Karen Suitt

• Partner with Network/Contracting team, payors such as Humana, Premera & UnitedHealthcare for direction and clarity on contract intent, understand the strategy, and communicate identified audit findings to internal business partners
• Project Management: Initiated the Watchlist Process: Designed and developed the Watchlist process to manage new direct hospital contracts efficiently.
• Defined Objectives and Scope: Established clear objectives and scope for the project, ensuring alignment with organizational goals.
• Collaboration and Team Coordination
• Quarterbacked Multiple Teams: Led and coordinated efforts between the Network/Contracting team, CME team, Configuration team, and Claims UAT team.
• Facilitated Communication: Organized and facilitated regular meetings to ensure all teams were aligned and informed about project progress and requirements.
• Cross-Functional Collaboration: Worked closely with cross-functional teams to identify and resolve issues, ensuring smooth execution of the process.
• Execution and Implementation
• Managed Contract Review and Approval: Oversaw the completion of network/contract-specific criteria, contract review forms, and pre-production configurations.
• Ensured Timely Notifications: Coordinated notifications to the CME team 60 days prior to the effective date, detailing provider type and SOT for the provider roster and contract.

Impact and Results

• Improved Efficiency: Streamlined the contract management process, reducing operational costs and improving overall efficiency.
• Enhanced Collaboration: Fostered a collaborative environment, leading to better communication and coordination between teams.
• Successful Project Execution: Achieved project goals within the established timeline and budget, ensuring successful implementation of new direct hospital contracts.
• Collaborates with cross functional teams (PDM, Claims, Market Operations lead and other local market resources) to determine root cause
• Market Expansion and Implementation of new markets
• Attends all implementation meetings and serve as a resource for contracting teams to understand market level contract strategy, re-imbursement methodologies, Products, submission timelines, and help coordinate re-contracting events that may occur during or after post-implementation
• Meets with business partners weekly with a Status Report explaining inventory, update to policies, working sessions, and influence the market with contracting requirements
• Works Independently to manage assigned projects

• Negotiate and re-negotiate Physician and FQHC/RHC contracts
• Function as the single point of contact for all ongoing contractual and service issues as needed
• Educate providers on fee structures to ensure collaborative agreement and understanding of company services and the fees associated with them
• Network Development & Expansion of HBPs , Radiology, Anesthesia providers for Alabama and Tennessee
• Identified gaps in the market and negotiate a competitive rate
• Review and/or maintain reports (e.g., metrics, dashboards, spreadsheets) associated with provider contract loading and auditing (e.g., turnaround time, number of contracts loaded, accuracy) to assess performance, determine potential issues, and/or prioritize workloads (e.g., submissions to be addressed first)
• Manage contract maintenance including tracking, calculation of adjustments, review of payment appendices to support the change, and working directly with Network/Contracting and Operations for review
• Build and maintain relationships with business partners to ensure desired results are attained and maintained
• New Fee schedule builds for Community and State and Medicare and Retirement meeting SCR requirements
• Developed strong relationships with clients and vendors, fostering mutually beneficial partnerships.

• Direct loader for enterprise-wide market operations for Alabama, Mississippi, Louisiana, Tennessee, and Arkansas
• Executed Contracts and Amendments in Emptoris/CLM
• Provided quality assurance on various platforms
• SME for FQHC/RHC contracting
• Collaborated with internal business partners to ensure data integrity
• Assisted with audits and quality improvement initiatives
• Reduced manual workload for staff by automating routine tasks related to provider data maintenance and updates.

• Negotiated and re-negotiated Tier 2, and 3 Hospitals
• I functioned as the single point of contact for all ongoing contractual and service issues as needed by the facility
• Cross-functional, collaborated with multiple departments to meet company objectives
• Network Development
• Developed standard communication letters to FQHC/RHC providers
• Migrated over 90 delegated and non-delegated FQHC’s and RHC’s to the new facility hybrid template for Mississippi and Alabama markets
• Responsible for contract submissions through Emptoris, BPM, PhyCon, Navigator, and CME
• SME for River Valley to CSP facets transition for eligible FQHC’s/ RHC’s clinics and providers in Mississippi
• Increased client satisfaction by cultivating strong relationships and understanding client needs.
• Enhanced service offerings with regular feedback sessions to identify areas for improvement.
• Developed tailored solutions, enhancing client engagement and retention.
• Analyzed market trends to inform strategic recommendations for clients.
• Facilitated contract negotiations, securing favorable terms for both clients and company.
• Increased client satisfaction by building strong relationships and addressing their needs promptly.
• Maintained high client retention rate by providing exceptional customer service and anticipating client needs.
• Managed a diverse portfolio of accounts, ensuring timely communication and effective problem resolution.
• Conducted regular account reviews to identify areas for improvement and ensure continued success.
• Successfully resolved escalated issues, preventing potential loss of valuable clients while maintaining positive relationships with all parties involved.
• Collaborated with sales team to identify potential upsell opportunities and expand client base.
• Established clear communication channels between clients and internal teams, ensuring seamless project execution.
• Negotiated contract terms with clients, securing favorable agreements for both parties.
• Actively participated in networking events within the industry, expanding professional connections and generating leads.
• Cultivated long-term relationships with key stakeholders in assigned accounts, fostering trust and loyalty among clients.
• Streamlined internal processes for better efficiency in account management tasks.
• Implemented strategies to increase revenue from existing accounts through upselling and cross-selling initiatives.
• Improved overall team productivity by implementing best practices in organization and time management.
• Assisted in the development of training materials for new hires, ensuring smooth onboarding process.
• Developed customized account plans for clients to help them achieve their business goals.
• Conducted quarterly business reviews with major accounts to assess satisfaction and identify areas for improvement.
• Cultivated portfolio of high-value clients by leveraging industry knowledge and strategic networking.
• Achieved recognition for outstanding client service, contributing to team's reputation for excellence.
• Identified at-risk accounts through diligent monitoring and analysis, implementing retention strategies to prevent churn.
• Spearheaded coordination of cross-functional teams for delivering customized solutions that met client needs.
• Enhanced team performance with regular training sessions on product knowledge and customer service excellence.
• Fostered detailed understanding of product offerings, enabling effective communication of features and benefits to clients.
• Coordinated with product development teams to relay client feedback, influencing future product enhancements.
• Boosted client retention by developing and implementing comprehensive account management strategy.
• Leveraged CRM tools to maintain accurate records of client interactions and transactions.
• Optimized account allocation among team members to ensure balanced workload and focus on high-priority clients.
• Established long-term customer relationships to enhance client loyalty and satisfaction.
• Monitored market trends to advise clients on potential impacts to their business, positioning as trusted advisor.
• Streamlined account management processes, reducing response times and improving client service quality.
• Negotiated contracts with focus on maximizing profit and ensuring client satisfaction.
• Developed targeted presentations for key accounts, effectively communicating value proposition and securing commitments.
• Implemented CRM system to track client interactions and feedback, leading to more personalized service.
• Drove revenue growth by identifying new business opportunities within existing accounts.
• Increased upsell opportunities with strategic account reviews, identifying and addressing client needs.
• Enhanced client engagement through regular newsletters and updates on product developments and industry news.
• Built relationships with customers and community to promote long term business growth.
• Facilitated client meetings to gather feedback and adjust strategies accordingly, ensuring alignment with client objectives.
• Gained customer trust and confidence by demonstrating compelling, persuasive and composed professional demeanor.
• Fostered lasting relationships with customers through effective communication and quick response, resulting in long-term loyalty and expanded client base.
• Developed and maintained strong working relationships with professionals within assigned territory.
• Met with customers to discuss and ascertain needs, tailor solutions and close deals.
• Kept detailed records of daily activities through online customer database.
• Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
• Maintained current knowledge of evolving changes in marketplace.
• Negotiated prices, terms of sales and service agreements.
• Fielded customer complaints and facilitated negotiations, resolving issues and reaching mutual conclusions.
• Met existing customers to review current services and expand sales opportunities.
• Recorded accurate and efficient records in customer database.
• Monitored service after sale and implemented quick and effective problem resolutions.
• Worked with sales team to collaboratively reach targets, consistently meeting or exceeding personal quotas.
• Contributed to team objectives in fast-paced environment.
• Stayed current on company offerings and industry trends.
• Achieved or exceeded company-defined sales quotas.
• Set and achieved company defined sales goals.
• Collaborated with managers to provide customer feedback and recommend operational changes to meet emerging trends.
• Trained new employees on customer service, money handling and organizing strategies.
• Increased sales with execution of full sales cycle processing from initial lead processing through conversion and closing.
• Presented professional image consistent with company's brand values.
• Served customers with knowledgeable, friendly support at every stage of shopping and purchasing.
• Developed, maintained and utilized diverse client base.
• Attended monthly sales meetings and quarterly sales trainings.
• Selected correct products based on customer needs, product specifications and applicable regulations.
• Contributed to event marketing, sales and brand promotion.
• Consulted with businesses to supply accurate product and service information.
• Informed customers of promotions to increase sales productivity and volume.
• Promoted conversion of casual shoppers into customers through product knowledge and product solutions to meet customer needs.
• Generated advertising brochure for vendor use.

• Negotiated and re-negotiated Tier 1, 2, and 3 Hospitals and Ancillary contracts
• Functioned as the single point of contact for all ongoing contractual and service issues as needed by the facility
• Collaborated with Sales in the negotiations decisions so they can maintain their key accounts
• Network Development in multiple gap-fill Counties
• Accountable for identifying facilities eligible for HP3 programs and attended weekly calls with the Hospital Facility Advocate for facilities in the PAM program
• Submitted contracts through Emptoris, CCI, and CME
• Accountable for reducing non-par spend in South Florida by contracting non-participating Hospital-Based Physicians (HBP’s) for South Florida on UnitedHealthcare paper and hospital-based fee schedules
• Responsible for Unit Cost Trend (UCRT) and implementing the network strategy for the South Florida Market
• Fee Schedule Migration Project; responsible for migrating 1,500 providers to current market standard fee schedules
• Facilitated contract negotiations, securing favorable terms for both clients and company.