Serves as central resource to Physician Organization (PO) for analysis that supports
contracting and finance initiatives. Resource to payor organizations and physician members on
a wide array of financial and utilization management issues. Performs fee schedule and
utilization analyses, incorporating payor and Medicare billing guidelines, and proposes
contract terms and pricing to support contract negotiations for Physician Organization and its
members.. Works directly with PO staff to refine analyses, generate ideas and create action
plans for appropriate interventions, and develop reporting program for PO. Maintains master
contract renewal schedule and is responsible for initiating negotiations and analyses on a
timely basis. Participates in contract negotiations with payors.
Principle Duties and Responsibilities
1. Create and maintain system and models for comparing and analyzing payor fee schedules.
Incorporate Medicare fees, RVUs and guidelines into analyses.
2. Conduct rate analysis and sensitivity models in support of contract negotiations. Propose
contract terms and pricing structure to payors, and participate in contract negotiations.
3. Function as main resource for contract implementation audit. Work closely with Specialty
Department administrators and community-based groups to ensure terms of negotiated contract
4. Serve as main resource to physician members, BIDPO medical director, Executive Director and
Board members for creation and interpretation of analyses, development of financial/utilization
reporting program, BIDPO credentialling criteria and profiling initiatives based on claims data
5. Manipulate data and generate relevant reports. Develop and generate standard monthly
production reports as well as ad hoc reports for utilization and financial reporting to
support contract negotiation and implementation.
4. Collaborate with PO leadership to research national and regional benchmarks on utilization
performance, and to establish appropriate targets for incentive programs. Research national
and regional programs on physician profile metrics.
5. Become expert on BIDPO/BIDMC data patterns and nuances, as well as professional coding and
6. Work with PO staff and Credentialling Committee to establish and monitor utilization
criteria for BIDPO membership.
7. Present contracting information to BIDPO physicians, either in presentations or informal
Knowledge, Skills and Abilities Required
1. Baccalaureate Degree is required. MBA or MPH is preferred.
2. At least two years of experience in a hospital, large group practice, or managed care
setting with involved experience with analytic functions.
3. Knowledge and experience with CPT, ICD-9 and DRG coding is required.
4. Strong interpersonal and communication skills are essential.
5. Superior analytic and computer skills are required to effectively perform in-depth analyses
to support contracting initiatives.
6. Proficient in Access, Excel, PowerPoint and Word software programs.
Reports to the Director of Contracts and Finance, Beth Israel Deaconess Physician
Beth Israel Deaconess Physician Organization, LLC (BIDPO) links BIDMC physicians and their
practices to managed care arrangements: contracts, payer relationships, enrollments, medical
management, plan rules and policies.
BIDPO represents over 1000 physicians, podiatrists and psychologists who are affiliated with
Beth Israel Deaconess Medical Center: over 200 primary care physicians and 800 specialists.