| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Street Address Sweet AlyssumPunta Gorda, FL Street Address
(Cell) PHONE NUMBER AVAILABLEEMAIL AVAILABLEEDUCATIONEastern Michigan University; Ypsilanti, MichiganBachelor of Science in Organizational Communication/Management 1990RELEVANT SKILLSBusiness DevelopmentClient ManagementProvider RelationsFinancial AnalysisRisk Adjustment FactorPerformance ManagementQuality AnalysisPhysician CompensationWORK EXPERIENCE3/2023-Current Optum RemoteClient ManagerBuild and strengthen client relationships while serving as the primary point of contact for overall and day to day program deliveryProactively manages external relationships by identifying needs, communicating product/program value proposition, and providing exceptional quality customer serviceDevelop and execute strategic account plans that strengthen business relationships, drive partner engagement, and align with organizational goals and objectivesSupport client success through education of partnership value and identify opportunities for enhanced performance10/2017-3/2023 WellMed Medical Management Fort Myers, FLSenior Physician Business ManagerPreparing groups for CAHPS survey, educate staff on Best Practices and Key Survey Questions.Review HOS data with groups, provide feedback and educate accordingly.Provide monthly reports to providers on Quality Score, Risk Adjustment Factor, Hospitalization/ ER and Financial Summaries.Provide on-going education; identify barriers and solutions to achieve group success.Review complex quarterly financials with providers during Joint Operating Committee Meetings.Identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs.Analyzes network adequacy based on defined access standards, target markets to identify theneed to recruit new provider.Compile and analyze data to determine root cause of issue and escalate the problem to appropriate cross-functional team for further analysis if necessary.Provide on-boarding and orientation to new providers.Participate company initiatives related to compliance or advocating company resources.Work with internal groups to identify barriers, understand and improve internal tools, resources, systems and changes.4/2015- 10/2017 Gulf Coast Medical Group Venice, FLAssistant to Group Practice AdministratorCompiles financial reports for the 75 providers and 36 clinics.Daily interaction with day to day operations of 36 clinics.Coordinates with clinics to assure proper communication of information and prepares for provider and staff meetings.Acts as a liaison with the providers and clinic staff.Prepares expense reports for providers, staff and clinics.Maintains and facilitates compensation agreements for providers.Liaison with contracted insurance companies.Knowledge of revenue cycle including denials.Assists with practice acquisitions.Assists with the recruitment process for new providers and credentialing.10/2012- 3/2014 Lincare Oxygen Fort Myers, FLLocation/Practice ManagerOperational, financial and human resource management.Compiled financial information for the location.Managed performance of practice operations, finances and 16 support staff.Reviewed monthly financials and created action plans accordingly.Communicated and collaborated with directors via monthly operations meetings.Responsible for daily/weekly/monthly sales, budget and P&L reports for senior management.9/2009- 3/2012 Arcadia Home Care & Staffing Kalamazoo, MIBranch ManagerReported weekly income, managed financial information for branch.Overall management of day to day operations for the branch office, including 36 employees.Analyzed P & L and accounts receivable reports on a monthly basis. Researched and reported on variances and resolved problems.Led a multidisciplinary team in discussing flow charting and improving operations.Handled and resolved patient complaints.Monitors data entry including schedules, payroll, client information and Employee information.Negotiate contracts, account resolution and manages aged accounts.Assures the maintenance of quality assurance and our ACHC accreditation.Major gifts leadership position with Alzheimers Association Walk Chair Member.4/2008- 6/2009 Sojourner House Assisted Living Kalamazoo, MIResidence DirectorCompiled and analyzed financials for the location.Created expense analyses and reports.Recruit, train and continually updates staffs knowledge of procedures and clients needs.Assures implementation of policies and procedures relating to resident care.Responsible for overall administration and operation of facility.Assures a high degree of customer satisfaction at residence.Promptly investigates complaints and reports findings.Supervises and completes payroll, managing budget and billing for resident services.Manages 16 staff members and 4 department heads.Develops and implements marketing plans to accomplish occupancy targets.Assures that adverse findings by organizational quality reviews or statesurveyors are promptly corrected and remain in compliance.2007-2008 CMC-Northeast Medical Center Concord, NCEducation Support SpecialistProvide support for the Education and Development Department, which includes creating courses, registering students and tracking units.Utilizes computer programs and applications effectively to include-graphic displays of data submissions.Maintains employee education scheduling and tracking system for the medical center, which includes compiling reports.Worked with the Compliance Department to educate staff and maintain qualifications.2005- 2007 St. Joseph Mercy Health System Ann Arbor, MITeam Leader - Inpatient AdmissionsManaged up to 17 employees consisting of admitting staff and financial counselors.Monitored daily work for quality assurance requirements, identified improvement needs, created action plan and tracked outcomes.Communicates with hospital Physicians, Finance Department, Medical Records, Clinical Departments, Patients, and third-party administrators.Participates in interviewing and hiring new team members, identifies employee improvement needs.Educated in system registration, patient accounting and network applications and insurance verification.Participated in the Lean process of improvement, educated staff on changes and tracked progress.1996-2003 Botsford Continuing Care Corporation Farmington Hills, MIDirector of Admissions- Skilled Nursing FacilityMarket facility to hospital Physicians, Discharge Planners, and Social Workers.Recruited and credentialed physicians for nursing facility.Negotiate and completed contractual arrangements with payers.Analyze financial statistics daily and prepared fiscal budgets.Knowledge of federal and state procedures and regulations. Created policies and procedures as needed.Evaluated our compliance program to maintain efficiency.Experience with Excel spreadsheets, Microsoft Windows, AS400 Financial System, and Achieve Patient Care System.References Available Upon Request |
