Allison Hennessey
Morgantown,USA
Summary
Dynamic leader with over 10 years of experience in credentialing, enrollment, and licensing processes within healthcare organizations. Expert in developing and implementing streamlined procedures that enhance operational efficiency and compliance. Proven track record of managing teams to achieve strategic goals while ensuring quality control and regulatory adherence. Skilled in building cross-functional relationships to support organizational growth and improve client satisfaction.
Skilled executive with robust experience in strategic leadership and operational management. Adept at driving projects to successful completion through effective team collaboration and adaptive problem-solving. Expertise in business development, financial oversight, and cross-functional team leadership. Known for integrity, reliability, and results-driven approach in dynamic environments.
Overview
7
7
years of professional experience
Work History
Associate Vice President, Credentialing and Provider Enrollment
Privia Health
10.2023 - Current
- Lead a national team of credentialing resources, focusing on consistency in hiring processes and empowering team development.
- Foster a culture of growth and empowerment by developing leaders, providing opportunities for advancement and increased responsibility, and ensuring team members are fully trained and capable of independent work.
- Assure strict compliance with all government regulations and health plan requirements pertaining to provider enrollment and credentialing; meticulously monitor departmental activities for unwavering adherence to policies, procedures, and regulatory mandates.
- Design, implement, and manage continuous process and quality improvement initiatives across all facets of payer enrollment, data entry, credentialing, and provider enrollment; develop and execute training programs to educate and enhance credentialing staff readiness for resource improvements and adaptability.
- Create and maintain robust processes that ensure data accuracy and integrity, while providing critical information to internal and external systems, improving overall efficiency and resource utilization.
- Work to external partners to optimize resource utilization.
- Manage the intricate flow of critical information among payers, contracted MSO facilities, and Privia Medical Groups, ensuring seamless communication.
- Coordinate the preparation of comprehensive management and operational reports, providing valuable insights for informed decision-making.
- Uphold the highest standards of confidentiality for all provider information, ensuring compliance with privacy regulations.
Director of Operations - Payer
Medallion
09.2023 - 02.2024
- Managed global teams, including both onshore and offshore resources, to ensure operational excellence.
- Oversaw comprehensive vendor management with external partners, ensuring strategic alignment and performance.
- Led implementation responsibilities for new client integrations, ensuring seamless transitions and effective delivery teams.
- Established dedicated client-facing teams to support all functions of credentialing, onboarding, and enrollment.
- Developed comprehensive training programs and standardized policy and procedure processes aligned with industry best practices.
National Director of Credentialing and Enrollment
Optum
03.2019 - 09.2023
- Directed national-wide operations for Payer Enrollment, Credentialing, Contracting, and Licensure services.
- Spearheaded the development and implementation of client growth strategies.
- Improved internal employee retention by implementing a new, effective communication methodology.
- Restructured operational teams to ensure optimal productivity and efficiency.
- Provided leadership and strategic guidance to all functions within the credentialing and enrollment space.
- Founded and established the National Credentialing Centers of Excellence, standardizing best practices.
- Authored and implemented all policies and procedures to ensure alignment with NCQA and Joint Commission standards.
- Led strategic platform vendor management, implementation, and deployment for UnitedHealth Group.
- Served as a Subject Matter Expert (SME) for Optum Ventures, advising on growth and funding initiatives.
Director of Partnerships and Solutions Consultant
Medallion
03.2022 - 02.2023
- Served as a Subject Matter Expert (SME) for Medallion's team to align operational and service offerings with client needs.
- Managed and completed all Request for Proposals (RFPs) and contracting for Medallion's services.
- Acted as an industry product advocate for Medallion's services, representing Medallion at virtual and onsite speaking engagements.
Education
Fairmont State University
Fairmont, WVSkills
- Operations oversight
- Team leadership across onshore and offshore teams
- Enrollment, Credentialing, Contracting
- Licensure Services, Provider Data Management, Onboarding
- Negotiation and conflict resolution
- Compliance & Process Improvement: Policy and Procedure Development, NCQA, Joint
- Technical Services: MD Staff, Verity HealthStream, Medallion, Symplr, Jira, Athena One, Epic, Edifecs, Workday, Veradigm, Modio, Enterprise Now, QCTRL, Salesforce
- Operations management
- Organizational development
- Utilization review
- Partnership development
Timeline
Associate Vice President, Credentialing and Provider Enrollment
Privia Health
10.2023 - Current
Director of Operations - Payer
Medallion
09.2023 - 02.2024
Director of Partnerships and Solutions Consultant
Medallion
03.2022 - 02.2023
National Director of Credentialing and Enrollment
Optum
03.2019 - 09.2023
Fairmont State University