Provider Programs Manager jobs in Tacoma, WA

In 2020, united in a fierce commitment to deliver the highest quality care and exceptional patient experience, Virginia Mason and CHI Franciscan Health came together as natural partners to build a new health system centered around the patient: Virginia Mason Franciscan Health. Our combined system builds upon the scale and expertise of our nearly 300 sites of care, including 11 hospitals and nearly 5,000 physicians and providers. Together, we are empowered to make an even greater impact on the health and well-being of our communities. 

         
CHI Franciscan and Virginia Mason are now united to build the future of patient-centered care across the Pacific Northwest. That means a seamlessly connected system offering quality care close to home. From basic health needs to the most complex, highly specialized care, our patients can count on us to meet their needs with convenient access to the region’s most prestigious experts and innovative treatments and technologies.  

While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that may include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility, and more!

Job Summary:

This job is responsible for managing and evaluating provider compensation program operations for the Virginia Mason Franciscan Health (VMFH) Physician Enterprise and its affiliates to facilitate consistency/alignment of provider compensation arrangements/payment practices and compliance with internal policies/procedures and applicable regulatory requirements.  In addition, an incumbent works with a wide variety of internal stakeholders to implement and evaluate the impact of new/revised provider compensation models that assure alignment with VMFH/CommonSpirit goals are consistent with best market standards/practices.

Work also includes: 1) managing ongoing administration of provider compensation policies, including documentation of fair market value and commercial reasonableness of all models; 2) serving as key contact with the CommonSpirit national provider compensation function to facilitate alignment with system-wide standards and procedures; 3) coordinating the smooth transition of acquired provider staff to VMFH programs; 4) participating in the planning and development of the provider compensation operating plan; 5) overseeing/coordinating compensation/payroll, accounting and financial reporting for the provider compensation program; and 6) supervising subordinate staff engaged in provider compensation-related services and activities. 

Work is accomplished in close collaboration with multiple VMFH provider compensation committees, VP Operational Finance, and National Compensation leadership.  An incumbent consults with higher level management on major operational or business decisions prior to implementation. 

Work requires knowledge of quality-based provider compensation models, contracting and related regulatory requirements and judgment/critical thinking in addressing operational issues and ensuring compliant operations.  Also requires knowledge of general business planning, employee supervision and best practice standards relating to physician/provider compensation/productivity metrics/measures. 

Essential Duties:

Manages daily activities relating to timely and accurate compensation/payroll, accounting and financial reporting for the provider compensation program.

• Leads the development and implementation of consistent reporting on all physician compensation provisions and physician productivity as required.
• Oversees the translation/administration of payment arrangements in provider contracts into accurate payment practices.
• Assures that wRVU information used to calculate provider compensation is accurate and contains all relevant modifications, and that value-based metrics are updated and processed in a timely manner; implements methodologies for tracking non-wRVU activities for which providers are compensated.
• Provides hands-on management during the comprehensive process for quarterly provider compensation resets or draw pay reconciliations; performs quality checks on compensation reset or draw calculations to assure data accuracy.
• Performs semi-annual audits of provider payroll activities to ensure documentation is accurate and processing is accurate.
• Oversees and coordinates reimbursement modeling for the various service lines; assures that reimbursement, in coordination with the Revenue Integrity department, is in alignment with the latest benchmark information; ensures that compensation practices are audited periodically and that variances/deficiencies are identified and addressed.
• Provides staff oversight to assure timely, accurate and consistent analysis, reconciliation and reporting of provider compensation metrics.

Assures, in collaboration with VMFH accounting and VMFH provider recruitment functions, timely and accurate setup of providers across the physician enterprise.

• Coordinates the development, review and update of procedures for provider-related workflows, including medical directorships, call time tracking, provider builds and reporting.
• Troubleshoots system setup and onboarding issues; provides status reports to leadership on current/future concerns or issues.

Assures provider compensation program and related activities are executed in compliance with all regulatory requirements, physician/provider contract terms/provisions and CommonSpirit National fair market value standards and established guidelines.

• Keeps abreast of regulatory requirements, professional standards and competitive industry practices, as well as organizational initiatives with potential to impact current strategies and practices.
• Ensures internal processes are fully documented, understood and followed; appropriately escalates issues to Director or Vice President.
• Monitors accuracy of provider compensation calculations by developing audit processes and conducting periodic compliance reviews; implements/enforces quality control/quality assurance and productivity standards.

Participates, as a member of the finance team, in activities necessary to complete an accurate forecast and budget of all operational activities.

• Develops, or oversees the development of, patient volume (wRVU) forecasts and budgets in the National budgeting system.
• Identifies resources needed to accomplish performance objectives, and exercises appropriate cost control to stay within budget for the Provider Compensation Department.
• Identifies and addresses department variances; oversees activities and resources to be fiscally-responsible and complies with VMFH policies and standards.

Manages and evaluates assigned staff engaged in financial analysis/modeling and tracking/validating/processing provider compensation per contract terms/provisions.

• Ensures that assigned staff are qualified and properly trained to perform assigned job duties; mentors and provides professional guidance to staff; ensures that staff understand and apply internal guidelines appropriately.
• Establishes performance standards/objectives and evaluates staff performance; addresses performance management concerns; addresses and resolves escalated questions/issues per established practices.
• As needed, provides leadership and direction to Provider Comp staff in support of various ad hoc analyses and projects deemed appropriate by the Director or Vice President.

Performs related work as required.

Education/Work Requirements:

• Bachelor’s degree in Healthcare Administration, Accounting, Finance or related field, and five years of progressively responsible related work experience that would demonstrate attainment of the requisite job knowledge/abilities, including three years in a supervisory or management capacity.
• Master’s degree in a related discipline is preferred.  Work experience in a large integrated medical group is preferred.