Physician Contracting Administrator II
Northside Hospital
Physician Contracting Specialist
Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.
Responsibilities
Works daily within the Physician Contracting Department on the origination, coordination and administration of physician contracts while supporting standardized and centralized contract administration, compliance and records management.
PRIMARY DUTIES AND RESPONSIBILITIES
- Constructs and actively negotiates agreements for physician employment, physician services, and independent contractors for more complex agreement types. Ensures the use of appropriate language that reflects the relationship of the parties and assures that the language and the structure of the relationship is in compliance and consistent with institutional policies, Medicare fraud and abuse statutes, Stark regulations, and IRS and INS requirements. Works in conjunction with internal and external Legal Counsel.
- Works independently to obtain Fair Market Value opinions from external consulting firms.
- Collaborates with leadership to construct and critically critique statements of business necessity in accordance with Physician Contracting protocol.
- Aggregates data and performs financial analysis to assist in decision-making.
- Contributes to the achievement of established department goals and objectives and adheres to company and department policies, procedures, quality standards, and safety standards.
- Leads the development of training programs for departments / units within the hospital regarding the Legal Database, contracting processes, locum tenens processes, roles, and responsibilities.
- Assists with the development and implementation of physician contracting standards and policy and procedures for the contracting process for each Northside entity.
- Develops, manages and maintains the essential data related to physician contract origination and administration. Serves as a resource to Physician Contracts Administrator I.
- Ensures that each physician contract is supported by essential documentation such as approval signatures, fair market value analysis, commercial reasonableness, and statement of business necessity.
- Maintains and assures confidentiality of all contract and compensation information.
- Follows system and departmental document retention policy and assures that all agreements are tracked and retained.
- Serves as a contact for supporting departments at each Northside entity involved in physician contracting, including but not limited to various clinical service lines leaders, Human Resources, Billing, Managed Care, Risk Management, Medical Staff Office, Finance, etc.
- Assists with maintenance of physician compensation survey data and performing internal calculations of value and fair market value as needed.
Qualifications
REQUIRED
- One (1) year of experience working with physicians and/or in physician contracts
- Two (2) years of experience working in healthcare, preferably for a hospital or health system.
PREFERRED
- Bachelor's and/or Master's Degree in healthcare related field or business.
- Previous experience working with Physicians.
- Outstanding organizational skills
- Excellent interpersonal and communication skills.
Work Hours:
8a-5p
Weekend Requirements:
No
On-Call Requirements:
No
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