Adept at driving strategic partnerships and negotiating multi-million dollar contracts, I excel at MultiPlan, Inc., where I spearhead initiatives that significantly enhance market penetration. My blend of analytical prowess and effective team leadership has consistently fostered organizational growth and performance excellence.
Overview
22
22
years of professional experience
Work History
Regional Manager
MultiPlan, Inc.
08.2012 - Current
Company Overview: National Managed Care Company
Successfully negotiated new contracts and renegotiated complex existing contracts to gain deeper penetration and higher discounts for $200M+ worth of utilization over the past 7 years
Collaborate with some of the largest healthcare providers in the nation to develop and maintain a business relationship
Analyze providers’ chargemaster, market trends, and national trends to ensure best tactics are being used in the negotiation and tailoring the contract to each unique provider
Develop negotiation strategy so that the contract is beneficial to all parties and maximizes benefits for clients and their members while meeting client criteria and staying compliant with their policies
Consistently a top producer and go to person for other colleagues for strategy advice, sales pitches, and tips on closing a deal
Manage a regional territory made up of health systems, facilities, ancillaries, IPAs, groups, and individual physicians
Responsible for identifying and completing financial studies for entities across the country to target for market expansion bringing value to the company
Monitor market trends and legislations nationally to ensure compliant business practices
Effectively negotiate rate structures and contract language that is compatible with MultiPlan’s business model while limiting risks to the company and our clients
Comfortably works hand-in-hand with Legal and Senior Executives of all levels at MultiPlan for compliance and high priority projects
Maintained a pipeline of 100+ targets and prioritized accordingly to gain maximum penetration for company success
Resolve any provider/client issues promptly to prevent escalation
Build long lasting business relationships with internal and external customers based on quality service
Travel up to 50% to maintain positive business relationships and engage in new ones with prospective providers
National Managed Care Company
Contract Specialist
Rockport Healthcare Group, Inc.
10.2011 - 08.2012
Company Overview: National PPO
Successfully negotiated beneficial contracts that created deeper penetration and higher discounts
Reviewed contract language to ensure all parties were in compliance with federal, state, provider, and corporate requirements
Accountable for building positive relationships with providers and provider organizations to guarantee quality service
Responsible for identifying and contracting providers within a 13 state territory with focus on the Workers’ Compensation product
One of the top producing contract specialists within our organization; met monthly/quarterly goals consistently
Created custom fee schedules in 2 states as a tool for company contractors to use when negotiating terms and rates
Analyze financial reports to target the highest utilized providers to make certain we maximize the benefit to our client
Audited new loaded data for quality assurance
Assisted the sister company, an imaging network, in re-contracting providers for deeper discounts
Worked with several departments daily (Executives, Account Management, Provider Services, Data Management, etc.) to successfully meet company goals and maintain positive relationships with clients, providers, and network partners
National PPO
Executive Assistant to Chief Operations Officer
Myers Park Mortgage, Inc.
Charlotte, NC
09.2010 - 09.2011
Company Overview: Accredited Mortgage Lender
Accountable for assisting the management of 3 divisions (Wholesale, Retail, and National Lending Center) for the #1 mortgage company with over 100 employees based in Charlotte, North Carolina
Arranging and maintaining travel, meeting, and event schedules
Responsible for collecting data to create and maintain reports, spreadsheets, charts, agendas and tables for use by the Senior Executive Management team and company wide distribution
Managed confidential company files and made sure they were secured and easily accessible by the Senior Executive Management team when needed
Tracked and maintained daily metrics reporting for all Operations employees and sent out daily progress reports to various departments
Utilized technology to record and store training and meeting sessions facilitated by Senior Management both in person and via webinar
Prepared training materials and manuals for new employee training classes
Worked hand in hand with various departments to ensure a smooth work flow
Reported monthly loan records to outsourced QC company and disseminated reporting results to appropriate parties for response
Analyzed and reported quarterly HMDA requirements
Tracked and upheld all Operations employees’ time off and remaining PTO hours
Screened applicants and scheduled interviews
Prepared meeting agendas for Department Head Meetings, Senior Executive Management Meetings, and National Lending Center Meetings
Applied confidentiality and exercised considerable judgment and discretion
Accredited Mortgage Lender
Provider Contractor
Prime Health Services, Inc.
Brentwood, TN
12.2008 - 08.2010
Company Overview: Nationwide PPO
Responsible for identifying, recruiting, and contracting facilities, hospitals, physicians and other medical provider groups for a full line of products
Negotiating contracts to ensure a cost effective contract in compliance with all state, provider, and corporate requirements
Contracted over 8,200 healthcare providers from December 2008-August 2010 for the company’s largest client accounts
Analyze data and use data to develop strategies for contracting and re-contracting
Responsible for initial credentialing in compliance to state/federal policies
Conducting research to determine applicable state/federal regulatory requirements regarding reimbursement, credentialing, etc
Solely responsible for out-of-network bill negotiations
Work hand-in-hand with Account Management to ensure satisfied Type A Clients (Top Priority)
Contributed to the transition and implementation of moving corporate headquarters from Florida to Alabama including, adding approximately 5000 hospice groups and patients into a new software system
Responsible for red-lining contracts and assisting the President/CEO
Assisted in managing a company of approximately 120 employees
Liaison between client and Hospiscript for any disputes, resolutions, and or concerns
Responsible for contacting and contracting pharmacies for new and current accounts to guarantee effective communication as well as regular follow-ups to ensure compliance and avoid tribulations
Exclusively accountable for negotiating claim reimbursements in order to satisfy the pharmacies and prevent conflicts with clients
Accountable for a smooth implementation for new clients and maintaining positive relationships with existing clients
Liable for educating pharmacies on the utilization of our system to avoid any dilemmas
Converting safety nets with new and existing clients to maximize their benefits
Obtaining and completing special projects for Senior Management
Data Entry (see computer skills)
PBM Company
Executive Administrative Assistant
Quality Home Healthcare, Inc.
Wetumpka, AL
05.2003 - 01.2004
Company Overview: DME Company
Assisted President and CEO with daily activities for effective and efficient business management
Responsible for Accounts Receivable and Accounts Payable
Analyze denials and review medical records and coding for an appeal resolution
Responsible for billing and collecting on insurance claims and self-pay patients
Administered order intakes and processing necessary paperwork (pre-certs, pre-auths, etc)