Provider Contract Analyst Jobs in Decatur, GA (NOW HIRING)

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Works daily within the Physician Contracting Department on the origination, coordination, and administration of physician/provider compensation models and contracts while supporting standardized and centralized contract and compensation administration, compliance, and records management.

RIMARY DUTIES AND RESPONSIBILITIES

1. Senior Administrator will construct and work with more complex compensation models and agreements such as employment, PSA, Hospital-Based Services, MSA, and others. Ensures the use of appropriate language and methodology 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.
2. Works independently to obtain Fair Market Value opinions from external consulting firms.
3. Collaborates with leadership to construct and critically critique statements of business necessity in accordance with Physician Contracting protocol.
4. Aggregates data and performs financial analysis to assist in decision-making.
5. Contributes to the achievement of established department goals and objectives and adheres to company and department policies, procedures, quality standards, and safety standards.
6. Leads the development of training programs for departments /units within the hospital regarding physician/provider compensation methodology, payment processing, and roles and responsibilities regarding contracting and compensation process compliance.
7. Assists with the development and implementation of physician/provider contracting and compensation standards and policy and procedures for each Northside entity.
8. Develops, manages and maintains the essential data related to physician/provider compensation and agreement origination and administration.
9. Serves as a resource to Physician Contracts Administrators, Contracting Specialists and Leadership. Serve as a mentor to new employees in the department.
10. Ensures that each physician or provider contract and compensation plan is supported by essential documentation such as approval signatures, fair market value analysis, commercial reasonableness, and statement of business necessity.
11. Maintains and assures the confidentiality of all contract and compensation information.
12. Follows system and departmental document retention policy and assures that all agreements are tracked and retained.
13. Serves as a contact for supporting departments at each Northside entity involved in physician contracting and compensation, including but not limited to various clinical service lines leaders, Human Resources, Billing, Managed Care, Risk Management, Medical Staff Office, Finance, Business Optimization, etc.
14. Lead maintenance of physician compensation survey data and perform internal calculations of value and fair market value as needed.
15. Work on special projects as requested by departmental and/or hospital leadership.
16. As requested, attend meetings to represent the department and serve as the physician/provider compensation and/or contracting subject matter expert.
17. Annually or as requested by Leadership, present to the contracting and recruiting department (or other departments as requested) on topics relating to best practices of provider compensation, industry changes, etc.

REQUIRED

1. Bachelor’s degree in healthcare related field or business.
2. Two years of experience working with physicians and/or in physician contracts, with a focus on physician and provider compensation.
3. Five years’ experience working in healthcare, preferably for a hospital or health system.

PREFERRED

1. Master’s Degree in healthcare related field or business.
2. Previous experience working with Physicians. Outstanding organizational skills.
3. Excellent interpersonal and communication skills.
4. Ability to manage multiple high-volume, high-level and complex agreements and relationships with leadership teams with minimal oversight