Physician Arrangements Program Director
US-OR-PORTLAND
Job ID: 23-35407
Type: Regular Full-Time
System Office 1919 Building
Overview We have a very clear mission at Legacy: to make life better for our patients, our community and each other. We show it every day, in everything we do.
If your skill and compassion as an Physician Arrangements Program Director combined with your desire to lead a team of providers reflects that mission, you belong at Legacy, making a difference through coordinating the physician complaince program.
Responsibilities The Physician Arrangements Program Director provides system-wide leadership and direction in facilitating and coordinating the Physician Arrangements Compliance program.
Utilizing a strong foundation of regulatory knowledge, professional experience, and an in depth understanding of the key requirements of the Stark and Antikickback statutes and Legacy policies, this position will maintain and continually improve Legacy's physician arrangements compliance program.
In this role you are responsible for monitoring and auditing contracts with and payments to physicians and midlevel providers, and for identifying, promptly reporting, and helping to resolve any regulatory or compliance issues with the corporate compliance leadership team.
This position will assure that Legacy's physician arrangements processes (monitoring, contracts, FMV, commercial reasonableness, pay, etc.) continue to meet regulatory standards, facilitating updates to the program as needed.
This role will help establish program goals and targets and support leaders and staff in achieving compliance and program goals. The program director will also participate in program review activities designed to improve processes using the Plan-Do-Check-Act ("PDCA") process.
In this work, you will be responsible for ensuring all current and revised/improved processes are documented and coordinated across the system for consistency. Routine staff and leader training will be drafted and administered by this position as well as program reports for the corporate compliance committee structure, including the Board Audit and Compliance Committee.
This role will maintain a centralized process for monitoring each component of the physician arrangements program. The work will be decentralized, but the monitoring and auditing function will be managed by this role in accordance with the following elements:
- Are there adequate/current policies/procedures for establishing a physician arrangement?
- Is there documented medical need and justification for an arrangement?
- Has the physician selection process been properly evidenced?
- Is the standardized process for documenting "Fair Market Value" being maintained?
- Is the standard for "commercially reasonable services" being applied to all arrangements consistently?
- Are all essential contractual terms and conditions addressed?
- Are there separate files to support and document each physician arrangement?
- Are there measurable performance standards required before payments are made?
- Are there internal controls for accounting and documentation of physician services?
Qualifications Education:
Bachelor's degree in accounting, compliance, legal or healthcare related field.
Background/Experience in accounting, contracting, human resources, auditing, compliance, healthcare (Preferred). Master's Degree preferred. Equivalent additional experience can satisfy education requirement.
Experience:
Minimum of four to six years' experience in a clinical setting or healthcare administrative setting with demonstrated expertise in physician arrangement program management within a healthcare system. Background in operations, recruitment or finance helpful.
Skills:
- Detail Oriented.
- Excellent Communications Skills.
- Excellent Presentation and facilitation skills.
- Excellent Interpersonal Skills.
- Microsoft Office Proficiency.
- Organizational Skills.
- Ability to Multitask.
- Excellent interpersonal skills, including conflict resolution, presentation and facilitation skills, able to present complex information to a diverse stakeholder group.
- Ability to work in a team environment and with diverse groups of both clinical and non-clinical personnel.
- Organizational skills, ability to manage multiple, complex projects simultaneously.
- Strong computer literacy especially in Word, Excel and PowerPoint programs with ability to learn new software programs.
- Experience working both independently and as part of a global multifunctional team.
- Ability to develop and/or review comprehensive audit reports and write summary documents for senior management and functional areas.
LEGACY'S VALUES IN ACTION:
Follows guidelines set forth in Legacy's Values in Action.
Equal opportunity employer/vet/disabled.
Compensation details: .55 Hourly Wage
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