committee on Vital and Health Statistics (NCVHS). The Director takes responsibility for maintaining the integrity of the UB-04 Data set, which is a strategic intellectual asset of the AHA. The Director advises AHA leadership on the best strategic future course for administrative transactions, given the move toward value and other changes in the broader health and technology landscape, with a view toward efficiency and burden reduction.

ESSENTIAL FUNCTIONS
1. Provide strategic leadership and oversight of the AHA’s administrative simplification agenda, including both policies enacted under HIPAA and the Affordable Care Act, as well as any future regulatory and legislative efforts.
2. Guide AHA’s advocacy efforts on strategic administrative simplification, including comment letters, member advisories and other educational tools to improve member understanding and achieve correct and timely implementation of national transaction standard changes.
3. Coordinate closely with the AHA’s clinical coding team, including AHA Central Office and Coding Clinic.
4. Build consensus with other national organizations when convening NUBC meetings as they gather to evaluate changes to national billing standards. Collaborate with various federal agencies and national health plans to harmonize implementation strategy and provide instruction for correct implementation of any new reporting changes.
5. Represent the AHA and serve as an effective liaison to designated federal agencies, health care organizations, and coalitions involved in the development of administrative transaction standards, such as the Division of National Standards at the Centers for Medicare & Medicaid Services, NCVHS, and the Workgroup for Electronic Data Interchange (WEDI). To maintain national coordination of efforts, serve as AHA’s liaison to the National Uniform Claim Committee (NUCC) and the Dental Content Committee (DeCC).
6. Provide AHA leadership with an assessment of emerging trends in payment policies and introduction of new billing data elements or approaches that influence the administrative simplification framework..
7. Ensure the maintenance and annual release of the UB-04 Data Set on a predictable cycle, in coordination with AHA’s Health Forum.

QUALIFICATIONS
Education:


Required Education:  Master's Degree



Desired fields of study:  Health care administration, finance, policy, or related area. 

Years of experience may be substituted for education.

Experience:

• Minimum of 12  years of experience in health care with a demonstrated ability to understand policy and other regulatory issues.

• Expertise in administrative simplification laws and regulations, reporting requirements, and areas of challenge and opportunity.



Knowledge Requirements:

• Expert knowledge of administrative simplification legislation and regulations and in particular how billing data flows and the electronic transactions needed to exchange this information efficiently. Must also have familiarity with the ASC X12 standards (process for maintenance, structure of the standard for carrying information) and associated business rules developed by CAQH/CORE.

•  Expert knowledge of importance of standards for the hospital and health system payment cycle, compliance activities, and research to improve understanding healthcare delivery.  Strategic knowledge and understanding of how changes in health care and technology may shape the future of administrative transactions, with a view toward burden reduction and efficiency.


Technical Requirements:

• Intermediate computer and Microsoft Office (Word, Outlook, Excel, PowerPoint) skills are required.
• Adobe publishing experience or similar is a plus.

• Ability to create member surveys on readiness and understanding of major billing or clinical coding changes.

BENEFITS

We offer an excellent total compensation package, which includes medical/dental coverage (PPO/HMO), vision care, life insurance, short and long-term disability plans, 401(k), tuition reimbursement, paid vacation/holidays/sick days, wellness programs and more!

The American Hospital Association (AHA) is an Equal Opportunity Employer.  We evaluate qualified applicants without regard to race, color, religion, sex, national origin, disability, veteran status, and other legally protected characteristics. We will provide reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Assistance Act of 1974 and Title I of the Americans with Disabilities Act of 1990. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the employment process, please call (312) 422-3000 and ask for the Vice President, Human Resources and let us know the nature of your request and your contact information.

The AHA participates in the E-Verify Program.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

EEOC/Equal Opportunity Employer