Summary of Experience An exceptional operations professional with more than 20 years in a healthcare setting. Established and implemented regulatory policies and procedures, quality services and revenue management metrics. Responsible for all provider claims reimbursements, satisfaction and provider contract negotiation functions and oversight. Experienced in payment software, quality audits and technical problems associated with system reimbursement, root causes, and implementing effective data resolutions. Experienced in training teams to maintain a working knowledge of regulatory guidelines, implementing new business requirements, various contractual covered services within RFPs, MOUs, LOAs and State billing requirements. Familiar with all healthcare settings, including hospitals, MCO's, Home Health, Skilled Nursing, clinics and reimbursement methodology. Knowledge of ICD-9-10, medical records review and provider data and loading. Ability to provide oversight and direction to stakeholders located in multiple service locations and coordinating projects and regulatory billing solutions. NOTABLE ACHIEVEMENTS * Set challenging cross-functional goals that support the organizational financial goals and strategies. * Integrated functional strategies, utilizing business expertise to reach operational improvements. * Deployed resources to reach financial forecast and maximize business objectives. * Lead workgroups for managing/building talent inside organization and for improving internal/external relationships. * Orchestrated the development of productivity metrics, essential for improving payments, billing requirements, and improve billing efficiencies. * Established provider communication guidelines for training and educational purposes. * Monitored company policies and developed new operational procedures in order to increase provider satisfaction.

Highlights:

• Services
• Financials
• Management
• Behavioral Health
• Business Operations
• Project Management
• Project Manager
• director operations
• Provider Network
• Claims Operation
• Healthcare