Internal Provider Contract Representative - Highlands County Florida
at Adventist Health System

Date Posted: 4/10/2017

Job Description

Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Adventist Health System - Courtland

Job Posting:  Full-time

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for an Internal Provider Contract Representative position that will be based in our PHSO department.  This position is based at our Courtland Campus in Orlando, FL.

This position has the opportunity to be responsible for assisting the Provider Relations and Contracting Manager with the evaluation and negotiation of new and existing FHHS and CIN related contracts, working directly with physicians to resolve issues and concerns and interfacing with internal teams to ensure processes are executed in an efficient manner that result in a superior experience for the provider.

Specific job duties include:
  • Assist with negotiations of physician and ancillary FHHS or CIN contracts.
  • Assist in monitoring performance of existing contracts.
  • Assist in monitoring current agreements for recommendation on timely negotiations.
  • Evaluate new contract proposals from physicians and ancillary providers.
  • Maintenance of negotiation correspondence files.
  • Contact and work collaboratively with physician practices and ancillary providers to provide or obtain information and resolve conflicts.
  • Work with Contract Support and Provider Data Management to assist in maintaining the accuracy of the contract database.
  • Coordinate with all PHSO internal departments on activities related to operational issues.
  • Assist other departments in understanding payer contracts and educate internal personnel on managed care principals.
  • Prepare monthly updates on status of contracts in negotiation.
  • Responsible to ensure the proper configuration of contracts with the applicable TPA.
  • Analyze rates and local market conditions to support contract negotiations.
  • Other duties as assigned.

Job Requirements

Education Requirements:
  • Bachelor’s degree in a related field or 4+ years’ experience in health insurance managed care environment.
Experience Requirements:
  • 3+ years’ experience with payer and/or provider contracting background working with health insurance, medical billing, patient accounting, provider relations or managed care
  • Knowledge of basic payer contract language.
  • Experience with physician professional service compensation methodologies and issues.

If this position sounds like a great match for your skills set and experience, please apply online now!

Job Snapshot

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.