Dominique ROHDE
San Diego,TX
Summary
Strategic Contract Manager with extensive experience excelling in revenue cycle management, insurance contract negotiation, and revenue optimization. Proven track record in enhancing payer performance and maximizing reimbursement through strategic financial analysis and client communication. Adept at utilizing analytical tools to drive insights and improve contract compliance, ensuring alignment with organizational goals.
Overview
8
8
years of professional experience
Work History
Contract Manager
Acuity Eye Group
San Diego, CA
07.2024 - 04.2025
- Manage and negotiate insurance contracts with payers and managed care organizations to ensure competitive reimbursement rates and favorable terms for all clinics, and five surgery centers.
- Oversee the insurance contracting process from start to finish, including drafting, reviewing, and executing contracts.
- Collaborate with clinical and operational teams to understand financial needs and service offerings, ensuring all contracts align with the ASC, clinic goals, and financial performance.
- Monitor payer performance, identify issues with reimbursement, and analyze areas of potential revenue increase to ensure maximum revenue recovery, and aid in negotiating rate amendments.
- Create and present detailed reports on contract performance, payer trends, financial outcomes, and contract rate enhancement impact predictions to senior management.
Contract Modeling and Management
Guidehouse
San Diego, CA
08.2019 - 07.2024
- Analyze large sets of data to ensure the precision of calculated expected reimbursement and revenue.
- Monitor contract performance through account pricing, reviewing trends, and addressing any discrepancies by confirming facility rates are up to date, or improving contract modeling structure for further accuracy.
- Lesion between systems engineering, management, and operations to ensure error-free outputs.
- Prepare reports and presentations for hospital facilities to display payer versus pricing performance.
- Work with System Engineering to coordinate and educate on how system functions are expected to work from a user perspective, to facilitate system enhancements and fixes for seamless operational use.
- Utilized various software and tools to streamline processes and optimize performance.
Managed Care Specialist
Revenue Masters
San Diego, CA
06.2018 - 08.2019
- Primary contact for clients to ensure that contracts, rates, and fee schedules provided are updated.
- Analyze hospital contracts, contracted rates, and program rates into the system for accurate calculation of hospital, clinic, or physician expected reimbursement.
- Update all Medicare rates for all clients each quarter for lab, DME, pharmacy, radiology, and physician.
- Troubleshoot or solve any inquiries hospital staff may have regarding the pricing of patients' accounts.
Contract Analyst
Guidehouse/Navigant Cymetrix
San Diego, CA
04.2017 - 06.2018
- Worked with facilities' contracts to accurately price expected reimbursement for commercial and government claims.
- Learned Medi-Cal and APR-DRG reimbursement, and trained colleagues on this complex rate methodology.
- Worked with hospital finance staff to confirm that billing was accurate, and that contracts and rates were up to date.
- Identified trends in the payment of accounts to determine if a contract modeling update needs to be made.
Education
Bachelor of Science Degree - Business Management & Healthcare Management
Missouri State University
Springfield, MO05.2016
Skills
- Insurance contract negotiation
- Revenue cycle management
- Payer relations
- Contract compliance
- Regulatory knowledge
- Financial analysis
- Financial reporting
- Analytical tools
- Data analysis
- Commercial and government fee schedules
- Creating insights
- Generating reports
- All Microsoft and SQL, JIRA
- Analyzing complex contract terms
- APR-DRG, MS-DRG, CPT, HCPC
- Client communication
- Payer performance monitoring
- Revenue optimization
- Reimbursement methods
- ASC Groupers
- Commercial, Medicare & Medicaid reimbursement
References
- Kristi Russell - Director of Managed Care Contracting - (619) 887-0250
- Tarryn Webb - Contract Modeling Management - (817) 823-8112
Timeline
Contract Manager
Acuity Eye Group
07.2024 - 04.2025
Contract Modeling and Management
Guidehouse
08.2019 - 07.2024
Managed Care Specialist
Revenue Masters
06.2018 - 08.2019
Contract Analyst
Guidehouse/Navigant Cymetrix
04.2017 - 06.2018
Bachelor of Science Degree - Business Management & Healthcare Management
Missouri State University