Qureos Mentor

AdventHealth Corporate

<div>All the benefits and perks you need for you and your family
Benefits from Day One
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location: Monday-Friday 8am-5pm (Hybrid- Maitland, FL open to remote if not local)
The role you'll contribute:
This position is responsible for physician contract review and interpretation; as well as, the building and maintenance of rates and terms into designated contract management systems for Florida and multi-state providers. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms and provides appropriate reconciliation of patient accounts and estimates. This affords AdventHealth leadership the foundation for reporting and determining overall payer performance and allows AdventHealth the ability to accurately model contracts for future negotiations. The accuracy of these builds is also essential for estimating month-end net patient revenue. Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental initiatives, rules and regulations. Develops and maintains a strong working relationship with AdventHealth Florida and Multi-state Division leadership, Managed Care Reimbursement team, Regional Revenue Cycle leadership, Finance/Accounting, physician practices and AH Physician Enterprise in order to ensure compliance and awareness of negotiated contract terms and rates.
The value you'll bring to the team:
<ul><li>Systems * Uses acquired knowledge, experience and contract details to load, maintain and test contract management systems with a high level of accuracy of payment calculations. * Responsible for netting down system-wide accounts receivable. * Updates contract information in appropriate programs for assigned contracts. * Performs necessary research to obtain and maintain non-contracted payer reimbursement including Medicare, Medicaid, Tricare and other govt payers. * Responsible for ensuring accurate patient estimation through accurate calculation of estimated reimbursement. * Periodically audits contract management systems to ensure accurateness. * Provides the necessary feedback regarding system failures or inefficiencies so that the operational function of contracts and labor performance is not compromised. * Responsible for timely entry of contract data into the Managed Care database which includes addition of new payors, renewals and terminations to ensure the accuracy of reporting provided to all providers. * Works closely with physician group billing and system departments to resolve contract load issues and identify trends to ensure contract management systems are accurate and working appropriately.</li>
<li>Communication * Effectively communicates with staff, leadership, payors and/or providers. Provides * Clearly and successfully represents self and this organization in a professional, * courteous manner. * Participates in meetings as assigned or requested. * Deals with patient information in a sensitive manner to ensure respect and privacy * for patient and expeditious handling of related issues. * During negotiations of the contract, works with the managed care team and other internal departments to identify issues or limitations of the contract that could have a negative impact on contract operations and administration. * Provides follow-up as appropriate with internal departments, providers and * leadership regarding parameters or limitations of contract fee schedule. * Support and Liaison-15% * Supports the overall mission of Advent Health and the role of the Managed * Care Department in that mission. * Demonstrates an eagerness to assist co-workers in the completion of tasks as needed. * Performs special projects and tasks as requested by senior staff and leadership. * Supports the contracting team, internal departments and providers as applicable to * assist with, identify and resolve operational, accounts receivable, billing and other * related issues. * Serves as liaison between Managed Care and provider groups by providing continual * education, support and training for the application of contracts as needed. * Demonstrates and encourages a team environment between hospital departments, * regions, payors and provider groups.</li>
<li>Information * Keeps all pertinent payor information up to date for distribution to AH Regional Managed Care Departments. * Maintains contract information in an organized manner to promote consistency in departmental operations. * Extracts pertinent contract information to update database which provides reports for distribution to senior staff, AH Multistate Managed Care Directors and provider groups. * Responsible for remaining current on regulatory updates and rate changes that affect Medicare, Medicaid and TriCare reimbursement for contract loading and analysis purposes. * Obtains, updates, and disseminates quarterly fee schedule updates (eg Injectables, Immunizations) to all appropriate parties including, but not limited to physician team * members, physician billing departments and AH Physician Enterprise.</li>
<li>Development, Education and Training * Maintains Epic Certification (CPE) Continuing Professional Education. * Displays a willingness to grow and develop skills required to perform his/her job duties and assist in the training and education of team members. * Takes the initiative to seek out education and training experience when there is a need and to stay informed of changes in the field of managed care and the objectives of the department. * Leads or facilitates in education of staff of Florida and Multi-State AH physician groups as requested. * Actively participates in providing constructive feedback and ideas for new development of contract management systems. * Deadlines, Timeliness and Performance Standards-10% * Completes assigned tasks in the appropriate time period and maintains an acceptable * workplace. * In group situations, effectively contributes to the overall completion of work product * according to the applicable directive and deadline. * Does not interfere with the ability of co-workers to complete duties. * Readily able to adapt to new situations and changing priorities in order to accomplish * department goals. * Adheres to applicable internal policies, procedures and guidelines set forth by AdventHealth, its associated hospitals, physician groups, PHOs and ancillaries during the execution of assigned duties. * Abides by all applicable rules, regulations and laws prescribed by any authoritative * governing body such as state regulations, AHCA, etc.</li>
</ul>Qualifications
The expertise and experiences you'll need to succeed:
<ul><li>Associate Required</li>
<li>Bachelor's in business or healthcare administration or related field Preferred</li>
<li>4 Work Experience Required</li>
<li>Microsoft Office</li>
<li>Detail oriented</li>
<li>Assertive</li>
<li>High degree of competency in contract language interpretation</li>
<li>Ability to problem solve and think analytically</li>
<li>Strong organizational skills</li>
<li>Effectively communicate with all department levels</li>
<li>Ability to grow strong relationships</li>
<li>Certification in Epic Contract Management</li>
<li>Patient Accounting knowledge</li>
<li>CPT/HCPC coding knowledge</li>
</ul>Our people are passionate about what they do, the product they sell, and the customers they serve. If you're looking for an opportunity to be a part of a work family that values collaboration, innovation and dedication, we're the right company for you.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Managed Care
Organization: AdventHealth Corporate
Schedule: Full-time
Shift: 1 - Day
Req ID: 25017121
\#additional
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.</div>

Physician Contract Administration

<div>Overview
If you're looking for an amazing place for quality of work and quality of life ... Look no further than AdventHealth Ocala , a 385-bed non-profit hospital located in the heart of the sunshine state! At AdventHealth Ocala, we pride ourselves on whole person care; taking care of our patients' mind, body, and spirit in a friendly community with a low cost of living, no state income tax, hiking, shopping, close to major cities &amp; theme parks, natural springs, horse parks and tons of amazing restaurants!
Position Information:
<ul><li>Looking for BE/BC Orthopedic Surgeons including general, total joint &amp; upper extremity for new program!</li>
<li>Comfortable with general ortho call</li>
<li>Can expect to ramp up quickly</li>
<li>State of the art equipment</li>
<li>Brand new $40-million-dollar building located on hospital property</li>
</ul>When you join AdventHealth Ocala, you become part of one of the largest health care systems in the nation. With 55 hospitals in 9 states and more than 2,000 providers, AdventHealth is the largest faith-based hospital in Florida with more than 100,000 employees nationwide fulfilling our mission to Extend the Healing Ministry of Christ. Our diverse medical staff in Ocala provides a variety of service lines from primary care to specialists in cardiology, gastroenterology, women's health, general surgery and more.
Benefit Highlights:
<ul><li>Compensation Package with VERY competitive base salary plus RVU incentives</li>
<li>Signing Bonus &amp; Moving Expenses</li>
<li>Cell Phone stipend</li>
<li>Boards, Licensing and DEA fees</li>
<li>Excellent health, vision and dental package</li>
<li>25+ days Paid Days Off plus CME time &amp; allowance</li>
<li>Occurrence based Malpractice - no tail coverage required!</li>
<li>403b with match</li>
</ul><ul><li>AdventHealth is a 501c3. Eligible candidates may qualify for the Public Student Loan Forgiveness Program.</li></ul>
Practice Description
The West Florida Division Medical Group continues to grow rapidly to meet the needs of the communities we serve. Over the last six years, we've nearly tripled in size with a projection to grow to 835 providers by the end of 2025. With the addition of AdventHealth Port Charlotte, we span a broad geography in eight counties, with practices in Charlotte, Hardee, Highlands, Hillsborough, Marion, Pasco, Pinellas and Polk counties as well as five Care Pavilions. Our providers represent 40 specialties and we care for one million patients annually. Using leading edge technology, innovation, and compassion, we deliver our brand of whole-person care.
At AdventHealth Medical Group, we offer our employees extensive benefits, including opportunities for ongoing training and continuing education. What's important to us is what's important to you: the health and overall well-being of your patients, your colleagues and yourself. AdventHealth Medical Group staff provides care at locations throughout West Florida, including fifteen AdventHealth hospital locations.
Hospital Description
With a rich history of medical leadership, AdventHealth Ocala has served the people of Marion county for more than 100 years. Together, we've experienced many &quot;firsts,&quot; including creating the TimberRidge ER, an off-site emergency department that's the first of its kind in Florida and becoming the first hospital in the county to offer minimally invasive heart procedures like TAVR, MitraClip&trade; and the Watchman&trade; implant. With your trust, AdventHealth Ocala has grown into a nationally recognized 385-bed, full-service community hospital. And today, aside from being the only hospital in the region to deliver babies, we have Marion County's only dedicated children's emergency room, pediatric unit and level II neonatal intensive care unit.
Location Description
Ocala community. Welcome Home.
Ocala offers the best of everything. It's a great place to raise a family; safe with a low cost of living, thriving local economy, no state income tax and top-rated public schools! Ocala is known for its natural beauty and the perfect setting for hiking, biking and enjoying the sunshine.
This vibrant city is a gateway to all of Florida's best features. Sun-kissed beaches, family-oriented theme parks, big-city nightlife, airports&mdash;they're all within an easy hour's drive. It's suburban living without the hassles of a big city; a place that gracefully emphasizes more of what life's all about... a laid-back lifestyle that makes living the good life easy.
Category: Physician Services
Req ID: 148820386</div>

Ocala FL Orthopedic Surgeon Jobs with AdventHealth

<div>All the benefits and perks you need for you and your family:
<ul><li>Benefits from Day One</li>
<li>Paid Time Off from Day One</li>
<li>Career Development</li>
<li>Whole Person Wellbeing Resources</li>
<li>Mental Health Resources and Support</li>
</ul>Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift : Monday Friday
Location: Hybrid (Maitland, FL) preferred open to remote
The role you'll contribute:
This position is responsible for managing the AdventHealth Florida and Multi-state Physician Contract Administration team. This team is responsible for contract review; as well as, the building and maintenance of rates and terms into designated contract management systems for physician and ancillary contracts within AdventHealth Florida and Multi-state Divisions. This position carries responsibilities which have direct impact on the revenue cycle of AdventHealth. Precision of the contract build ensures payer accountability and compliance to the negotiated contract rates and terms.
This position provides guidance and direction to department leadership within Patient Financial Services (PFS), Physician Practice leadership and Managed Care staff regarding contract interpretation and the implementation and operation of language, policy and procedures including state and federal regulation. Enforces contract compliance and accountability and ensures adherence to the terms of the agreements by all parties. Evaluates trends in data in order to report accurate outcomes and communicate opportunities for improvement, resolve and growth. Encompasses outstanding customer service skills and is responsible for building and maintaining positive relationships with both internal and external customers
The value you'll bring to the team:
Skilled in building, maintaining and testing in complex contract management systems with a high degree of accuracy.
Responsible for the accuracy of the information in the Contract Management database which serves as an informational tool for hospital departments including Directors, CFOs and VPs.
Ensures appropriate documentation for record keeping of contracts and correspondence by Contract Administration for tracking and historical purposes.
Oversees the work performed to ensure the Perceptive Content system for assigned contracts is properly and accurately maintained for documentation and historical purposes.
Takes a lead role in managing projects such as the development of new systems, processes and operations. Gives input, leadership and guidance to system programmers and other key personnel.
Ensures projects stay on course through delegated assignment and effective leadership of staff.
Identifies and communicates system limitations in order to streamline and maximize utilization. Initiates tickets with AdventHealth IS or program developers as appropriate for system fixes or needed enhancements.
Provides the necessary feedback regarding system failures or inefficiencies so that the operational function of contracts and labor performance is not compromised.
Is a key player in high level Joint Operation Committee meeting discussions with regional PFS departments, variance and denial operations teams and Payers in order to resolve open AR and operational contract issues while actively contributing to the provider payer relationships.
Responsible for engaging in communication with Physician Enterprise leaders to keep them informed of any concerns related to managed care reimbursement and operational contract issues.
Ensures key stakeholders are aware of any payer policy updates, operational changes, and governmental initiatives that may have a direct or indirect impact on physician contract operations or contract terms and rates. Guides and directs facilities on processes based on this communication.
Initiates and participates in internal and external meetings with the purpose to resolve issues, collaborate, strategize and provide feedback for developing action plans for current or future revenue opportunities.
Effectively communicates with department Directors, CFOs, and Vice President regarding major payer issues that could have significant impact; either financially or operationally.
Takes a lead role in the collaboration and communication with outside vendors hired to facilitate the organization in certain initiatives including but not limited to account audits, system development, integrated partnership etc.
Required to play an active role in the development of new Contract Management systems as well as other products, policies and procedures that would impact the Managed Care team relative to processes and workflows.
Qualifications
The expertise and experience you'll need to succeed:
<ul><li>5 payer/provider contract negotiations</li>
<li>Experience with leading a managed care department or team</li>
<li>Bachelor's Degree</li>
</ul>This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Managed Care
Organization: AdventHealth Corporate
Schedule: Full-time
Shift: 1 - Day
Req ID: 25017681
\#additional
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.</div>

Manager of Physician Contract Administration

<div>All the benefits and perks you need for you and your family:
Benefits from Day One
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Shift : Monday- Friday 8am-5pm
Job Location : Altamonte Springs, FL
The role you will contribute:
Responsible for overseeing the strategy, plan design, and optimization of either health and welfare plans, financial benefits, or time away plans and policies within AdventHealth's Total Rewards Center of Expertise team. This position evaluates and enhances benefit offerings to reflect best practices and ensure full compliance with federal and state regulations. Collaborate with vendors, consultants, and legal advisors, and serve as the lead for major initiatives to maintain competitive positioning and positively impact team members' well-being.
The value you will bring to the team:
<ul><li>Collaborate with Benefits Director to develop and implement benefits strategies to align with organizational goals.</li>
<li>Monitor benefits trends, benchmark data, and employee feedback to recommend plan design changes and ensure competitiveness and cost-effectiveness.</li>
<li>Maintain relationships with third-party administrators, brokers, and carriers to ensure service quality and issue resolution.</li>
<li>Lead the implementation of benefit plan changes, open enrollment, and related projects, ensuring minimal disruption and high engagement.</li>
<li>Develops benefits related communication such as open enrollment, retirement, PTO, or LOA communications, and delivers messages to key stakeholders.</li>
<li>Maintain and update plan documents, SPDs, and required notices and ensures compliance with IRS, ERISA, ACA, EEOC, GINA, and other regulatory requirements.</li>
<li>Excellence written and verbal communication skills, including the ability to explain complex concepts to diverse audience.</li>
<li>Other duties as assigned.</li>
</ul>The expertise and experiences you'll need to succeed:
<ul><li>Bachelors degree in human resources, Business Administration, or related field.</li>
<li>Minimum of 5 years of experience in benefits administration or human resources management, preferably in large, multi-state organization.</li>
<li>Deep knowledge of U.S. benefits regulations, compliance requirements, and industry best practices.</li>
</ul>Preferred Qualifications:
Professional certification such as Certified Employee Benefits Specialist (CEBS) is preferred.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Operations
Organization: AdventHealth Corporate
Schedule: Full-time
Shift: 1 - Day
Req ID: 25033758
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.</div>

Benefits Manager COE

Join AdventHealth Corporate and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

AdventHealth Corporate

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Physician Contract Administration

Ocala FL Orthopedic Surgeon Jobs with AdventHealth

Manager of Physician Contract Administration

Benefits Manager COE