Michaun Laster
Merrillville,IN
Summary
Confident Physician Liaison promoting effective communication, relationship building, and time management skills. Offering more than 10 years of calling on prospects and turning them into referral opportunities. Talented, smart, and a valuable addition to any team.
Professional contract management expert with significant experience in negotiating, drafting, and overseeing contracts. Strong focus on fostering collaboration within teams and driving results in dynamic environments. Skilled in risk assessment, compliance, and stakeholder communication. Known for adaptability, reliability, and results-oriented approach.
Analytical professional prepared for this role with extensive experience in data analysis and interpretation. Known for delivering actionable insights and driving process improvements that align with business goals. Highly collaborative team player with focus on achieving results and adapting to changing needs. Skilled in statistical analysis, data visualization, and project management.
Overview
20
20
years of professional experience
Work History
Network Contract Manager/Audit Analyst
Intuitive Technology Group (Optum)
04.2024 - 09.2024
- Tracked contracts for management and issued regular tracking reports covering current status and upcoming milestones.
- Ensured compliance with all legal requirements by diligently monitoring contracts and maintaining up-to-date knowledge on regulations.
- Ensured timely execution of contract amendments, keeping pace with changing business needs.
- Created reports, presentations and other materials for executive staff.
- Enhanced team collaboration by providing clear communication of complex findings through visualizations and reports.
- Streamlined reporting processes, significantly reducing time required to generate insights.
Intuitive Technology Group (Optum-United Health Group)- Network Contracting
11.2020 - 10.2023
- Leading telephonic, electronic, and in-person provider recruitment contracting to targeted providers for participation in the network.
- Contracting and negotiating contract terms, including adding new lines of business to already existing contracts or targeted new providers to participate in the new lines of business, including executing new provider agreements with non-standard language, and collecting starting credentialing documents for processing.
- Tracking and maintaining documentation of each provider’s outreach with the goal to collect all negotiated and signed agreements from providers within the target timelines, utilizing plan tracking databases and OAS developed tracking tools.
- Serving as key resource for other contracting staff within the team and providing mentoring on the job training and development.
- Telecommute ( Work From Home)
Community Healthcare Systems (Managed Care) - Network Development Specialist (Provider Relations)
10.2016 - 09.2020
- Act as a liaison between physician offices and the appropriate Managed Care Entity.
- Present Hedis Quality Measures and requirements to providers, office managers, and staff.
- Receive incoming calls from provider offices concerning prior authorizations, claim issues, and member issues.
- Conduct annual site visits for provider offices to ensure compliance with insurance plan requirements.
- Mastered development, recruitment, maintenance, and education of the Clinical Integration Network, Physician Hospital Organization, and MDwise St Catherine Network.
- Set up contracts with numerous MCE ( Managed Care Entities) such as Blue Cross Blue Shield, Cigna, MDwise, and UHN.
- Conducted Medicaid round tables at major hospitals for the public needing health assistance and different Medicaid plans available.
Advanced Resources (Presence Health Partners) - Provider Network Specialist
04.2015 - 04.2016
- Research claims discrepancies and work with claims department for resolution.
- Research and resolve provider contracting issues including referrals and membership discrepancies.
- Manage ADA requirement restructuring project for PHP network.
- Validate provider data in Credentialing system as well as Claims systems.
- Confirm Managed Care contracts and determine proper benefit assignment for participating providers.
- Manage escalated inquiries from internal clients and offer immediate resolution.
Indiana Family Social Services/ Call Center - Eligibility Specialist
09.2012 - 03.2015
- Initiating calls to and responding to calls from clients in the data collection process.
- Reviewing applications submitted, identifying missing required client data and verifications that must be collected in support of the eligibility determination.
- Accurately and efficiently completing tasks with high quality and timeliness.
- Gathering detailed personal and income-based information related to applications for public assistance programs under the Family and Social Services Administrations (FSSA).
Kimberly Clark - Customer Relations
06.2008 - 06.2012
- Built long-term customer relationships and advised customers on purchases and promotions.
- Researched complex problems and resolved issues in a timely manner.
- Responds to customer requests with friendly, knowledgeable service, and support.
- Navigated multiple data bases for data entry, trailer look up, and data discrepancies.
Higher One Inc. - Customer Care Agent
08.2007 - 03.2009
- Retrieved customer queries by telephone or email.
- Identifying the issues of customers rapidly and precisely.
- Determining problems or issues in queries or complaints and proposing solutions for enhancements.
- Taking inbound helpdesk calls while working in office hours.
Hubbell Distribution - Inbound Customer Service Rep
11.2004 - 04.2007
- Distributed work orders to pickers for collection and loading of trailer trucks.
- Answered an average of 30 calls per day by addressing customer inquiries, solving problems, and providing new product information.
- Maintained up to date records.
Education
High School Diploma -
Lew Wallace High School
Gary, IN06.2002
Skills
- QNXT
- Echo and MD Staff Credentialing System
- Data Entry
- Strong verbal communication
- Conflict Resolution
- Accounting Software
- Administrative Skills
- Interpersonal Communication
- Critical Thinking
- Quickbase
- Merlin
- Icertis
- Customer Service
- Data Collection
- MS Word, MS Power Point, MS Outlook, MS Office, MS Excel
- Report Writing
- Recruitment
- Team liaison
- Salesforce
- Attention to detail
- Data research and validation
- Data processing
- Risk analysis
- Business operations analysis
Timeline
Network Contract Manager/Audit Analyst
Intuitive Technology Group (Optum)
04.2024 - 09.2024
Intuitive Technology Group (Optum-United Health Group)- Network Contracting
11.2020 - 10.2023
Community Healthcare Systems (Managed Care) - Network Development Specialist (Provider Relations)
10.2016 - 09.2020
Advanced Resources (Presence Health Partners) - Provider Network Specialist
04.2015 - 04.2016
Indiana Family Social Services/ Call Center - Eligibility Specialist
09.2012 - 03.2015
Kimberly Clark - Customer Relations
06.2008 - 06.2012
Higher One Inc. - Customer Care Agent
08.2007 - 03.2009
Hubbell Distribution - Inbound Customer Service Rep
11.2004 - 04.2007
High School Diploma -
Lew Wallace High School
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