Deanna Wolfe
Cleveland,OH
Summary
Dynamic and results-oriented healthcare professional with over 15 years of experience in network management, contracting, and reimbursement strategies. Proven track record of driving operational excellence, fostering strategic partnerships, and implementing innovative solutions to optimize healthcare delivery and improve patient outcomes. Skilled in hospital, ancillary, and physician contracting across commercial, Medicare, and Medicaid markets.
Overview
19
19
years of professional experience
Work History
Director Network Management
CIGNA HEALTHCARE
11.2020 - Current
- Proven track record of developing and managing provider networks effectively
- Proficient in negotiating agreements with healthcare providers, including hospitals, physicians, and ancillary services
- Extensive knowledge of regulatory requirements governing healthcare contracting, including compliance with Medicare, Medicaid, and commercial insurance regulations
- Managing business to ensure compliance and mitigate risk
- Proven ability to achieve financial targets while optimizing network performance and provider relations
- Effectively communicate complex concepts and negotiate win-win solutions.
Manager Network Management
MEDICAL MUTUAL OF OHIO
05.2018 - 10.2020
- Managed network development and contracting activities, ensuring alignment with organizational goals and regulatory requirements.
- Implemented network strategies to improve access, quality, and cost-effectiveness of healthcare services.
- Conducted joint operating committee meetings and collaborated with facilities on payment and reimbursement guidelines.
Senior Network Manager
UNITED HEALTHCARE
06.2006 - 05.2018
- Developed and maintained provider networks, negotiating contracts and fee schedules to support network adequacy and provider relations objectives.
- Led cross-functional teams to implement clinical programs, disease management initiatives, and quality improvement measures.
- Coordinated with sales teams to support product development and market expansion efforts.
Network Account Manager
GREATWEST HEALTH CARE
06.2005 - 06.2006
- Managed provider relationships and contract negotiations, ensuring compliance with regulatory requirements and company policies.
- Conducted monthly clinical meetings to support disease management programs and quality improvement initiatives.
Education
Skills
- Commercial, Medicare & Medicaid Agreements
- Affordability & Total Cost of Care Management
- Disease Management & Value-Based Reimbursement
- Knowledge of Various Payment Methodologies
- Budget Management & Financial Modeling
- Joint Operating Committee Facilitation
- Clinical Collaboration & Program Development
- Medicare Advantage (STARS/HEDIS) Optimization
- Hospital, Ancillary & Physician Contracting
Timeline
Director Network Management
CIGNA HEALTHCARE
11.2020 - Current
Manager Network Management
MEDICAL MUTUAL OF OHIO
05.2018 - 10.2020
Senior Network Manager
UNITED HEALTHCARE
06.2006 - 05.2018
Network Account Manager
GREATWEST HEALTH CARE
06.2005 - 06.2006
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