Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Jennifer M. Lea

Sauquoit

Summary

Proficient Provider Relations Representative bringing over eight years of field experience. With proven expertise in compliance and contract management. Skilled in fostering partnerships with local agencies and enhancing enrollment through strategic outreach. Strong leadership and communication abilities, coupled with in-depth knowledge of Medicare and Medicaid benefits, drive successful outcomes in healthcare service delivery.

Overview

18
18
years of professional experience

Work History

Provider Relations Representative

Nascentia Health
Syracuse
01.2020 - Current
  • Ensuring compliance with NYSDOH and CMS regulations.
  • Collaborated with internal teams and external providers to meet regulatory requirements and maintain current provider records.
  • Managed provider relations for a diverse network, managed and assisted with network contract for MLTC & DSNP.
  • Led the completion of audits and re-credentialing for providers, ensuring all necessary documentation was up-to-date and compliant.

Business Developer

iCircle
Webster
01.2018 - 01.2020
  • Assisted the provider relations team and contracting team with contracts with healthcare professionals and CDPAP agencies.
  • Collaborated and promoted iCircle services with agencies across Oswego, Oneida, Madison, Onondaga, Herkimer, Delaware, Cortland, Broome, Otsego, and Chenango counties.
  • Had great working relationships with local agencies such as local OPWDD agencies, local nursing homes, office for the aging, CDPAP agencies, and health home care agencies.
  • I was able to increase enrollment throughout my central NY area.

Independent Living Coordinator supervisor

ARISE
Syracuse
01.2012 - 01.2018
  • Assist individuals with benefits advisement specializing in Social Security Benefits.
  • Also assist individuals with finding housing, Medicaid & Medicare benefits, assisting with trust fund spend downs, also assisting to get long term care services in the home.
  • Community outreach to local business and have good standing relationship with local business.
  • I plan the American’s with Disabilities Act Celebration in Madison County with collaboration with agencies.
  • Attend many local committees including No wrong door through NY connects, long term care council meetings, non-profit meetings, along with being a part of local chamber of commerce.
  • I’ve grown a new grant NY Connects covering four counties and supervisor of four staff along with working with the grant holder agency.
  • Maintain & continuing outreach for business development in both grant’s.

Community Integration Specialist, Coordinator Assistant

ARISE
Syracuse
01.2009 - 01.2012
  • Give direct care to children and adults with developmental disabilities in Madison County.
  • Look over consumer’s ISP to work with the program coordinator to establish value outcomes for the consumer to work on.
  • Work with service coordinators to help establish a plan that will help the consumer meet their individualized goals.
  • Write weekly progress notes that meet OPWDD qualifications.
  • Help consumer’s work on their valued outcomes to establish independence.
  • Helped the coordinator approve paperwork that was given from direct care workers, wrote monthly summaries, made sure hours of service for individuals were being met.
  • Assisted direct care staff with issues that arose during their shifts with individuals & gave them direction on how to resolve the issue.
  • Assisted the Coordinator with supervising staff.
  • Insured hours being billed were within Medicaid requirements for services being delivered for direct support staff.

Respite Site Supervisor

Heritage Farm, Inc.
Bouckville
01.2008 - 01.2009
  • Oversee five respite staff; trained and recruited new staff.
  • I Planned weekend activities for adults and children with developmental disabilities that would meet their individualized goals while having fun with peers.
  • Also wrote annual reports, wrote and implemented a budget that the respite program followed, wrote weekend notes that meet OPWDD qualifications.
  • Worked with service coordinators to help a consumer come and enjoy respite.

Day Habilitation Specialist

Heritage Farm, Inc.
Bouckville
01.2007 - 01.2008
  • Scheduled activities for people with disabilities that would work on their individualized value outcomes.
  • Wrote daily notes that meet OPWDD qualifications.
  • Gave consumers the opportunity to interact with peers through constructive activities.
  • Helped consumers see their strengths and helped many consumers active their valued outcomes.

Education

Certification OPWDD Independent Broker -

State of New York, OPWDD
05.2025

Certification of Benefits Practitioner - Social Security Disability Benefits, Medicaid, Medicare insurance

Cornell University
Ithaca, NY
01.2018

Education - Special Education

John A. Logan Community College
Carterville, Illinois
03.2007

Education - Special Education

Mohawk Valley Community College
Utica, New York
05.2006

Certification - Early Childhood Education

Madison Oneida BOCES
Verona, New York
06.2005

High School diploma -

Oneida High School
Oneida, New York
06.2005

Skills

  • Partnerships with local businesses
  • Great communication skills
  • Public speaking
  • Knowledgeable of MLTC services
  • Knowledgeable of OPWDD services
  • Leadership skills
  • Employee Relations
  • Proficient in Word
  • Proficient in Excel
  • Excellent organization skills
  • Excellent personal skills
  • Knowledgeable of Social Security Benefits
  • Knowledgeable of contracts with healthcare providers
  • Knowledgeable of Medicare & Medicaid benefits
  • Able to collaborate with agencies
  • Knowledgeable of ICD-9 & CPT codes

Accomplishments

  • awarded Customer Service Person of the year
  • brought over 6,000 providers to provider network

Timeline

Provider Relations Representative

Nascentia Health
01.2020 - Current

Business Developer

iCircle
01.2018 - 01.2020

Independent Living Coordinator supervisor

ARISE
01.2012 - 01.2018

Community Integration Specialist, Coordinator Assistant

ARISE
01.2009 - 01.2012

Respite Site Supervisor

Heritage Farm, Inc.
01.2008 - 01.2009

Day Habilitation Specialist

Heritage Farm, Inc.
01.2007 - 01.2008

Certification OPWDD Independent Broker -

State of New York, OPWDD

Certification of Benefits Practitioner - Social Security Disability Benefits, Medicaid, Medicare insurance

Cornell University

Education - Special Education

John A. Logan Community College

Education - Special Education

Mohawk Valley Community College

Certification - Early Childhood Education

Madison Oneida BOCES

High School diploma -

Oneida High School

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