Alicia Smith Hernandez

• Drives the creation and improvements in RCM policies and claim submission procedures, optimizing operational effectiveness
• Contributes to the oversight of strategic workflow development and maintenance, as well as playbooks, educational materials, and collateral
• Lead successful implementations of new pilots and programs, ensuring enhanced program quality and efficiency
• Collaborates closely with Service Line Leaders, IT leaders, clinical leaders, and key stakeholders to drive strategic program management and continuous improvement
• Identifies provider network needs and implements strategic interventions for organizational success
• Responsible for the addition of new providers while ensuring consistent improvement in performance and capacity of existing providers
• Manages provider enrollment processes and credentials for healthcare organizations in multiple states and with various payers
• Develops clear goals, work plans, and schedules for staff, ensuring timely execution
• Facilitates comprehensive onboarding, training, and support to effectively engage providers with Ventricle Health processes and culture
• Effectively manages provider performance, quality, and outcomes by implementing necessary corrective actions

Other responsibilities:

· Established legal and operational frameworks for successful foreign medical PC entity set-ups; serves as designated liaison and registered agent for VH Provider Group, P.A.

· Managed company payroll for contractors and W2 employees

· Served as implementation and account manager for newly signed clients, leading weekly reviews of key takeaways and milestones

• Led, developed and managed an ambitious high-performing team by providing leadership in the establishment of the employment brand and developing supporting materials in order to communicate the value proposition through the business’s employment advertisements, career sites, and job descriptions
• Guided/advised Leadership, sales, and account management team for realistic expectations in the recruitment of specialty clinicians and setting competitive compensation structures/rates for sync and async visits
• Established quarterly KPI’s and OKR’s to challenge my team while balancing company goals
• Drove a culture of constant improvement, identifying, and implementing projects to increase business-wide recruiting effectiveness and efficiency
• Developed and implemented strategic talent acquisition tactics by evaluating the entire recruiting function, strategies, and procedures to find opportunities for improvement
• Owned the business’s recruiting efforts by determining the strategic direction and objectives of the recruiting department, supporting the business’s growth while simultaneously maintaining its culture and quality standards
• Provided sound leadership that ensured the delivery of the business’ operational standards in recruitment activities
• Streamlined recruitment processes and oversaw the screening and selection processes for evaluating potential candidates conducted by the recruitment team
• Coached, managed, and developed, actively supporting my team’s professional growth - took on the role of their mentor, and guaranteed the successful onboarding of all new hires.

• Developed and scaled a small clinician network to a robust network of multi-specialty providers by leveraging my own personal professional relationships and scouting burgeoning talent to staff in support of new launches and offerings
• Recruited and built meaningful professional relationships with specialists, medical directors, and advisors in newly created verticals
• Owned the creation of provider schedules and managed overall provider adherence while being mindful of licensed provider coverage; exceeding company-established SLA’s in order to deliver exceptional patient experiences
• Created, built out, and executed a unique scheduled coverage program for independent contractors in an answer to scheduled coverage challenges
• Leveraged connections in the Telemedicine field to keep a pulse on market rates and payment models and rolled out compensation changes/adjustments accordingly
• Collaborated with the data team to identify and create meaningful reporting metrics to capture SLA infractions, schedule adherence, and monthly “report cards” in response to provider requested feedback on their performance
• Main POC for all questions/requests pertaining to the network from leadership, general managers, customer care, and other key business stakeholders
• Authored job descriptions, escalation procedures, and hiring and on-boarding processes/agendas for the medical group.

• Analyzed existing network coverage with sales pipelines to anticipate and/or plan for expansion of licensed coverage and guided the Recruitment team accordingly
• Monitored ongoing provider network incentives; ensured appropriate coverage and minimized extra payment costs
• Supported the medical business segments for Health Systems, Enterprise clients, and payor groups by providing network coverage and strategic recruitment plans to meet volume needs
• Supported VP of Clinical Operations by conducting Locums contract negotiations (including terms and conditions) with outside agencies and national provider networks
• Collaborated with VP of Call Center to identify root cause analysis and resolution for Provider consultation and system failures
• Performed monthly outreach/touchpoints to non-active Providers on the network; providing feedback to management in terms of platform, education/training, IT, and overall system enhancement opportunities
• Conducted monthly audits and reviews for scheduled adherence with scheduled network clinicians
• Responsible for outreach and feedback to Providers with poor Provider scorecard averages while documenting conversations and assigning Provider performance plans (if necessary)
• Responsible for overall NPS scores for clinicians by preparing and analyzing quarterly survey results and implementing “win-back” programs to improve overall clinician satisfaction
• Implemented a Provider “buddy” system for onboarding support
• Served as the immediate POC to resolve all escalated provider-related issues.

• Aggressively recruited well-qualified applicants from a variety of sources, including cold calling, sourcing on applicant tracking system and LinkedIn, social networking, and various job boards
• Collaborated with department heads companywide by providing assistance as needed with recruitment, retention and talent search at all levels of personnel
• Provided sound hiring advice to management
• Partnered and developed trusting relationships with hiring managers to determine requirements, job descriptions and effective hiring strategies
• Drove and managed the recruiting process for both hiring managers and applicants
• Conducted in-depth telephone assessment of applicants through comprehensive interviewing and work history review
• Managed the screening, presentation, selection, reference checks, closing, and administrative components involved in full cycle recruiting.

• Worked closely with business units and hiring managers to review and analyze needs for talent acquisition
• Continuously focused on delivery to the business, process improvement, the candidate experience, advancing the technology and recruitment strategies, developing meaningful metrics, and building up the talent brand
• Developed recruiting strategies designed to identify qualified candidates for each client’s needs using various tools such as candidate databases, proprietary job sites, public job sites, LinkedIn, social media, and networking events
• Evaluated the strengths and weaknesses of candidates through screening conversations and in-person interviews
• Negotiated wages, benefits, and other terms and conditions of employment with candidates
• Understood the needs, qualifications, and expectations of the potential candidates to ensure the best possible fit professionally and culturally.

• Developed and grew client base by consultative sales services for temporary and temporary to permanent solutions; actively called clients and conducted face to face meetings with key hiring managers
• Negotiated bill rates and conversion fees with C-suite decision makers
• Matched candidates by interviewing and placing on assignment by effectively matching skillsets, culture, and personality to client specifications; ensuring less than a 4% replacement rate
• Called selected candidates to explain start date, compensation, parking, dress code, company culture, environment, and hours
• Conducted thorough candidate screenings to include supervisory reference calls.

• Provided leadership in Client Account Management and lead the Project Management Office including organizational structure, establishing process and procedure standardization, and collaboration on strategic business development
• Responsible for entire project implementations with Fortune 500 clients, multi-hospital systems, and regional health plans
• Heavily collaborated with major privatized payers to ensure facilitation within the claim adjudication process; handled back-end claims submissions between HSA/FSA/HDHP and PPO plans, insurance billing rules, and major medical benefit offering.