Job Summary The AVP-Provider Contracts is the key administrative leader overseeing HonorHealth's independent physician and provider contracting strategy and execution, including medical directorships, hospital-based services agreements, and call stipend arrangements, and will also serve in an advisory role in the realm of employed physician compensation strategy and structure. Moves forward the goal of developing contracting strategies that are legally compliant and fiscally sustainable, supportive of high-value care, and which complement the overall Network physician and provider alignment strategy. Management oversight includes contracting with independent physicians and providers for medical director, call coverage, and co-management services at all Network facilities (with an annual budget of approximately $50M), and works in an advisory capacity related to HonorHealth Medical Group leadership on the development, communication, and execution of compensation practices for the employed medical group. Will work closely with, and build strong collaborative relationships with, both external and internal constituents. Internal partners will include Network SVP/Chief Physician Executive), Network and Regional Hospital CEOs, Hospital C-suite leadership teams, Innovation Care Partners CEO, Network CFO, Analytics leadership, Legal, Physician Billing, Quality Department, Human Relations Department, and Service Line dyad leaders.
Provides leadership to Provider Contracting Team, and works with stakeholders across HonorHealth's Integrated Delivery Network (IDN) to ensure provider contracting strategy and budget remain aligned with network goals and objectives. Proposes, recommends, and develops with senior management the independent physician/physician group contracting strategies for the Network, which may include hospital based physicians, on call coverage, medical directors and other administrative work, co management, and certain ambulatory based physician contracts. Develops and implements compliant policies and procedures designed to optimize quality, while minimizing expense. Analyzes independent physician contracts for utilization, expense and performance metric achievements. Works closely with with designated stakeholders and other leaders to support the cost effectiveness goals of the IDN. Provides leadership and direction related to physician contracting data. Presents physician and provider contracting data to senior management Network leaders to serve as a basis for key strategic and financial decision making, and presents proposals to maximize contracting value.
Directs and manages the independent physician contract negotiation process, and execute this function in a manner designed to build independent physician relationships, and to maximize value by balancing quality outcomes and contracting cost. Initiates and oversees the development and execution of necessary Fair Market Valuation ("FMV") analysis. Works closely with the FMV consultant, legal team and executive management to ensure accurate and timely FMV reports are executed per Network practice, and that contracts are developed and executed in a fully compliant fashion. Interacts and negotiates with physician and physician groups, following the direction and provisions outlined by executive management, legal department, and the HonorHealth Physician Contracting Team Charter, Policies and Procedures.
When requested, serves in an advisory capacity to HonorHealth Medical Group executive and administrative leadership to review the contracting strategy/contracting model for all HonorHealth employed physicians and advanced practice providers. Works (as an advisor in a matrixed fashion) with the CMO of HonorHealth Medical Group (HHMG), Human Relations Department, and other HHMG administrative leaders , to ensure that the compensation model is market competitive, and evolves to meet the needs of the reimbursement environment (e.g. value-based reimbursement).
Oversees the Provider Contracting Department staff, and ensures adequate staffing levels, inclusive of hiring/onboarding, evaluating, managing performance, coaching and developing employees. Ensures employee productivity, employee development, monitor quality of work, and ensures alignment of departmental goals with the HonorHealth mission, vision, and values. Ensures departmental compliance with all policies, and exercises accountability to financial stewardship through development and maintenance of departmental budget.
Works with key medical leaders, service line directors and Quality to determine key measurable compliant performance metrics, that balance positive quality outcomes, transparency and expense. Ensures accurate and timely payment of performance metrics to independent physicians.
Oversees the function and use of the physician contracting portal, which is used by physicians to report Medical Director hours, Committee hours, etc. Ensures independent physician contracts are maintained and up to date through contract repository database system.
Performs other duties as assigned.
Internal Number: 2018-11831
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