CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "Provider contracting"

Director - 7 Years of Experience - Near 33629

Professional Summary Strategic Healthcare Leader with 20 years of achievement driving enterprise initiatives in progressively responsible operational leadership roles, managing multimillion-dollar budgets, and assuring compliance of managed care plans. Detail-oriented multitasker adept at transforming internal processes, implementing complex compliance policies, and organizing optimal work flows in fast-paced environments. ...

Tags for this Online Resume: Medicare, Compliance, Management, Audit, Cms, Documentation, Leadership, Metrics, Budgeting, Application Design, management, consulting, operations, population health, provider contracting

Senior BD/VP Business Development -30+ years selling services to pharmaceutical and biotechnology companies

Summary: 1991 to Present (please see Chronology Section below) Serve as an effective business developer & manager of sales teams (e.g. consultant when not an employee) for many firms providing services to pharmaceutical companies. Currently providing value-added business development consulting services to CRO clients to enable them to acquire new business with pharmaceutical/life science companies. I have also held employme...

Tags for this Online Resume: Biotechnology, Pharmaceutical, Pharmaceutical Industry, Clinical Research, Research, Consulting, Due Diligence, Managed Care, Planning, Strategic Planning

Medical & Health Services Manager - 18 Years of Experience - Near 89141

SKILLS SUMMARY * Provider Relations and Liaison * Trainer, Presenter, Speaker * Medicaid, Medicare Advantage, Dual Eligible * Network Management, Development, and Recruitment collaboration with Regional Teams * P4P, PPO, POS, Managed Care, Medicaid, and Medicare contracting * Ancillary, Physician/Medical Group, and Facility contract administration * Complex issue resolution * HIPAA, NCQA, and CMS Compliance and contracting ...

Tags for this Online Resume: AR, Accounts Receivable, Compliance, Corrective Actions, Field Work, Financial Services, Medicare, Managed Care, Healthcare Exchange, Medicare Advantage, Medicaid Managed Care, Project Management, Provider Contracting

Director - 15 Years of Experience - Near 18104

SUMMARY OF QUALIFICATIONS Diverse professional with accomplishments in various industries and disciplines. Extensive project management experience with capital projects and daily plant operations, facility retrofit, procurement of professional service providers and contract negotiations. Exceptional conceptualist. Catalyst for bringing vision to profitable results. Dynamic cross functional team player. Entrepreneurial think...

Tags for this Online Resume: Contract Negotiations, Planning, Manufacturing, Construction, Facilitator, Leadership, Project Leadership, Project Management, Project Manager, Architect

Navy - 20 Years of Experience - Near 23456

PROFILE Superior Program Manager with extensive Government Contract, Navy and Commercial Ship Management and Repair experience, Contract Proposal Development & Business Management. Currently Manages the technical and day to day operations and maintenance of 8 MPF T-AKR 310 Class LMSR's and seven port engineers in FOS under MSC PM-3. Expert Naval Maintenance Manager & General and Program Manager with extensive experience man...

Tags for this Online Resume: Complaints, Management, Program Manager, Training, ABS, Security, Budgetary, Cost Control, Government

Civil Service - 20 Years of Experience - Near 23430

PROFESSIONAL SUMMARY Motivated Contract Specialist/Acquisition Planner with 17 years of contracts experience working in the Navy Ship Repair Community and the Veterans Affairs, including the technical and contract requirements, budgets, and department functionality. Areas of expertise include analyzing price proposals, financial reports and negotiating contracts on behalf of the Department of the Navy and Veterans Affairs. ...

Tags for this Online Resume: Alexandria, Audit, Billing, Email, Engineering, Financial, Management, Market Research, Material Handling, Microsoft PowerPoint, DAWIA III, Contract Specialist, Veterans Affairs, Navy, CENTCOM, NAVSEA, NAVSEA HQ

Training & Development Manager

SUMMARY Leads and is accountable for the success of an assigned transition project. Responsible for an array of activities including initializing and planning projects, developing project cost structure, tracking and reporting project deliverables, managing risk, applying project management processes and tools and ensuring projects are competed on time, within budget and with high customer satisfaction. KEY RESPONSIBILITIES...

Tags for this Online Resume: Documentation, Training, Management, Pricing, Customer Service, HR, Human Resources, Sales, Applications, Banking Industry

Plant Manager - 20 Years of Experience - Near 53925

SUMMARY I am a broadly experienced and thoroughly capable lean transformation leader focused on applying the twin pillars of lean thinking - continuous process improvement and respect for people - to achieve key business goals. As a change manager with 25 years of experience in accounting, sales, operations, engineering, and R&D I coach and develop people's problem solving skills to create and continuously contribute to a h...

Tags for this Online Resume: Planning, Research and Development, Strategic Planning, Consulting, Distribution, Manufacturing, CMOS, Imaging, manufacturing, production, "project management", continuous improvement, ISO 9001, Quality

Quality Assurance Director - 20 Years of Experience - Near 60440

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 associate...

Tags for this Online Resume: Services, Financials, Management, Behavioral Health, Business Operations, Project Management, Project Manager, director operations, Provider Network, Claims Operation, Healthcare

Business Teacher - 14 Years of Experience - Near 91761

Summary program management, project management and reporting. Sixteen years Entrepreneurial experience providing contracting services to the for-profit and non-profit entities to increase capacity through program development, strategic planning, on-site fiscal management and training of staff and officers.

Tags for this Online Resume: education, training, instructor, substitute, teaching, Management, Protocol, Procurement, Program Manager, Business Development

Director

KEY QUALIFICATIONS - OVER 21 YEARS EXPERIENCE IN MEDICARE, MEDICAID, AND MEDICARE-MEDICAID PLANS (MMP) Profit & Loss Accountability * Product Implementation / Mgt * Marketing & Communication Strategy * Product Strategy & Development * Business Development * Collateral / Campaign Development SUMMARY OF PROFESSIONAL EXPERIENCE CAPTIAL BLUECROSS HARRISBURG, PA 17050 SEPTEMBER 2015 - PRESENT DIRECTOR OF MEDICARE PRODUCT DEVELOP...

Tags for this Online Resume: Cms, Management, Market Research, Networking, Research, Pricing, Benefits, Marketing Management, Policies and Procedures, Product Development

Executive Director - 20 Years of Experience - Near 94552

CAREER SUMMARY: Professional in program management with over 20 years' significant experience managing and executing complex, multiple State and Federal contracts using State and Federal funds. This involved selection of all service providers, contracting with them and oversight of provider performance to contract specifications. Service contracts awarded were in excess of $27 Million and included overall day-to-day oversig...

Tags for this Online Resume: Financial Analysis, Inventory, Management, Quality, Budgeting, Information Technology, Planning, Policies and Procedures, Referrals, management