Provider Contract and Focus Arrangement Compliance Professional

Department:
Corporate Compliance

Schedule/Status:
8am - 5pm; Full Time

Standard Hours/Week:
40

General Description:
The Provider Contract and Focus Arrangement Compliance Professional reports to Inspector General/Chief Corporate Compliance Officer. This position assists management with the strategic development, implementation and ongoing administration of provider contract management and focus arrangements compliance programs and other assigned areas. Position assists with implementing and monitoring compliance controls to prevent, detect, correct the risk associated with third party contracting and referral source arrangement to assist Parrish Healthcare (PHC) with compliance to laws, regulations, statutes and organizational policies and procedures. Discreetly work with confidential and highly sensitive information. Routine daytime travel may be required.
The position shall exemplify the desired Culture of Choice® and philosophies of Parrish Healthcare.

Key Responsibilities:

• Responsible for enterprise-wide provider contract administration and focus arrangement compliance programs-to include reviewing compliance with PHC policies, applicable laws, regulations and accrediting agencies standards; coordinating legal counsel reviews; timely contract execution by parties; completing research and various analysis, writing reports, and assisting with providing training and education to care partners.
• Evaluates third party contracts to ensure contracts meet PHC requirements and vendors are not excluded from federal programs before requesting PHC's authorized representative signature.
• Administers the provider focus arrangement electronic time log system. Maintains a centralized provider contract and focus arrangement repository database.
• Coordinates with Administration and Human Resources with coordinating and securing focus arrangement compensation valuations and commercial reasonableness documentation to ensure compliance with healthcare laws and regulations.
• Assists Physician Arrangement Review Team to process the review and approval of focus arrangements agreements in accordance with PHC policies. Coordinates with management to ensure all supporting documentation is stored in a centralized provider contract repository database. Ensures Physician Arrangement Review Team's process is completed prior to execution of contracts by PHC's authorized representative.
• Assists with preventing, detecting and correcting improper focus arrangement payments. Complete continuous review, auditing and monitoring of reported provider services, time logs, and incentive compensation requests to ensure compliance with contract terms and PHC policies before payment request are submitted for processing.
• Generates reports on provider contract management and focus arrangement activity and prepare status reports. Brief management in real-time on identified concerns and issues of non-compliance to include providing corrective action recommendations intended to correct the identified issue.
• Monitors and identifies changes in provider contract and focus arrangement requirements, operations and organizational structure that may affect the accuracy or efficiency of the provider contract and focus arrangement programs and suggests modifications to the programs' processes to maintain and enhance efficiency and effectiveness.
• Assist with internal and external audits in support of provider contract and arrangement activities.
• Participates in work groups and committees as requested.
• Performs similar or related duties as assigned.
• Knows fire, disaster and safety procedures and regulations as it pertains to the work area.

Requirements:

Formal Education:

• Bachelor's Degree in Healthcare or Business required or Associate's Degree with minimally 3 to 5 years of applicable work experience and is actively pursuing a Bachelor's degree.

Work Experience:

• 2 to 5 years healthcare, contract management, compliance, or accounting experience.

Required Licenses, Certifications, Registrations:

• N/A

Parrish Healthcare is a caring community of healthcare professionals passionate about excellence and fulfilling our mission of providing Healing Experiences For Everyone All The Time®.

Parrish Healthcare has a Culture of Choice®. This means a we have a healing work environment that empowers people to aspire to be their very best. We partner passionate, talented and skilled people in the right role with the right resources. We provide a clear and strategic direction to achieve superior results on behalf of the communities we serve.