Linda Minshew
Round Rock,TX
Summary
Proven leader in healthcare network development, notably at Vytalize Health, where I spearheaded the strategic expansion and retention of provider networks. Expert in fostering payer and stakeholder relationships, my approach has consistently exceeded growth targets. Skilled in operational performance and building strong teams, I've driven innovations that significantly enhanced efficiency and revenue.
Overview
26
26
years of professional experience
Work History
Consultant
Linda Minshew
04.2024 - Current
- Recruit and build full CMS-adequate networks.
- ACO Sales (MSSP/REACH)
- Lead the strategic vision for provider networks.
- Collaborate with stakeholders to ensure alignment of vision, processes, and strategy.
Regional Vice President, Primary Care Development/ACO Sales
Vytalize Health
12.2022 - 04.2024
- Recruited and built a network of primary care providers for MSSP/REACH ACO in four states.
- In the first year, the team brought in 15K lives in uncharted territories, which paralleled successes in markets established for 3 years.
- Lead the strategic vision for growth and retention, including market research, analyses of provider performance data, attribution, marketing strategies, training, development, and general operational structure.
- Developed and implemented policy/procedure workflows, KPIs, and performance as they relate to departmental efficiencies and company operations.
- Reduced sales qualification stage time by 50%.
- Managed a growth sales team of nine Growth Directors and Senior Directors (Medicare PCP recruitment).
- Collaborated with internal teams to ensure adherence to company, legislative, and CMS guidelines.
- Worked closely with C-Suite/other stakeholders such as IPA’s, CIN’s and other aggregators to improve alignment, enrollment processes, cost of care reduction and implementation
Vice President, Provider Network Strategies
onehome (Humana)
Austin, TX
08.2021 - 12.2022
- Built and maintained a national strategic network of home health, DME, and infusion providers.
- Led strategic vision and goals for network growth, retention, and account management.
- Proactively built synergistic partnerships with internal and external partners, including payor relations.
- Identified and implemented process improvements and turnkey solutions that provided visibility into KPI adherence, advancement, and barriers for key initiatives.
- Collaborated with the health plan UM to develop effective referral and authorization standards.
- Managed Network team, including Provider Data Management, Contract Configuration staff, Salesforce administration, as well as Provider training and Network Account Managers.
Vice President, Provider Networks, Physician Engagement and Growth
agilon Health
05.2018 - 08.2021
- Built and maintained a full provider network for a start-up Risk-Based Entity, with a 12-week turnaround.
- Managed full implementation of Salesforce
- Led the strategic vision and goals for provider and member market growth and retention.
- Met the goal of 2x CMS growth annually.
- Proactively built symbiotic partnerships with internal/external partners, including payor relations
- Led the market in Service Level Agreements for nephrology, oncology, and retinal population health programs.
- Served as Vice President of the CSCA Board of Directors and served on the National Diversity & Inclusion Team.
- Member of a nationwide task force on operational structures and efficiencies, including the development of UM and claims processes.
- Managed Network team, including Provider Data Management, Contract Configuration staff, as well as Provider Engagement Sr Mgrs.
- Indirectly managed a team of over 100 Medicare-licensed agents.
- Led the market CMS Direct Contracting (DCE)
Sr. Mgr/Director – Network/Ops/Growth
Anthem
Austin, TX
01.2009 - 05.2018
- Exceeded goals annually by building, maintaining, negotiating and contracting over 200 contracts annually, including professional, ancillary, and facility.
- Ensured the company met or exceeded CMS and state guidelines to provide adequate access to care, and ensured competitive positioning.
- Managed Value-Based Reimbursement (VBR) operations, which transformed and standardized the program, created uniform efficiency, processes, and systems that supported business needs.
- Managed collaborative relationships with delegated risk entities, which increased membership growth, compliance, quality, HEDIS, STARS, cost of care, and MLRT performance.
- Responsible for JOC structure and administration, leading growth discussions, strategies, and implementation.
- Executed financial reconciliations and audits (upwards of $20 million), allowing full reconciliation that detailed performance and utilization, which contributed to quarterly profits.
- Led numerous task force groups, which ensured the analysis and clarification of VBC data.
- Outstanding claims knowledge, including claims adjudication methodologies, data setup, and denial resolution of both inpatient and outpatient (full revenue cycle)
Provider Relations Manager (Medicaid)
TMHP
Austin, TX
01.2008 - 12.2008
- Company Overview: (ACS)
- Built and Managed remote high performing and dynamic team of 17
- Developed and implemented statewide recruitment and retention project through portal and system enhancements, providing easier online contracting methodology and staff training
- Streamlined claims issue submission process, increasing provider recruitment and improved claims adjudication
- Managed statewide provider recruitment taskforce and acted as liaison for government and internal stakeholders
Commercial Contracting Manager
GREAT WEST HEALTHCARE
Austin, TX
12.2004 - 12.2007
- Managed Provider Data Management tasks at nearly 100% accuracy
- Negotiated provider contracts, including researching fee schedules, contract pricing and utilization
- Addressed providers’ problems such as claims issue research, market and industry trends, utilization, configuration, coding, and other issues resulting in increased and consistent revenue
Medicaid Operations Manager
HUMANA / PCA STAR
Austin, TX
04.1999 - 12.2004
- Managed statewide team of 16
- Wrote and implemented marketing and educational strategies to member and provider community with success in reduction of TCOC in NICU births, THSteps, and Provider network gaps
- Addressed providers’ problems such as claims research, market and industry trends, utilization, configuration, coding, and other issues resulting in increased and consistent revenue; amended commercial contracts
- Responsible for department budget
Education
MBA - Healthcare Administration
WGU University
B.S. - Business Administration
WGU University
Certified Project+ CompTIA - Project Management Certification
Skills
- Start-up companies
- Strong-performing teams
- Operational performance
- Payer and stakeholder relationships
Timeline
Consultant
Linda Minshew
04.2024 - Current
Regional Vice President, Primary Care Development/ACO Sales
Vytalize Health
12.2022 - 04.2024
Vice President, Provider Network Strategies
onehome (Humana)
08.2021 - 12.2022
Vice President, Provider Networks, Physician Engagement and Growth
agilon Health
05.2018 - 08.2021
Sr. Mgr/Director – Network/Ops/Growth
Anthem
01.2009 - 05.2018
Provider Relations Manager (Medicaid)
TMHP
01.2008 - 12.2008
Commercial Contracting Manager
GREAT WEST HEALTHCARE
12.2004 - 12.2007
Medicaid Operations Manager
HUMANA / PCA STAR
04.1999 - 12.2004
MBA - Healthcare Administration
WGU University
B.S. - Business Administration
WGU University
Certified Project+ CompTIA - Project Management Certification
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