Value Based Care Network Development Consultant

About Orlando Health:

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.

Position Summary:

The Value Based Care Consultant of Network Development is directly responsible for network development initiatives, provider and facility contracting, network reporting and analytics, and provider customer relations functions needed to execute and support the Orlando Health’s Clinically Integrated Network (CIN) strategies.

Essential Functions:
Acts as the liaison between the physician provider, third party administrator, and employer groups to trouble shoot provider claim issues, identify claim payment trends and other financial issues.
Manages incoming provider inquiries and triages to ensure follow-up with provider and internal departments occurs so that identified problems are resolved.
Prepares, analyzes, evaluates, and negotiates complex managed care arrangements with physicians, high volume specialists, and ancillary providers of care using Orlando Health Network’s specific contracting standards.
Provides education to Orlando Health Network physicians and staff on value-based contracts and network contracts.
Identifies network gaps and partners with analytics resources to fill gaps with high-value providers.
Interfaces with credentialing, care coordination, and medical director to ensure the appropriate and necessary quality providers are contracted and credentialed for health plan participation.
Attends meetings/in-services and presents information in department and other meetings, as requested.
Exhibits excellent analytical, problem solving and organizational skills, and has the ability to prioritize multiple assignments, adapt to changing priorities and situations, and follow through on the completion of assignments by deadlines.
Identifies and documents stakeholder/business requirements necessary to support business operations activities, and lead approved initiatives, projects, and continuous improvement activities.
Serves as project management support and tracks all assigned Orlando Health Network initiatives.
Coordinates meetings, prepares meeting agendas, and manages all meeting materials, as necessary.
Facilitates multidisciplinary discussions to effectuate system change, process improvement, and provider engagement.
Provides support for data review, market analysis, program growth, and provider relationship activities.
Works collaboratively with other team members on the execution of projects that support strategic priorities.
Stays current on national and local healthcare trends and maintains working knowledge of healthcare systems, physician integration, insurance products, regulatory/legislative policy, market research data and healthcare data.
Identifies process improvement opportunities through report analysis to achieve the Quadruple Aim.
Analyzes performance reports and data to inform decision-making, process, and program implementation.
Tests and refines workflows to support sustainable operational functions for the department.
Understands data storage and data sharing methods, investigates data to determine patterns and trends, leverages different data sources for analyses, and develops reports and presentations for various stakeholders.
Utilizes Microsoft Office software suite (specifically, Excel, PowerPoint, and Word) at a high level of proficiency.
Develops and maintains strong organizational knowledge (e.g., information systems, human resources, finance, facility management, materials management, marketing, risk management, legal, corporate compliance, quality, etc.).
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions:
Works comfortably in teams as a participant and facilitator, including temporary teams for project-based initiatives.
Participates in professional healthcare and community associations to keep abreast of current healthcare trends.
Communicates effectively through all forms of media, uses active listening and communications skills, and leverages these presentation skills to engage, inspire, and establish credibility with provider partners.

Education/Training:
Bachelor’s degree in health administration, business administration, public health, health sciences, or another related field required.

Licensure/Certification:
None.

Experience:
One (1) year of professional experience required. Completion of an Administrative Internship program in a hospital, physician group, or healthcare setting may substitute for the one (1) year of required work experience.