Announcement No.: AD10162013-28
Position: Associate Director of Healthcare Systems & Financing
Division/Department: Healthcare Systems & Financing
Salary Range: $75,500 - $115,000
FLSA Status: Exempt
Work Site: Arlington, VA
Work Hours: 8:00 am – 5:00 pm (not actual work hours)
Area of Consideration: All applicants
Opening Date: October 16, 2013
Closing Date: Open Until Filled
The Associate Director assists the Director and Deputy Director in support of OHSF responsibilities. This person assists the Director with compliance and enforcement activities regarding the Mental Health Parity Act and for the state health exchanges and Medicaid markets. They assist the Deputy Director in the management of APA’s relationships with commercial and public insurers; management of APA activities with the AMA CPT Advisory Committee, and the AMA RUC Update Committee, CMS officials and Medicare Contractors, and the development of APA input to Medicare Physician Fee Schedules. They serve as one of the staff liaisons to the Council on Healthcare Systems, Committee on RBRVS, Codes and Reimbursements and Committee on Reimbursement. They work with other OHSF staff to identify and respond to the needs of APA members as they relate to the economic dimensions of psychiatric practice and patient care. They assist the Director and Deputy Director in the development and implementation of special projects and study activity in support of OHSF responsibilities.
Assists the Director and Deputy Director with management of APA’s relationships with commercial and public insurers.
Along with the Deputy Director is responsible for management of liaison with and representation of APA member interests with insurers (commercial and public) regarding core issues of significance for psychiatrists including but not limited to:
- Physician fee schedules and alternative reimbursement methods
- Medical management issues
- Procedural coding and documentation
- Insurance coverage issues
- Provider network adequacy
- Care delivery initiatives
- Provider contracting
This responsibility includes triaging and coordination with the appropriate APA governance components and interdepartmental collaboration as appropriate.
Assists the Director with compliance and enforcement activities regarding the Mental Health Parity Act for the commercial health exchange and Medicaid market.
Includes ongoing monitoring of parity implementation and development and implementation of a work plan to address compliance issues. The work plan is developed in conjunction with the director and APA’s General Council.
Assists the Deputy Director in the management of APA activities with the AMA CPT Advisory Committee, and the AMA RUC Update Committee, CMS officials and Medicare Contractors, and the development of APA input to Medicare Physician Fee Schedules.
Along with the Deputy Director represents the interests of APA members with key external audiences regarding physician coding and documentation, valuation and fee schedule issues.
This includes: Monitor activities of all relevant stakeholders including non-MDs; prepare (draft and assemble relevant information) and coordinate APA communications to the AMA and CMS on relevant issues; prepare and coordinate oral presentations on relevant issues at specific CPT/RUC meetings; attend and participate in relevant CPT/RUC meetings; provide substantive input on issues as appropriate; and working with external technical consultants.
Staff Liaison to the Council on Healthcare Systems, and Committee on RBRVS, Codes and Reimbursements and Committee on Reimbursement.
Assists in the development of agendas, analysis and preparation of meeting materials; assists in writing and editing the draft minutes of the meeting for review by each group.
Assists in monitoring activities of other groups within the governance structure, keeping chairs appraised accordingly (e.g. Assembly action papers)
Assists in preparation of appropriate reports for the JRC, Assembly and BOT and attend those meetings when necessary.
Identify and respond to the needs of APA members as they relate to the economic dimensions of psychiatric practice and patient care and assist in the development and marketing of products and services to meet those needs. Maintain liaison with relevant AMA health policy staff.
Identify the needs of APA members as they relate to reimbursement issues; develop an effective strategy to meet those needs including the identification and evaluation of current educational activities of the APA and other organizations and development of additional programs/services/resources where appropriate. Maintaining liaison with the AMA Health Policy staff to facilitate appropriate collaboration
Assists in the management if the APA CPT Coding Network. Includes responding to basic CPT coding questions; forwarding more complex issues on CPT coding and documentation from APA members to APA’s CPT coding experts for review and response; providing CPT questions and responses for relevant columns in Psychiatric News and other necessary member education activities.
Develops, maintains and updates data/information on economic and practice management issues relating to compliance, fraud and abuse, risk management, medical record documentation, and general economic data.
Works with other APA departments to identify sources of information to develop educational materials for distribution to APA members.
Serves as resource for the staff answering the APA Practice Management Help Line, responding to more detailed questions and requests for information.
Works with Director and Deputy Director regarding the development and implementation of special projects and study activity in support of OHSF responsibilities.
EXPERIENCE AND PROFESSIONAL QUALIFICATIONS:
Bachelor’s degree required, masters or legal degree preferred. Minimum of 5-7 years of transactional experience in the area of managed care or the healthcare delivery field and/or 5-7 years of experience practicing in a healthcare related capacity. Strong written and oral communication skills, strong analytical skills, ability to coordinate multiple activities simultaneously, professional presentation. Travel required.
HOW TO APPLY:
Interested applicants must submit resume, cover letter with salary requirements.
RESUMES SUBMITTED FOR CONSIDERATION WILL NOT BE RETURNED TO THE APPLICANT. Employment will require a background check.
WHERE TO APPLY:
Via Email: HRAPPS@psych.org
Via Mail or Delivery: Office of Human Resources
American Psychiatric Association
1000 Wilson Boulevard
Arlington, Virginia 22209-9998
ATTN: Associate Director of Healthcare Systems & Financing
Via Fax: (703) 907 - 1088
OFFICIAL JOB OFFERS ARE MADE BY THE DEPARTMENT OF HUMAN RESOURCES ONLY
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