Julie Wohrlin

Managed Provider Relations Department. This included a Network with over 3,700 contracted providers including Primary Care Providers, Specialists, Hospitals, Urgent Care Centers,Skilled Nursing facilities, Hospice facilities, Assisted Living facilities, FQHCs and Behavioral Health across the Medicaid. Medicare and Marketplace Lines of Business with ten direct reports, this included generating state reports, working with OIG and Internal Departments. Other duties included but ere not limited to creating workflows, training Provider Relations Representatives, ensuring metrics were met for Quality Performance, New Provider Orientations and ensured complaints were addressed in a timely manner in accordance with state and federal regulations.

Promoted a culture of continuous improvement within the provider relations team, regularly soliciting feedback from healthcare providers and incorporating suggestions into strategic plans.

Established strong relationships with key stakeholders in the healthcare industry, positioning the organization as a trusted partner in patient care.

As a Contract Negotiator I prepared product proposals, contract terms and conditions and document modifications. I also

Managed assigned contracts throughout lifecycle, identifying need for and implementing amendments, renewals, terminations and other necessary contractual actions. I ensured compliance with all applicable laws, regulations, and policies during the drafting and execution of contracts. Additionally, I

collaborated with cross-functional teams to ensure alignment on contract requirements and deliverables.

As a Senior Provider Relations Advocate I acted in a supervisory role to other Provider Relations Advocates. Additionally, I facilitated timely resolution of escalated issues through effective collaboration with internal departments and external partners. I cultivated long-lasting relationships with influential providers, fostering trust and loyalty towards the organization. Other duties included I ensured compliance with industry regulations by monitoring changes in legislation and updating policies accordingly; collaborated with cross-functional teams to streamline the onboarding process for new providers, reducing timetomarket.

As a Senior Provider Liaison, I acted in a supervisory role for other Provider Liaisons. In addition to acting in a supervisory role, I was responsible for functioning as a liaison between behavioral health providers and Presbyterian Health Plan for 1,000 behavioral health providers. Additionally I iver saw the Value Based Program directed at facility inpatient stays. I served as the primary point of contact, fostering strong relationships between internal teams and external partners. Additionally, I

maintained up-to-date knowledge of industry trends, sharing insights with colleagues to drive continuous improvement efforts. Part of my role also included solving conflicts and addressing issues that occurred between other entities and business.