Program Manager, Fee for Service

About Us

The Department of Health and Wellness offers opportunities to grow and advance in a dynamic sector that touches the lives of all Nova Scotians. Along with our partners, including Nova Scotia Health and the IWK Health Centre, we are committed to continually improving our health care system. With a focus on collaborative primary health care, continuing care, improved supports for mental health and addictions, digital health, capital infrastructure and more, the department is thinking differently about how to plan, fund, legislate and monitor to improve access and service delivery. To do this, we need leaders at all levels of the organization who embrace a challenge and believe in their ability to make a difference.

About Our Opportunity

An exciting opportunity exists to join the Department of Health and Wellness as a Program Manager, Fee for Service (FFS), within our Physician Services group.

Responsible to the Director, Physician Agreement, the FFS Program Manager influences care delivery compensation for the entire province, ensuring accountability, consistency and transparency in clinical service remuneration. This role is responsible to evolve the Physician Manual to be responsive to clinical delivery innovation, allowing for effective remuneration and informed decision-making of executed services. In this position, the Program Manager is the departmental lead for all FFS programs, payment and billings systems for physician compensation. Specific responsibilities include but are not limited to day-to-day budget and expenditure management, fee code reviews and physician audits, support and direction to the Fee Committee, the analysis of billing trends, patterns and code-specific FFS costing, liaison with Medavie/MSI on issues/processes related to payments, audits and appeals.

The Program Manager is responsible for the planning, development, management and budgeting of the FFS portfolio with a budget exceeding $448 million.

Primary Accountabilities

As Program Manager, FFS your role carries specific accountabilities, which include the management of FFS programs, payment and billing systems. It is crucial that you stay informed about Branch programs and activities and foster collaborative relationships within the province. Key accountabilities include:

• Overseeing and coordinating all aspects related to Fee-for-Service programs, payments, and billings.

• Managing the day-to-day budget and expenditure activities within the department, ensuring effective allocation of financial resources within budgetary parameters.

• Serving as a point of contact and communication between the department and Medavie/MSI and other stakeholders, addressing issues and processes related to payments, insured services, audits, and appeals. This may involve resolving payment discrepancies, clarifying billing procedures, and addressing concerns from healthcare providers.

• Planning, implementing and measuring accountability frameworks to ensure standards are met in line with the Act(s) and negotiated agreements.

• Identifying shortcomings, suggesting improvements and implementing approved revisions to current processes, systems and procedures related to FFS physician compensation.

• Contributing to the audit plan to verify accuracy and compliance with established fee schedule and billing rules.

• Collaborating with peers within/outside the Branch on health system initiatives, new fee requests, operational processes, business planning, etc.

Qualifications and Experience

Ideally you would hold a bachelor's and have several years of progressive leadership experience preferably in a public/health sector (or an acceptable equivalent). Preference will be given to candidates with a clinical background and a master's degree.

The successful candidates must be effective communicators with above average skills in negotiation, problem solving, program analysis, people management, Microsoft Office (including Outlook, Word, PowerPoint, Excel), data analysis/management, financial analysis/management and organizational change management. All these skills must be demonstrated in your work experience to date.

To be successful in this role, you have experience in a leadership capacity, have evaluated financial programs and are familiar with contractual language. Broad knowledge of health services, policies, programs, and legislation (e.g., Health Authorities Act, Heath Services and Insurance Act) would be an asset. Strong organizational and project/program management skills are required in this fast paced, high profile Branch. These positions work under tight time constraints and competing priorities, therefore the ability to manage a diverse number of programs, tasks and staff requiring ongoing planning/monitoring/implementing will be key to your success. You also possess sound judgment when making decisions and have strong relationship building and verbal/written communication skills. You will be proficient at engaging your team/stakeholders and influencing others to build support.

The Government of Nova Scotia has adopted the LEADS Leadership Framework. During the interview, candidates will be expected to express how they have demonstrated the key behaviours and capabilities required to effectively lead in a caring and inclusive environment. LEADS Domains includes Leads Self, Engage Others, Achieve Results, Develop Coalitions and Systems Transformation.

We will assess the above qualifications and competencies using one or more of the following tools: written examination, standardized tests, oral presentations, interview(s), and reference checks.

Equivalency

Include, but not limited to:

• An equivalent combination of related training and experience may be accepted in place of education requirements.

• Applicants relying on education and experience equivalencies must demonstrate such equivalencies in their application.

Benefits

Based on the employment status, the Government of Nova Scotia offers its employees a wide range of benefits such as a Defined Benefit Pension Plan, Health, Dental, Life Insurance, General illness, Short and Long Term Disability, Vacation and Employee and Family Assistance Programs. For information on all our Benefit program offerings, click here: Benefits for government employees.

Working Conditions

• Normal work week is 35 hours/week, 7 hours/day. You may be required to work overtime on occasion.

• Most of your time is spent in a comfortable office setting sitting for long periods of time.

What We Offer

• Career development where you have access to career guidance, tools, resources, and ongoing training for every stage of your career.

• Engaging workplace: our employees feel valued, respected, connected, and tuned in, we have forward-thinking policies and strategies.

• Countless career paths.

• Department specific flexible working schedules.