Experienced professional with the ability to educate, train and implement initiatives through strategic planning and data mining. Through collaboration and training attained a successful direction of the network development staff to exceed all yearly goals. Worked through complex provider networks; pricing, development and team management. Analyze network reimbursement methodologies and provide process improvement strategies. Ability to negotiate and close high level multi-million dollar contracts through regulatory national markets. Managed the expansion into the Medicare Advantage products. Assessed and implemented contracts for Affordable Care Act and Market Place. I am looking for a position where I can use my skills in a direct manner with the provider community and with others in a forward thinking company. • Analysis and evaluation of current network contracts for any needed contractual or reimbursement modifications based on network need. • Oversee and manage contract administration for all provider and corporate (vendor) contracts. • Manage and negotiate ‘wrap’ networks i.e. MultiPlan, and HRGi. • Manage Optum Transplant network contract. • Managed the successful expansion into a Medicare Advantage program. • Manage and evaluate all Provider Relations assisting in all conflict resolutions. • Lead complex contract negotiations with large Hospital Systems, PHO, IPA organizations. >

Highlights:

• will relocate
• Healthcare Reform
• Contract Negotiations
• Compliance
• Contract Management/Operations
• Reimbursement Analysis
• Operations
• ACA