Felecia Johnson
San Marcos,CA
Summary
Experienced cultivating, maintaining, and driving business relationships. Successful account and contract management within Medicaid, Medicare, federal, specialty network, LOAs, skilled nursing, ancillary. mental health, pharmacy, MSO, and Cal-AIM. Excellent communication, interpersonal and leadership skills, excels in challenging deadline driven environments.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Provider Contracting Intermediate
TALENT SOFTWARE SERVICES
06.2022 - 06.2023
- Negotiated cost-effective competitive contractual relationships with Blue Shield of California’s network of professional providers
- Quickly provided contract interpretation regarding contract concerns or new company, federal, and/or state regulation requirements
- Ensured company stayed protected during contract process from conception to completion.
Contract Manager
PROVEN RECRUITING
11.2020 - 01.2021
- Responsible for collaborating effectively with clinical/legal teams and stakeholders to review redlines proposed and identifying contract renewals
- Monitor existing contracts for upcoming expiration dates.
Contract Administrator
VINCENT BENJAMIN
06.2020 - 11.2020
- Reviewed contracts for special provisions, terms and conditions to ensure compliance with appropriate laws, regulations, policies, business objectives
- Provided contract education and responsibilities for contract compliance.
Contract Manager
ADVENTUS TECHNOLOGIES
09.2018 - 02.2019
- Reviewed contracts for special provisions, terms and conditions to ensure compliance with appropriate laws, regulations, policies, business objectives
- Provided contract education and reimbursement regarding contract agreements
- Ensured that the contract was specific and based on the Bureau of Labour and Statistics of The U.S
- Department of Labour per specified state in which services were performed.
Compliance Manager
ADECCO
05.2016 - 01.2017
- Executed and ensured FDA regulatory and contract service agreements
- Maintained SAP database to identify and monitor client complaints
- Audited investigation analysis of customer complaints.
Contract Solution Analyst
BEACON
10.2015 - 01.2016
- Prioritized, investigated, and resolved contracting and provider relations issues
- Responsible for departmental plans, state and federal audits
- Coordinated with the claims department to ensure claims adherence by providing contract terms to the configuration department.
Contract Specialist
ACT1/SPHERION
01.2013 - 09.2015
- Negotiated cost effective agreements with varies mental health providers such as Psychologists and other mental health providers
- Implemented executed contracts and resolved escalated contractual reimbursement issues
- Supported contracting initiatives within assigned markets; amended contracts to ensure regulatory compliance
- Responsible for recruitment strategies to maintain network adequacy.
Education
Bachelor Of Science - Health Promotion
HEALTH UNIVERSITY OF HOUSTON
Houston, TXSkills
- Network management
- Contract Negotiation
- Draft Contracts/Amendment
- Provider Relations
- Network Adequacy
- Redlines
- Project Management
- Compliance/Auditing
- Contract Interpretation
- Account Management
Certification
0F99572, Licensed Health and Insurance Producer
Timeline
Provider Contracting Intermediate
TALENT SOFTWARE SERVICES
06.2022 - 06.2023
Contract Manager
PROVEN RECRUITING
11.2020 - 01.2021
Contract Administrator
VINCENT BENJAMIN
06.2020 - 11.2020
Contract Manager
ADVENTUS TECHNOLOGIES
09.2018 - 02.2019
Compliance Manager
ADECCO
05.2016 - 01.2017
Contract Solution Analyst
BEACON
10.2015 - 01.2016
Contract Specialist
ACT1/SPHERION
01.2013 - 09.2015
Bachelor Of Science - Health Promotion
HEALTH UNIVERSITY OF HOUSTON
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