Heather Carlson
Faribault,MN
Summary
Experienced professional with a Masters of Health Informatics degree and a wealth of knowledge and expertise. Proficient in analyzing data and converting it into valuable insights for strategic business decisions. Skilled in data visualization and report generation, demonstrating strong analytical thinking and problem-solving abilities.
Overview
10
10
years of professional experience
Work History
Senior Payer Relations and Contract Specialist
Essentia Health
Duluth, USA
01.2021 - Current
- Responsible for ongoing management of contracts and the overall relationships with assigned payers, serving as a liaison between Essentia Health and the payer
- The scope of this relationship management includes managing the overall relationship between Essentia Health and the payers supporting revenue services, UM, population health, quality, and business development
- Responsible for the negotiation of fee for services and value-based payer contracts for the full suite of services offered within Essentia Health
- The negotiations include both language and reimbursement terms, within defined parameters and processes
- Knowledgeable in coding, payer claim edits, varied reimbursement methodologies, and in health plan business practices
- Subject matter expert for assigned payers
- Responsible for the dissemination of policies, procedures, and programs to ensure Essentia Health success within the agreement
- Compile data from contracts for use by multiple departments
Contract Specialist
South Country Health Alliance
Owatonna, USA
08.2018 - 01.2021
Credentialing Specialist
South Country Health Alliance
Owatonna, USA
08.2015 - 08.2018
Client Relationship Assistant/Data Analyst
Agilis
Albert Lea, USA
04.2015 - 06.2015
Education
Masters - Health Informatics
St. Catherine’s University
St. Paul, MN12.2023
Bachelors - Healthcare Management
St. Catherine’s University
St. Paul, MN08.2019
Skills
- Quality assurance
- Research and analysis
- Tableau dashboard creation
- SQL querying capabilities
- Python
- Data Visualization Abilities
Timeline
Senior Payer Relations and Contract Specialist
Essentia Health
01.2021 - Current
Contract Specialist
South Country Health Alliance
08.2018 - 01.2021
Credentialing Specialist
South Country Health Alliance
08.2015 - 08.2018
Client Relationship Assistant/Data Analyst
Agilis
04.2015 - 06.2015
Bachelors - Healthcare Management
St. Catherine’s University
Masters - Health Informatics
St. Catherine’s University