Lisa Taylor
Mesa,AZ
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Overview
9
9
years of professional experience
Work History
DIRECTOR OF CREDENTIALING
Tribal Health
04.2023 - Current
- Developed high-performing team by providing mentorship, guidance, and opportunities for professional growth.
- Initial and re-credentialing/privileging for 1099 contracted physicians and APCs for Indian Health Hospitals all over the US, including the Federal Clearance process
- Developed and implemented strategic plans to increase department productivity and quality of services
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
DIRECTOR OF CREDENTIALING
Denova (previously Bayless Healthcare)
03.2022 - 04.2023
- Developed high-performing team by providing mentorship, guidance, and opportunities for professional growth.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
- Facilitated cross-functional collaboration for improved decision-making processes within the organization.
- Implemented primary source processes and train staff regarding NCQA/URAC Standards, on-boarding and terming behavioral health provider processes, and set up internal Credentialing Committee with aid of 3rd party vendor
- Manage provider accounts with CAQH, NPI/NPPES, NPDB, OIG/SAM AHCCCS APEP System (AZ Medicaid), and MEDICARE/PECOS systems.
CREDENTIALING & CONTRACTS MANAGER
Spooner Physical Therapy
08.2015 - 03.2022
- Managed the onboarding process for new providers, ensuring timely completion of all required documentation.
- Collaborated with department leaders to develop policies and procedures for maintaining accurate provider records.
- Contributed to expanding the company's presence from 15 to 23 locations and increasing the provider count from 80 to over 150.
- Negotiated favorable contract terms for clients, resulting in cost savings and risk reduction.
Education
Bachelor of Science - Health Administration Management
University of Phoenix
05.2013
Skills
- Operations and People Management
- Department Collaboration
- Strategic Planning and Project Coordination
- Contract and Vendor Management
- Regulatory Compliance (NCQA/URAC/JC)
- Delegated Credentialing
Timeline
DIRECTOR OF CREDENTIALING
Tribal Health
04.2023 - Current
DIRECTOR OF CREDENTIALING
Denova (previously Bayless Healthcare)
03.2022 - 04.2023
CREDENTIALING & CONTRACTS MANAGER
Spooner Physical Therapy
08.2015 - 03.2022
Bachelor of Science - Health Administration Management
University of Phoenix
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