Senior Director of Physician Contracting at Orlando Health

The Senior Director of Physician Contracting is responsible for physician managed care contract negotiations and contract management. The Senior Director oversees contract analyst 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.

About Orlando Health

Founded more than 100 years ago, Orlando Health is a private, not-for-profit healthcare organization with a long tradition of serving its many and varied communities across Florida, Puerto Rico and now into Alabama. With physicians in more than 105 specialties, the healthcare system attracts patients from across the state, region and nation.

The healthcare system encompasses award-winning hospitals, stand-alone emergency departments, behavioral health care, skilled nursing facilities, rehabilitation services and urgent care locations. Our network of primary care physicians and specialists extends from Florida to Alabama and Puerto Rico.

Orlando Health is nationally recognized for its pediatric and adult trauma programs as well as its high-performing community hospitals and specialty hospitals. Each year, we welcome more than 20,000 babies across the system and care for the most fragile in one of the nation’s largest neonatal intensive care units.

• Oversees all aspects of physician managed care contracting. Negotiates contracts, amendments, and letters of agreement. Signs off on contract documents and rate sheets before presentation to Vice President for final approval.
• Builds relationships with physician leadership teams, to better represent physicians during negotiations and build trust with executive leaders. Gains understanding of practice-specific service lines, market dynamics, and competitive footprint.
• Directs efforts of Physician Contracting Analyst, with emphasis on ensuring all payor rate sheets are reviewed and approved prior to loading in Epic, contract matrices are updated timely, and payor performance is monitored regularly.
• Coordinates contracting efforts with Senior Directors of Hospital, Ancillary, and Specialty Contracting to ensure that all Orlando Health services are addressed during negotiations.
• Ensures that Orlando Health website is regularly updated with correct list of accepted insurances, to maintain compliance with state and federal transparency regulations.
• Supports other revenue cycle leaders to address physician-related payor issues, including but not limited to referrals, authorizations, panel opening/closing, and accounts receivable.
• Leads payor Joint Operating Committee (JOC) meetings for physicians, integrating with Hospital, Ancillary, and Specialty Contracting Senior Directors as necessary.
• Manages projects to add physicians, either via acquisition or new hiring, 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. Work 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. Facilitates in-person learning as well as online resources.
• Maintains compliance with all Orlando Health policies and procedures.

Education

• Bachelor’s degree required.
• Master’s degree preferred.

Experience

• Seven (7) years in managed care contract negotiations required; health plan experience is a plus.
  • Up to 2 years of work experience can be replaced by a Juris Doctorate degree.
• Previous Leadership experience required.
• Proficient in Microsoft Windows, including Excel and Word.