Kim Hammond
South Charleston
Summary
Dynamic Provider Contract Consultant with a proven track record at Highmark Health Options, excelling in strategic planning and process improvement. Skilled in training and mentoring, I enhanced client satisfaction through effective communication and negotiation, driving continuous quality improvements and fostering strong stakeholder relationships.
Overview
13
13
years of professional experience
Work History
Provider Contract Consultant
Highmark Health Options
Parkersburg, WV
01.2023 - 03.2026
- Analyzed data trends to identify opportunities for process improvements and enhance service delivery.
- Developed strong working relationships with clients through regular communication and proactive problem-solving approaches.
- Collaborated with stakeholders to ensure compliance with regulatory requirements and industry standards.
- Developed training materials and conducted workshops to enhance staff knowledge on operational best practices.
- Streamlined project workflows, resulting in improved efficiency across various departmental functions.
- Played a key role in dispute resolution between parties by facilitating open dialogues that led to mutually beneficial resolutions.
- Established and maintained relationships with key stakeholders for growth opportunities and successful partnerships.
- Optimized customer experience by delivering superior services and effectively troubleshooting issues.
- Developed effective improvement plans in alignment with goals and specifications.
Provider Contract Consultant
Highmark Health Options Delaware
Wilmington, DE
03.2021 - 01.2023
- Collaborated with stakeholders to ensure compliance with regulatory requirements and industry standards.
- Facilitated communication between departments to align objectives and improve overall project outcomes.
- Evaluated program effectiveness through comprehensive assessments, driving continuous quality improvement initiatives.
- Negotiated favorable terms for clients, ensuring their interests were protected while maintaining strong business relationships with vendors.
- Enhanced client satisfaction by promptly addressing concerns and implementing effective solutions.
Manager Provider Relations
Gateway Health Plan
Pittsburgh, PA
05.2016 - 03.2021
- Developed training materials for new providers, enhancing understanding of health plan policies and procedures.
- Analyzed provider feedback to identify trends, implementing improvements in service delivery and support systems.
- Led initiatives to improve provider satisfaction scores through targeted outreach and relationship building.
- Collaborated with cross-functional teams to enhance operational efficiencies in provider relations processes.
- Assisted providers in navigating through various reimbursement processes, resulting in timely payments and reduced financial disputes between parties.
- Served as a liaison between healthcare organizations and providers and health systems to ensure seamless communication regarding claims processing and payment matters.
- Researched and resolved disputes, billing discrepancies, and claims efficiently to maintain customer satisfaction, boosting satisfaction ratings.
- Facilitated communication between providers and health plan to resolve inquiries and ensure compliance.
- Led cross-functional teams to enhance operational efficiency and service delivery.
- Developed and implemented strategic initiatives to improve member engagement and satisfaction.
- Oversaw compliance with regulatory requirements, ensuring adherence across multiple departments.
Advanced Medical Support Assistant
Veterans Administration
Lebanon, PA
04.2015 - 05.2016
- Coordinated patient appointments and follow-up care to enhance patient satisfaction and streamline operations.
- Provided comprehensive administrative support to healthcare providers, optimizing workflow efficiency.
- Monitored patient inquiries, delivering timely responses to enhance communication and service quality.
- Maintained strict compliance with HIPAA regulations, ensuring the protection of sensitive patient information.
- Promoted effective communication among medical staff by serving as a reliable liaison between physicians, nurses, and administrative personnel.
- Managed high call volume, addressing patient inquiries and concerns with professionalism and empathy.
Blood Bank/Donor Center Associate
Hershey Medical Center
Hershey, PA
11.2012 - 04.2015
- Managed patient intake processes to enhance workflow efficiency.
- Coordinated scheduling and appointment management to optimize provider utilization.
- Trained new staff on operational procedures and customer service standards.
- Streamlined communication between departments, improving response times for patient inquiries.
- Assisted Blood Bank Technicians by efficiently delivering platelets and blood products throughout the hospital.
- Maintained inventory by stocking blood and platelets in date order to ensure timely usage and minimize waste.
Education
Associate of Science - Business Management
Harrisburg Area Community College
Harrisburg, PA05-2014
Skills
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
- Negotiation
Timeline
Provider Contract Consultant
Highmark Health Options
01.2023 - 03.2026
Provider Contract Consultant
Highmark Health Options Delaware
03.2021 - 01.2023
Manager Provider Relations
Gateway Health Plan
05.2016 - 03.2021
Advanced Medical Support Assistant
Veterans Administration
04.2015 - 05.2016
Blood Bank/Donor Center Associate
Hershey Medical Center
11.2012 - 04.2015
Associate of Science - Business Management
Harrisburg Area Community College