AREAS OF EXPERTISE________________________________________________________ Contract Management Contract Negotiations DHCS reporting Medicare Medicaid Project Management Relationship Building Team Management Training & DevelopmentPROFESSIONAL EXPERIENCE and ACHIEVEMENTS__________________________________ LIBERTY DENTAL PLAN, Irvine, CA 07/2014 - 12/2014 Manager, Provider (Professional) Relations Responsible for the oversight of the Professional Relations Department for California. This includes managing Enterprise provider network recruitment and service activities for all product lines and networks within California. Duties include: * Managing and developing staff to achieve objectives determine staffing needs, setting goals, coaching and evaluating the performance of direct reports ensure staff is trained and working with department/enterprise to develop written training materials and documenting processes * Participating in Quality Management/Utilization Review committees and manage direct reports' timely response to action items * Directing all provider recruitment and retention projects while managing progress through the use of integrated reporting tools * Compiling statistical information regarding provider issues and preparing executive summary reports for presentation to executive leaders and other departments. * Overseeing educational outreach with the provider network including on-site promotion and training activities with emphasis on e-commerce between provider organizations and the enterprise * Preparing various periodic internal and external reports (DHCS, CMS, DMHC) including updates on recruitment and service projects as directed by executive staff and regulatory agencies. * Monitoring staff's performance to ensure that goals and production standards and objectives are met * Conducting interviews, hiring network management staff, prepare training materials and schedule orientations * Reviewing and maintaining contract documents to ensure that documents are accurate, complete and that compensation is appropriate to the product and region Cindy Paxton (714) 305-5182 Resume: Page 2 SUN LIFE FINANCIAL, Irvine, CA 02/2008 - 11/2013 Provider Network Manager Recruit and negotiate contracts with providers and large group practices. Develop and retain a quality network which exceeds financial targets. Support sales through competitive market analysis and as a product expert for Employee Benefits and Managed Care Plans. Supervise and manage provider relations staff. * Attained business goals by team's participating in the development of new benefit plans from inception through regulatory approval process and marketing to customers. * Achieved business objectives by leading team to consistently exceed corporate goals for provider relations/contracting and network growth. * Complied with regulators by developing, negotiating and implementing Quality Management practices, contracts and credentialing policies and procedures. * Built strong, trusting and long-term client relations through integrity, frequent contacts and follow up. * Ensured quality and cost-effective productivity by fostering a culture of continuous improvement. * Decreased travel expenses by training staff to utilize electronic communication, reducing product development costs 50% through sharing audit results and recruiting via telephone. * Efficiently streamlined business processes by managing staffs' implementation of an internet based shared audit warehouse, which decreased quality management expenses. * Decreased healthcare costs by conducting periodic reviews of providers' contract performance.

Highlights:

• Benefits
• Regulations
• Managed Care
• Medicare
• Contracting
• Recruiting
• Negotiating
• Liaison
• Networking
• Management
• Grievance
• Providers
• healthcare
• Members
• Service
• Payors
• Resolve
• Retention
• Resolution
• Accountable
• Credential
• Quality management
• Claims research
• Claims
• Eligibility
• Cobra