Mysticlyd@hotmail.com - 916 225-4915 Possess a very strong background in the medi-cal managed care environment. Desire to advance as a health care professional by utilizing demonstrated success in claims administration/processing grievance & appeals provider education and training provider relations contracting and strategic planning. Manage and audit large group * Experience in managing large medical groups and hospitals in Santa Clara, Alameda, Contra Costa, and Butte Counties. * Support and maintain processes in regards to, communications, complaints and facilitate resolutions between physicians, hospitals and medical groups. * Manage current work flows within the Provider Relations department. * Manage budget and accountability to include outside events and company expenses. * Managed, coordinated and trained providers, hospitals and large medical groups for Rural Expansion Project and CMSP. * Coordinated and trained new team members with onboarding and serve as a resource for the team. * Managed expansion of the Unicare name as part of a team that contracted and built a provider network in provider networks by identifying necessary PCP specialists ancillary providers and assisting network support contracting and credentialing associates to maintain accurate provider data within DHCS guidelines for health plan compliance. * Support various marketing strategies in the community.

Highlights:

• marketing
• training
• Networking
• contracting
• Support
• Audit
• Managed Care
• Microsoft Outlook