Kerri A. Kerr
Oxon Hill,MD
Summary
Results-driven healthcare operations leader specializing in systems automation and vendor management. Led successful initiatives to modernize enrollment processes and enhance provider relations, resulting in improved compliance and service delivery. Expertise in managing cross-functional teams to optimize workflow efficiencies and bolster network stability in diverse healthcare environments.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Director, Benefits and Eligibility
Transit Employees’ Health & Welfare Plan
07.2022 - Current
- Directed annual benefit implementation and open enrollment, ensuring operational readiness and materials production.
- Managed vendor relationships and led benefits contract implementations, ensuring service quality and compliance with regulatory standards.
- Implemented secure automated enrollment systems and developed comprehensive SOPs for consistent processing.
- Transformed enrollment operations by introducing DocuSign technology, eliminating paper processes.
- Conducted benefits analysis to address compliance requirements and identify operational improvements, enhancing overall program effectiveness.
- Developed benefit communications with internal and external partners to improve member understanding of available options.
- Led cross-functional teams to enhance workflow efficiency and support staff performance.
- Automated key workflows and created user-friendly prompts to reduce errors and support needs.
Manager, Provider Relations and Contracting (Medicaid)
Magellan Health, Public Sector
09.2021 - 06.2022
- Expanded the behavioral health network by securing contracts with hospitals, multi‑specialty practices, and provider groups, increasing provider participation and improving member access across the DC Medicaid program.
- Accelerated provider onboarding by coordinating contract implementation with credentialing, reimbursement, claims, and enrollment teams, reducing cycle times and minimizing administrative defects.
- Cultivated relationships among Medicaid plans, District of Columbia agencies, and contracted providers to facilitate issue resolution and strengthen network stability.
- Strengthened payer accountability by partnering with Account Management to monitor post‑implementation performance and ensure adherence to reimbursement terms and service levels.
- Delivered education on Magellan’s Provider Portal, policies, and operational workflows to enhance provider engagement and streamline administrative processes.
- Participated in State Stakeholder Advisory Workgroup, analyzing benefit design and operational impacts to support Medicaid program improvements and inform policy decisions.
Manager, Provider Information & Credentialing
CareFirst BlueCross BlueShield
Columbia, USA
01.2014 - 09.2021
- Led credentialing and recredentialing for the region’s largest provider network, overseeing 50,000 participating practitioners, eight major hospital systems, and 400,000 non-participating practitioners, ensuring full compliance with NCQA and regulatory standards.
- Led provider data accuracy strategy for delegated entities and government programs, improving data integrity for Medicare Advantage and Medicaid networks.
- Directed credentialing operations and provider file maintenance, ensuring audit readiness and operational consistency.
- Managed team of 24 FTEs and contracted staff, enhancing productivity and quality across credentialing workflows.
- Served as the primary resource for interpreting provider contracts, regulatory requirements, and credentialing guidelines, advising leadership and operational teams.
- Analyzed CMS policy for Medicare Advantage and developed internal procedures to ensure compliance with network adequacy, data accuracy and reporting standards.
- Cultivated relationships with delegated hospital systems and large multi-specialty groups to advance provider experience initiatives and resolve operational issues.
- Columbia, MD
Manager, Patient-Centered Medical Home & Provider Relations – Networks Management
CareFirst BlueCross BlueShield
Columbia, USA
01.2001 - 01.2014
- Led implementation and oversight of the PCMH network, maintaining a panel of 3,500+ primary care physicians and ensuring strong network performance.
- Directed the PCMH Provider Relations Field Team and Service Desk, improving provider support, issue resolution, and operational efficiency.
- Cultivated relationships with high-profile provider groups, addressing escalated inquiries from providers and the Insurance Commissioner through cross-departmental collaboration.
- Oversaw PCMH Outcome Incentive Award pricing, appeals, and MMPP shared-savings reimbursement cycle, ensuring accurate and timely payments.
- Built and sustained executive‑level relationships with practice administrators and health system leaders across the region.
- Designed and delivered targeted provider education, including training, policy updates, and performance improvement resources.
- Columbia, MD
Education
Master of Business Administration - Human Resources
Strayer University
Master of Science - Healthcare Administration
University of Maryland
College Park, MDBachelor of Arts - Health Science & Policy
University of Maryland Baltimore County (UMBC)
Baltimore, MDSkills
- Team leadership
- Contract negotiation
- Systems automation
- Legal and regulatory compliance
- Vendor management
- Operations management
- Digital transformation strategies
- Cross-functional teamwork
- Regulatory compliance
- IT infrastructure management
- Cross-functional collaboration
- Leadership and team management
- Communication skills
- Network expansion
Certification
- Leadership Prince Georges
- Employee Health Benefits Associate (EHBA), America’s Health Insurance Plans, Center for Insurance Education and Professional Development
- Professional, Academy for Healthcare Management (PAHM), Academy for Healthcare Management
Timeline
Director, Benefits and Eligibility
Transit Employees’ Health & Welfare Plan
07.2022 - Current
Manager, Provider Relations and Contracting (Medicaid)
Magellan Health, Public Sector
09.2021 - 06.2022
Manager, Provider Information & Credentialing
CareFirst BlueCross BlueShield
01.2014 - 09.2021
Manager, Patient-Centered Medical Home & Provider Relations – Networks Management
CareFirst BlueCross BlueShield
01.2001 - 01.2014
Master of Business Administration - Human Resources
Strayer University
Master of Science - Healthcare Administration
University of Maryland
Bachelor of Arts - Health Science & Policy
University of Maryland Baltimore County (UMBC)