Allegheny Health Network Careers

Date: 01/18/2017
Non Union
Position Number: 55583
Location: AHN Corporate Office (North Shore)
Department: Physician Recruitment
Status: Full Time

Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities.  With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.

Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures.  Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.

Job Summary: Manage the physician contracting process from generating the offer term sheet through contract development and renewal. The incumbent will act as the intermediary between the physician organization and corporate legal to ensure physician contracts are prepared timely and using the most current contract terms. The incumbent will be responsible for populating the physician documents with the agreed upon financial terms.Respond to contractual issues both internally and externally. Ensure compliance with contractual terms.

Job Responsibilities:

• Prepare physician term sheets and contracts ensuring all agreed upon terms and conditions are accurate and completed. Work with legal, service lines vice presidents, department chairs, and administration to ensure contracts are completed timely and accurately.
• Prepare periodic reports that summarize agreement for both internal and external audiences. Conduct, collect and analyze data from claim and/or medical record reviews to continually improve the care and service to members and coordinate with the financial recovery areas to retract erroneous or inappropriate payments.
• Manage the physician contracting process from generating the offer term sheet through contract development and renewal.
• Act as the intermediary between the physician organization and corporate legal to ensure physician agreements are prepared using the appropriate template and terms and conditions. Serve as an advocate for the Physician Organization's contract needs for language and process changes.
• Work with sales and customer service to respond to questions/inquiries from customers/members related to appropriateness of services billed by providers. Consults with Medical Director on questions/issues related to medical necessity and appropriateness of services.
• Provide control and processing support for processing, documenting, and storing all physician agreements.
• Performs other duties as assigned or required.

Job Requirements:

• Associate Degree – Paralegal preferred. BA/BS/MBA and/or CPA preferred.
• Extensive progressive skills in: verbal and written communication; problem solving and resolution; editing; organizational skills; interpretation of product language, certificate and policy construction.
• Extensive experience with commonly used computer business applications to include but not limited to: Microsoft Word, Excel and PowerPoint.
• Experience with medical terminology and coding.
• Strong interpersonal organizational and analytical skills and the ability to perform under pressure within rigid time constraints, without the loss of efficiency, quality and professionalism as demonstrated by previous positions held.
• Willingness and agreement to continue educational course work in direct relation to the position and travel for additional training or business purposes as necessary.
• Demonstrated ability to analyze situations and data to identify issues, determine points of relevance and proper course of actions.
• Ability to identify, establish and meet goals and objectives.
• 0-3 years of relevant subject matter experience in the area of specialization required.
• 3-5 years experience in health care administration/delivery/finance or a related field preferred.