Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
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Christine Kaplan

West Chester

Summary

A strategic thinking executive who influences positive change in the healthcare industry. Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.

Overview

30
30
years of professional experience

Work History

Head of Operations-Consultant

CLINICAL INTELLI-PRINT, LLC
01.2024 - Current
  • Member of the executive management team directing all aspects of business strategy and execution for an automated publishing and printing solutions company for the clinical research industry.
  • Manage a team of 15 project coordinators/graphic designers and sales staff responsible for the day-to-day management, growth strategy and market expansion of our printing services.
  • Develop the organizational structure, strategic business plan, policies and procedures, and operational procedures.
  • Improved overall productivity with the introduction of innovative process improvement initiatives.

Vice President Provider Relations/Network Development

EVOLENT HEALTH
01.2008 - 01.2024
  • Company Overview: Prior to being acquired by Evolent Health in 2023, worked for National Imaging Associates, Inc. (NIA), a subsidiary of Magellan Healthcare
  • Manage and lead a global team of Managers responsible for the oversight of provider contracting and servicing of provider network.
  • Maintain and oversee provider contracting for over 15 markets with five health plans.
  • Proven ability to influence leaders and key stakeholders.
  • Excellent relationship-building skills and proven ability to work collaboratively through various departments and functional areas, promoting a culture of proactive teamwork.
  • Collaborate with network contracting colleagues, as well as legal department, compliance, credentialing and claim operations to optimize and streamline the entire contracting process.
  • Own and update the provider resources, including Provider Manuals and other educational tools.
  • Manage the provider education and communication programs for Magellan’s specialty medical services for the clients’ provider networks using a multi-media approach and a goal to standardize and consolidate provider related requirements communications.
  • Develop and execute a comprehensive provider relationship/engagement strategy spanning over 96 health plan partners nationally for 100,000 plus medical specialty providers to increase awareness and education.
  • Oversaw the provider portal, RadMD and contributed to a 25% overall usage increase nationally.
  • Contribute to the increase in the overall provider experience satisfaction rate of 5% in three years, resulting in an 85% overall satisfaction.
  • Oversee the assessment of network needs based on market research to meet network adequacy and ensure quality networks.
  • Direct, monitor, trend, routine, and long-standing provider complaints, claims, contracting, credentialing, and other network provider performance issues requiring educational and interventional initiatives.
  • Serve as a key health plan contact and support for all provider relations activities by participating in Joint Operation Committee (JOC) meetings.
  • Direct oversight of the workflow and provider education of the provider analytics program for two health plans in 15 markets.

Director, Provider Relations

AETNA
01.1996 - 01.2008
  • Company Overview: Formerly Coventry Health Care, Inc.
  • Oversaw the ongoing education, servicing, recruitment, and provider negotiations for over 25,000 providers in Delaware, New Jersey, and Maryland.
  • Managed Provider Relations field representatives responsible for the ongoing recruitment, servicing, and problem resolution for providers and staff.
  • Responsible for the oversight of provider contracting, credentialing, servicing, and other delegated functions for high-tech imaging services, dental and behavioral health services provided by third-party vendors.
  • Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
  • Enhanced team collaboration through regular communication, goal setting, and performance evaluations.

Manager, Medicaid Program – Operations

AETNA
01.2000 - 01.2003
  • Company Overview: Formerly Coventry Health Care, Inc.
  • Responsible for the day-to-day activities of the Health Plan’s Medicaid Product.
  • Developed and monitored the budget for the Medicaid Product.
  • Developed and managed the implementation of policies and programs as they related to state and federal mandates.
  • Responsible for the implementation and the strategic plan for growth for both Delaware and Maryland Medicaid.

Education

Master’s of Science - Health Care Administration

St. Joseph’s University
Philadelphia, PA

Bachelor’s of Science - Health and Human Development

Pennsylvania State University
State College, PA

Skills

  • Ability to Drive Initiatives Forward to a Successful Conclusion
  • Relationship Management
  • Strategic Leader in Network Development/Provider Relations and Enterprise-Wide Transformation
  • Proven Successes in Leadership and Team Management
  • Strong Negotiation and Communication Skills
  • Data Analytics and Reporting
  • Network Quality Performance

Affiliations

Pennsylvania State University and St. Joseph’s University Alumni Mentorship Program

Timeline

Head of Operations-Consultant

CLINICAL INTELLI-PRINT, LLC
01.2024 - Current

Vice President Provider Relations/Network Development

EVOLENT HEALTH
01.2008 - 01.2024

Manager, Medicaid Program – Operations

AETNA
01.2000 - 01.2003

Director, Provider Relations

AETNA
01.1996 - 01.2008

Bachelor’s of Science - Health and Human Development

Pennsylvania State University

Master’s of Science - Health Care Administration

St. Joseph’s University

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Christine Kaplan