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Emily Lee
Gladstone,OR
Summary
Accomplished Senior Provider Relations professional with extensive experience in mentoring and training teams. Skilled in facilitating educational sessions and resolving conflicts, contributing to improved provider relations and operational efficiency.
Overview
30
30
years of professional experience
Work History
Senior Provider Relations Representative
Providence Health Plan
Portland, OR
07.1999 - Current
- Developed and maintained strong relationships with providers in Multnomah County to enhance collaboration for PHP members.
- Led initiatives to streamline provider onboarding processes, improving efficiency with CAQH.
- Provided strategic guidance on contract negotiations, ensuring alignment with PHP goals and compliance standards.
- Mentored & trained new PR Reps on best practices for provider engagement & conflict resolution techniques.
- Facilitated training sessions for PR & Contracting teams, enhancing understanding of provider-related policies and procedures.
- Analyzed provider network to determine gaps & improve where needed.
- Managed the Multnomah County area, providing personalized support & service to maintain long-lasting relationships with large provider groups, including The Oregon Clinic, Providence Medical Group, and Compass Oncology.
- Strong liaison between providers & internal departments, ensuring effective collaboration, including Providence Health & Services.
- Perform site visits for current & potential network providers, showcasing the value-adds and benefits of joining PHP's network.
- Provide exceptional customer service to providers during the credentialing & contracting process, ensuring a smooth experience.
- Developed training materials for new Provider Relations Representatives, facilitating onboarding experiences and improved job performance.
- Yearly retreat organizer for the statewide PR team.
Account Specialist - Large Group Sales
Providence Health Plan
Portland, OR
06.1997 - 07.1999
- Assisted the large group sales team for quotes of employer groups with 50 or more employees.
- Managed client accounts to ensure accurate information and timely updates.
- Managed multiple accounts simultaneously, demonstrating exceptional organizational skills and attention to detail.
- Collaborated with sales team to upsell products and services, resulting in higher revenue generation.
Intake Specialist-Providence HOME Services
Providence Home Services
Portland, OR
07.1996 - 06.1997
- Coordinated intake processes to ensure timely service delivery and client satisfaction.
- Verified insurance policies with various companies before Home Health would schedule visits.
Education
Bachelor of Science - Healthcare Administration
Oregon State University
Corvallis, OR06-1994
Skills
- Health Plan contract interpretation
- Provider network & relationship management
- Educational presentations to large provider groups
- On-site visits & New Provider orientation
- Superb problem-solving abilities
- Excellent communication
- Team collaboration & leadership
- Conflict resolution
- Product and service sales
- Knowlege of Facets, Choreo, MS Suite, Zoom
Timeline
Senior Provider Relations Representative
Providence Health Plan
07.1999 - Current
Account Specialist - Large Group Sales
Providence Health Plan
06.1997 - 07.1999
Intake Specialist-Providence HOME Services
Providence Home Services
07.1996 - 06.1997
Bachelor of Science - Healthcare Administration
Oregon State University