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Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLE Cell:PHONE NUMBER AVAILABLEPROFESSIONAL SUMMARYExperienced and effective Provider relations and Business Development Manager with a solid background in healthcare and a passion for managing processes. Results oriented with a proven track record of improving market positions and maximizing opportunities for financial growth. In-depth knowledge in the following healthcare management systems: Medicare and Commercial Value Based Programs, Accountable Care Organizations, (ACOs), Independent Physician Association (IPA), Managed Services Organizations (MSO), Government Programs, Home Health, Senior Care, Physician Recruiting and Ancillary Contracting, Pharmaceutical Hospital Sales.SKILLS:Healthcare Financial Management: Expertise in provider reimbursement methodologies including Value Based Care, Fee-For-Service, Medicare/Medicaid, Performance Based Contracting and third-party Reimbursements.Leadership and Influence: Proven success as a leader in healthcare settings, with strong ability to influence stakeholders.Negotiation and Analysis- Skilled in negotiating, problem-solving and analyzing referral patterns in physician practices, specialty groups and hospitals,Network Strategy & Development- Proficient in using business acumen and relationship building to enter new markets and rejuvenate underperforming ones for strategic gains.PROFESSIONAL EXPERIENCEIntegraNet HealthExecutive Director of Network Development and Provider Relations 07/20- PresentIntegraNet Health, an ACO that offers Medicare value-based contracts with Aetna, Cigna, Anthem/Amerigroup, and Humana specifically designed for special needs patients.Portfolio Management- Manage operational and business issues for assigned territories, including individual and group practices, specialty groups, hospitals and ancillary accounts. Also identify new business opportunities to improve financial growth and help streamline workflow demands.Joint Operating Committee (JOC) Meetings: attend meetings with payors to address network development, quality, cost and client service issues.Relationship Management- Collaborate with physicians to enhance patient experience as measured by CAHPS surveys, STAR performance metrics.Performance Review & Training- Conduct monthly meetings with clinical and non-clinical teams to review performance metrics and service-related statistics. Provide training on utilization, policy and procedures, and the use of proprietary referral software and web-based patient tracking tools.Deliver high impact product presentations to key decision makers at the executive, C-Suite, and clinical levels tailoring content to diverse audiences.Sales Reporting- Prepare and present sales reports that identify and measure trends, and growth opportunities. Also evaluate and interpret physician referral patterns and trends to understand market dynamics.Network Strategy & Contracting- Recruit and contract small-mid, PCP and specialty groups, independent hospitals, and Individual Physician Organizations (IPAs). Manage negotiations and relationships throughout the process.North Texas CIN, Inc. (TXCIN)Physician Engagement (Provider Relations) 01/18-05/20TXCIN, a ACO with a clinically integrated network of physiciansRecruit new physicians and add additional contracts to existing accounts.Develop and manage accounts to proactively identify strategic objectives and actions in collaboration with internal partners.Managed an assigned territory of primary care, specialty practices and ancillary accounts to identify opportunities to improve financial growth and streamline workflow and business operations.Coleman Page 2Provide extensive education on HEDIS measures, utilization, policy & procedures, technical integration and the use of proprietary referral software and web-based patient tracking tools.Comply with guidelines established by Centers for Medicare and Medicaid (CMS) and other regulatory agencies.Owner/Administrator and Marketing Specialist Home Health 04/13-07/20Healthcare Transitions, LLC- A non-medical home health agency that specializes in post-surgical, post-natal and maternity care, adult & senior care.Managed day-to-day business operations as well as financial aspects of the business including budgeting and financial reporting.Developed a strategy to establish a partnership with PepsiCo through the Perks program. As a result, Healthcare Transitions was chosen to be the premier home healthcare agency to service PepsiCo employees. The partnership not only had a positive impact on the patient and referral base but also an increase in company revenues.Increased customer satisfaction by implementing efficient business processes and providing exceptional service.1st Health 07/12-04/15Business Development Manager (Chiropractic Medicine)Next Health, an ancillary service company specializing in quality care and cost reductions.Practice Integration- Recruited and integrated chiropractic practices into a Physical Medicine & Rehabilitation (PM&R) model, enabling chiropractors to double their revenue and enhance patient satisfaction and outcomes.Client Engagement- Led client meetings with physicians, practice managers to discuss and implement operational initiatives.Customer Management- Directed and managed customer expectations, overseeing the delivery of products and services throughout the contract life cycle.Trinitas Healthcare SolutionsBusiness Development Manager (Recruiter) 06/09-07/12Recruited physicians and clinical staff for hospitals, clinics, and specialty groups.Collaborated with business leaders to develop and implement recruitment plans, improving interview and selection processes.Eli Lilly and Company 11/2000-06/2009Senior Care Sales- Neuroscience Division 2000-2004Neuroscience Account Based- Hospital Accounts 2004-2007Cardiovascular Business Unit -Senior Specialty Representative 2007-2009Responsible for selling and disseminating disease state information. Targeted accounts: State and VA Hospital Accounts, Community Hospital Accounts, State School Accounts, Department of Defense, and Senior Care.Successes: Turned around underperforming territory into one of the top 10% performing territories in the nation by overcoming gatekeeper objectives, building, and establishing solid business relationships, and identifying /securing high-potential targets. Participated in the successful launch of nine medications for the treatment of Bipolar, Schizophrenia, Depression, ADHD, Cardiology, Diabetic Neuropathy, and Osteoporosis.EDUCATIONIndiana University, South Bend, INBusiness Management- August 1994 |
