PbR Specialist

My client a large NHS organisation are looking for a PbR Specialist to come on board and do analysis of Commissioning and Payment 'Challenge' Opportunities by the application of NHS Payment by Results (PbR) Guidance 2013/14

The person required will need to undertake a piece of work that enables Clinical Commissioning Groups (CCGs) to challenge health providers (primarily, but not exclusively, acute hospitals) by maximising the application of rules and guidelines within the 2013/14 publication of PbR guidance.

Time frame: 6 weeks (min)
Payment: £500 - £700 per day
Contract Start: Early Aug 2013

Criteria

The successful candidate will have;
1) Experience of working within a hospital contracting/finance department for a minimum two years. The individual will have worked in such a department within the last 3 years for at least 6 months.

2) A comprehensive understanding of the NHS payment mechanism. Payment by Results and currencies/tariffs utilised to support PbR 2013/14 and awareness of the direction of travel by referencing previous PbR guidance.

3) An understanding of NHS guidance on the 'rules of engagement' as expressed with the NHS guidance Code of Conduct for Payment by Results 2013/14.

4) An appreciation of patient pathways (and Best Practice Tariffs) to maximise potential efficiency gains alluded to in national guidance.

5) A working knowledge and understanding of a Price Activity Matrix (PAM) and Service Level Agreement (SLAM) reports.

6) A working knowledge of non-PbR payment mechanisms and contractual structures.

7) An appreciation of HRG coding (OPCs & ICD coding) and their impact on Healthcare Resource Group (HRG) codes.

8) An awareness of the NHS consultation programme regarding PbR National Tariff 2014/15: An Engagement Document

9) An awareness of organisational commissioning responsibilities with reference to CCGs, NHS England and Public Health (via the Local Authority)

The individual with be required to interpret guidance and propose challenges that may be applied providing clearly documented evidence to support the proposed challenge.

Sand Resources is an equal opportunity employer committed to a policy of treating all employees and job applicants equally. It is our aim to take all reasonable steps to employ and promote on the basis of ability and qualifications without regard to race, religion, colour, sex, age, national origin, disability or sexual orientation. Our recruitment takes place based only on skills and experience of the candidates.

Sand Resources is acting as an employment business in relation to this vacancy.