Cynthia Pelton
Delta,OH
Summary
Dynamic Provider Contracting Account Executive with a proven track record at AmeriHealth Caritas, excelling in client relationship building and contract negotiation. Successfully enhanced customer satisfaction and retention through strategic initiatives and effective communication, while streamlining account management processes to drive operational efficiency and improve client outcomes.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Provider Contracting Account Executive
AmeriHealth Caritas Family of Companies
10.2022 - Current
- Developed and maintained strong client relationships to enhance customer satisfaction and retention.
- Executed sales strategies to identify new business opportunities within assigned territories.
- Collaborated with cross-functional teams to align service offerings with client needs and expectations.
- Managed contract negotiations, ensuring compliance with company policies and industry regulations.
- Managed multiple accounts simultaneously while maintaining organization and prioritizing tasks efficiently.
- Boosted client satisfaction by developing and maintaining strong relationships through effective communication.
- Established long-lasting relationships with key decision-makers within client organizations, solidifying the company''s reputation as a trusted partner in their respective industries.
- Negotiated contracts successfully, securing favorable terms for both the company and clients.
- Streamlined account management processes for increased efficiency and improved client retention rates.
- Developed detailed reports analyzing account performance data, providing valuable insights for future strategy adjustments or improvements.
Provider Relations Network Manager
MediGold
05.2021 - 10.2022
- Led network infrastructure design and implementation for enhanced operational efficiency.
- Managed vendor relationships to optimize service delivery and cost-effectiveness.
- Lead all value-based agreement meetings and ensured follow through, working closely with MediGold SLT to assist in success of value-based initiatives
- Interim Vendor Procurement Manager facilitating vendor contract negotiations new and renewal
Senior Value Based Programs Specialist
Paramount Healthcare
01.2006 - 05.2021
- Led cross-functional teams to streamline healthcare operations and improve patient outcomes.
- Developed and implemented patient care protocols to enhance service delivery.
- Executed strategic initiatives that improved workflow efficiency across departments.
- Established performance metrics to assess team effectiveness and drive continuous improvement efforts.
- Followed all company policies and procedures to deliver quality work.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Negotiate and facilitate value-based agreements with providers resulting in significant savings to company and success improving health outcomes
- Implement governmental incentive programs, perform analysis, conduct reports and facilitate payments
- Active participant in Ohio's State Innovation Model
- Lead attribution algorithm (logic) for Medicaid product
- Participate with Governmental Sr. leadership on 1:1 calls with Ohio Department of Medicaid and Office of Health Transformation
- Work closely with upper management, internal departments, and providers regarding value-based initiatives
- Provided reporting for forecast analysis and ad-hoc reporting for all product lines in support of decision-making.
Education
State of Ohio Life And Health Insurance License
Hondros College
Toledo, OHState of Ohio Property And Casualty Insurance
Hondros College
ToledoSkills
- Relationship building and account management
- Customer relationship management (CRM)
- Business development and planning
- Lead generation
- Data analysis
- Strategy implementation
- Attention to detail
- Teamwork and collaboration
- Problem-solving
- Contract Management Software
- Walters Klewer LEAP 110 for ICD 10 coding and analysis
Certification
- Licensed State of Ohio Life and Health Insurance
- Licensed State of Ohio Property and Casualty Insurance
Timeline
Provider Contracting Account Executive
AmeriHealth Caritas Family of Companies
10.2022 - Current
Provider Relations Network Manager
MediGold
05.2021 - 10.2022
Senior Value Based Programs Specialist
Paramount Healthcare
01.2006 - 05.2021
State of Ohio Life And Health Insurance License
Hondros College
State of Ohio Property And Casualty Insurance
Hondros College