Carrie Gates-Nash
Methuen,MA
Summary
Results-driven director with expertise in leadership, account management, sales, and customer service in the cost containment industry. Proven ability to handle multiple projects under tight deadlines in a fast-paced environment. Strong decision-making, organizational, and leadership skills combined with successful relationship building.
Overview
23
23
years of professional experience
Work History
Director of Provider Services
PMCS
Scottsdale, AZ
12.2012 - Current
- Managed account needs for a variety of clients, including Multiplan, Optum, and Prime Health Services, to ensure that our clients are receiving the best service possible by having interpersonal communication, conflict resolution, and quality customer service skills.
- Responsible for the development and implementation of policies, procedures, and directives for the Provider Services Department through training, team, and individual meetings.
- Maintain knowledge of current legislation specific to state and federal requirements affecting Group Health/Commercial, Workers' Compensation, Auto, and Medicare Supplemental lines of business.
- Handle and resolve all escalated provider appeals received directly from clients, providers, Provider Services team members, and other departments, as determined by team leader.
- Responsible for the performance of the Provider Services team with regard to PMCS Advance and PMCS Select provider appeals processes and specific client Service Level Agreements (SLA's).
Client Service Manager
MultiPlan
Waltham, MA
06.2008 - 12.2012
- Selected to supervise complex customer account problems, analyzing patterns and issues to establish effective strategies for successful resolutions. Clients included Cigna and Aetna (now CVS Health).
- Promoted successful outcomes by fostering productive relationships with internal departments.
- Consistently ensured compliance with department guidelines.
- Received the prestigious Red Ring award on December 19, 2011, in recognition of exceptional job performance and exemplary attitude.
Provider Services Manager
MultiPlan
Waltham, MA
06.2007 - 06.2008
- Researched, investigated, and resolved issues in Network Development, Account Management, and Customer Service units.
- Ensured consistent delivery of quality service to sustain and grow a satisfied clientele base.
Senior Corporate Quality Management Coordinator
MultiPlan
Waltham, MA
01.2006 - 06.2007
- Demonstrated sharp business acumen while effectively managing a wide array of operational matters, including handling escalated issues and promptly resolving complaint/grievance filings.
Education
Bachelor of Science - Human Services
Lesley University
Cambridge, MA05-1999
Timeline
Director of Provider Services
PMCS
12.2012 - Current
Client Service Manager
MultiPlan
06.2008 - 12.2012
Provider Services Manager
MultiPlan
06.2007 - 06.2008
Senior Corporate Quality Management Coordinator
MultiPlan
01.2006 - 06.2007
Bachelor of Science - Human Services
Lesley University
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