Position Summary
Physician Contracting Analyst Fully Onsite | Downtown Orlando
This is a fully onsite role based in downtown Orlando. The ideal candidate will bring an in-depth understanding of physician billing and managed care with the ability to confidently navigate complex payer and provider environments. A legal background and experience redlining contracts is highly preferred but not required. This role requires a strong communicator who is comfortable working cross-functionally and externally.
Day-to-day responsibilities include communicating with internal and external stakeholders regarding issue resolution, participating in Joint Operating Committee calls, supporting payor issue resolution, and assisting with contract interpretation to ensure alignment with Orlando Healths operational and financial goals.
Position Summary
Responsible for supporting the Senior Director in all physician managed care contract negotiations and contract management. Works to ensure that all negotiations as well as day-to-day operations yield the most favorable financial and administrative terms for the Orlando Health system.
Essential Functions
Ensures all payor rate sheets are reviewed and approved prior to loading in Epic, all contract matrices are updated timely, and payor performance is monitored regularly.
Creates, maintains, and reviews monthly dashboards to assess payor performance, including but not limited to:
• Expected vs. actual reimbursement • Days in AR (accounts receivable) denial rates • Patient bad debt percentage
Coordinates analytical efforts with Analysts of Hospital Ancillary and Specialty Contracting to ensure that all Orlando Health services are addressed during negotiations.
Initiates process and technology improvements to optimize Orlando Healths contract management abilities.
Manages process to regularly update Orlando Health website with correct list of accepted insurances to maintain compliance with state and federal transparency regulations.
Supports Senior Director to address physician-related payor issues, including but not limited to:
• Referrals • Authorizations • Panel opening/closing • Accounts receivable
Participates in payor Joint Operating Committee (JOC) meetings for physicians, integrating with Hospital Ancillary and Specialty Contracting Analysts as necessary.
Assists with projects to add physicians and practice locations either via acquisition or new construction to existing Orlando Health managed care contracts within acceptable time frames.
Collaborates with Credentialing Verification Organization (CVO) to ensure all physicians and practice locations are properly credentialed and recredentialed.
Works with CVO to ensure payor directory listings are accurate.
Works with Employer Solutions Partner (ESP) team to align on payor strategy, educate Orlando Health staff, and implement operational workflow processes.
Aligns with Population Health/Value-Based Care team to leverage Orlando Health performance with payors.
Participates in system-wide education and training program for front-line and back-end revenue cycle staff, facilitating in-person learning as well as online resources.
Maintains reasonably regular punctual attendance consistent with Orlando Health policies, the ADA FMLA, and other federal, state, and local standards.
Maintains compliance with all Orlando Health policies and procedures.
Other Related Functions
Demonstrates proficiency in Orlando Healths Core Competencies:
• Connection - builds partnerships and works collaboratively with others to meet shared objectives. • Communication - develops and delivers communications that convey a clear understanding of the unique needs of different audiences. • Curiosity - maintains a mindset of continuous learning and seeks out resources as needed. • Commitment - holds self and others accountable to meet commitments. • Works as a team player in facilitating efficient and effective assistance to colleagues throughout the Orlando Health system.
Keeps abreast of legislative changes affecting Orlando Health. Maintains confidentiality. Assumes responsibility for professional growth and development. Represents Orlando Health through community interaction.
Education
Bachelors degree in healthcare administration, business administration, finance, or closely related field preferred.
Four years of contract management or healthcare analytical experience may be substituted for educational requirement.
Experience
Two (2) years of contract management or healthcare analytical experience required.