Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic

Jessica Canto

Miami Lakes

Summary

Healthcare leader with 12+ years of experience in payer contracting, hospital account management, and provider engagement across multi-state markets. Proven success negotiating with Medicare, Medicaid, and 25+ commercial payers to expand patient access, optimize reimbursement, and support physicians in delivering specialty care. Skilled in building trusted relationships with healthcare decision-makers, navigating complex reimbursement environments, and driving adoption of new agreements that impact patient treatment options. Recognized for strategic problem-solving, business planning, and clinical collaboration.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Managed Care Supervisor

Elevate ENT Partners
03.2025 - Current
  • Negotiated and managed payer contracts with Medicare, Medicaid, and 25+ commercial insurers, securing 15–25% rate improvements and ensuring specialty care access.
  • Partnered with physicians, compliance, and legal teams to review value-based care agreements, coverage criteria, and performance clauses.
  • Developed business analysis models to assess reimbursement trends, guide payer strategy, and forecast revenue impact.
  • Initiated hospital on-call agreements and market expansion projects, building partnerships with executives, physicians, and pharmacy staff.
  • Conducted territory gap analyses to identify growth opportunities and expand patient access across Southern markets.

Credentialing Supervisor

Elevate ENT Partners
12.2021 - 02.2025
  • Directed credentialing operations for 200+ physicians and advanced practitioners across multiple states, collaborating with hospitals, specialty pharmacies, and payers.
  • Reduced onboarding delays by 40% through checklist-based workflows and automated tracking tools.
  • Strengthened payer enrollment accuracy and timeliness for Medicare, Medicaid, and national commercial plans, ensuring compliance and faster access to patient care.
  • Partnered with hospital credentialing teams and payer reps to streamline approvals and resolve barriers to provider participation.

Credentialing Specialist, Team Lead

Envision Physician Services
05.2010 - 11.2021
  • Oversaw credentialing and payer enrollment for hospital-based providers, maintaining readiness for payer and hospital audits.
  • Coordinated insurance verification, contract renewals, and CAQH updates to ensure compliance and continuity of coverage.
  • Partnered with hospital administrators, clinical leaders, and physicians to support provider onboarding and access.
  • Delivered process audits and reporting to leadership, contributing to quality compliance and operational improvement.

Education

MBA - Business Administration

Florida International University
Miami, FL
08-2020

Bachelor of Arts - Management

Miami Dade College
Miami, FL
05-2017

Skills

  • Specialty Market Access
  • Hospital Account Management
  • Expertise in negotiating contracts
  • Territory & Business Development Analysis
  • Physician & HCP Engagement
  • Value-Based Care & Compliance
  • Clinical Coverage Criteria & Prior Authorization Processes
  • Bilingual: English / Spanish

Certification

  • Yellow Belt Lean Six Sigma
  • Human Resources Certificate

Languages

English
Full Professional
Spanish
Full Professional

Timeline

Managed Care Supervisor

Elevate ENT Partners
03.2025 - Current

Credentialing Supervisor

Elevate ENT Partners
12.2021 - 02.2025

Credentialing Specialist, Team Lead

Envision Physician Services
05.2010 - 11.2021

MBA - Business Administration

Florida International University

Bachelor of Arts - Management

Miami Dade College

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