Henry Ford Health System
Location
Troy, MI | United States
Job description
GENERAL SUMMARY:
Responsible for the evaluation, negotiation and execution of ancillary provider contracts and the facilitation of the physician application process. Ensures the development and maintenance of a network of providers sufficient to ensure provision of plan benefits.
PRINCIPLE DUTIES AND RESPONSIBILITIES :
Initiates and negotiates cost effective contracts for ancillary/professional providers.
Directs the evaluation and negotiation of contracts in compliance with company contract templates and reimbursement standards while maintaining network composition that includes an appropriate distribution of provider specialties.
Prepares, analyzes, reviews and projects financial impact of provider contracts.
Management of regulatory requirements regarding overall provider contracting including CMS, MDHHS, NCQA, and other operational requirements.
Directs the delivery of any ancillary and physician financial settlements.
Directs the administration of individual physician enrollment and contracting.
Management of ancillary and physician contracting team members.
Maintains up to date knowledge of all regulatory requirements and Managed Care Laws required for ongoing management of network provider contracts.
Perform other related duties as assigned.
EDUCATION/EXPERIENCE REQUIRED:
Bachelor’s Degree in related field, required. Master’s Degree in a related field, preferred.
Minimum of three (3) years of experience contracting and negotiating experience involving ancillary health care systems and physician/physician organizations, required.
Minimum of two (2) years leadership or supervisory experience, required.
Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies, required.
Extensive experience in provider and network development involving ancillary health care systems, integrated delivery systems and large physician groups, required.
Understands the reimbursement capabilities of FACETS and creates cost-saving provider reimbursement strategies and practices consistent with these capabilities, preferred.
Experience facilitating the physician application/credentialing process, preferred.
PHYSICAL DEMANDS/WORKING CONDITIONS:
Normal office environment with minimal exposure to noise, dust, or extreme temperatures.
Additional Information
Organization: HAP (Health Alliance Plan)
Department: Provider Contracting
Additional DetailsThis posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a $6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s major academic medical centers, receiving between $90-$100 million in annual research funding and remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical education and training, the health system has trained nearly 40% of physicians currently practicing in the state and also provides education and training for other health professionals including nurses, pharmacists, radiology and respiratory technicians. visitHenryFord.com.Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.Job tags
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