Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Michelle A. Wivell

Frederick,MD

Summary

Strategic and results-oriented healthcare contracting professional with over 30 years of experience, including 15+ years at UnitedHealthcare. Proven success in negotiating high-value contracts with Tier 1 physician groups, driving cost savings, and improving network performance. Adept at leading provider engagement initiatives, resolving complex issues, and implementing value-based care models. Certified in Medicare Implementation, Back Office Analytics, and Master Contracting, with a strong track record of enhancing provider satisfaction, streamlining operations, and ensuring regulatory compliance. Recognized for delivering measurable outcomes in network growth, operational efficiency, and provider retention.

Overview

34
34
years of professional experience
1
1
Certification

Work History

Network Contract Manager

UnitedHealthcare
04.2021 - Current
  • - Lead contracting efforts with Tier 1 physician groups to ensure high-quality, cost-effective care delivery across the network
  • - Negotiate complex agreements with top-performing provider organizations, aligning with strategic goals and regulatory requirements
  • - Collaborate with internal teams to support the onboarding and performance management of Tier 1 providers
  • - Analyze utilization and reimbursement data to identify opportunities for value-based contracting and network optimization
  • - Maintain strong relationships with key physician group stakeholders to enhance provider satisfaction and engagement
  • - Ensure contract terms support network adequacy, member access, and compliance with federal and state regulations
  • - Drive initiatives to streamline contracting processes and improve operational efficiency within the Tier 1 provider segment

Network Engagement Manager

UnitedHealthcare
03.2020 - 04.2021
  • - Managed strategic relationships with healthcare providers to support network growth and performance
  • - Facilitated engagement initiatives with physician groups to improve collaboration and contract compliance
  • - Supported the development and execution of provider education programs and onboarding processes
  • - Collaborated with internal teams to address provider concerns and enhance service delivery
  • - Analyzed provider feedback and performance data to identify areas for improvement and drive network enhancements
  • - Played a key role in transitioning Tier 1 providers into value-based care models

Senior Provider Relations Advocate

UnitedHealthcare
05.2016 - 03.2020
  • - Served as a key liaison between UnitedHealthcare and healthcare providers, ensuring strong relationships and contract compliance
  • - Supported provider onboarding, education, and issue resolution to enhance network performance and satisfaction
  • - Collaborated with internal departments to address provider concerns and streamline operational processes
  • - Monitored provider performance metrics and facilitated improvement initiatives
  • - Played a critical role in maintaining network adequacy and supporting strategic growth initiatives

PCRS Supervisor

UnitedHealthcare
10.2011 - 05.2016
  • - Supervised the Provider Claim Resolution Services (PCRS) team, ensuring timely and accurate resolution of provider inquiries and issues
  • - Oversaw daily operations, monitored performance metrics, and implemented process improvements to enhance service delivery
  • - Provided coaching, training, and performance evaluations to team members to support professional development and operational excellence
  • - Collaborated with cross-functional teams to address escalated provider concerns and streamline workflows
  • - Played a key role in maintaining provider satisfaction and supporting network integrity through effective issue resolution

PPR Supervisor

UnitedHealthcare
04.2008 - 10.2011
  • Supervised the Provider Phone Representative (PPR) team, ensuring timely and accurate resolution of inbound provider inquiries.
  • - Managed team performance through coaching, training, and quality assurance initiatives
  • Supervised daily operations to ensure adherence to service level agreements and quality standards.
  • Mentored and trained team members on effective communication techniques and conflict resolution strategies.
  • Implemented process improvements that enhanced call handling efficiency and reduced customer wait times.
  • Analyzed performance metrics to identify trends, leading to targeted coaching sessions for underperforming staff.
  • Conducted regular team meetings to align objectives, address challenges, and encourage feedback from agents.
  • Developed training materials and resources that increased the onboarding speed of new hires.
  • Collaborated with management to refine operational procedures, resulting in improved customer satisfaction scores.
  • Led initiatives to enhance cross-departmental communication, fostering a cohesive work environment among teams.
  • Monitored call quality and provided individual constructive feedback to enhance performance and address areas in need of improvement.
  • Trained team members on performance metrics and consumer behavior identification.
  • Achieved high-quality service levels by continuously monitoring calls and providing constructive feedback to agents.
  • Improved customer satisfaction by effectively resolving escalated issues and providing timely support.
  • Reduced average handle time through the implementation of effective call handling techniques and scripts.
  • Increased first-call resolution rates by equipping agents with comprehensive knowledge of products and services.
  • Collaborated with other departments for seamless coordination in addressing customer concerns, resulting in faster issue resolution.
  • Streamlined call center operations for increased efficiency by implementing new scheduling and workforce management strategies.

Office Manager / Billing Administrator

Medical Resource Group
07.1991 - 04.2008
  • - Oversaw daily operations of a busy medical office, including billing, scheduling, and administrative support
  • - Managed insurance claims processing, patient billing, and collections to ensure accurate and timely reimbursement
  • - Supervised front office staff and coordinated training, workflow, and performance evaluations
  • - Maintained compliance with HIPAA and other healthcare regulations
  • - Implemented process improvements to enhance office efficiency and patient satisfaction
  • - Acted as liaison between providers, patients, and insurance companies to resolve billing and service issues

Education

Certification/Diploma - Medical Management / Licensed Practical Nurse (LPN)

Frederick Community College
Frederick, MD
03.1999

Skills

  • Contracting & Network Management: Tier 1 physician group contracting, Value-based care models, Provider engagement and retention, Regulatory compliance (Medicare, CEP/SCP)
  • Operational Leadership: Team supervision and coaching, Process improvement and workflow optimization, Cross-functional collaboration, Issue resolution and escalation management
  • Technical & Analytical: Back Office Analytics, Claims and payment resolution systems, Data analysis and performance metrics, Microsoft Office Suite (Excel, Word, Outlook)
  • Communication & Relationship Building: Provider relations and education, Negotiation and stakeholder management, Training and onboarding coordination, Customer service excellence

Certification

  • Medicare Implementation Payer Certified – CEP/SCP
  • Master Contracting Program Completion – 2023

Timeline

Network Contract Manager

UnitedHealthcare
04.2021 - Current

Network Engagement Manager

UnitedHealthcare
03.2020 - 04.2021

Senior Provider Relations Advocate

UnitedHealthcare
05.2016 - 03.2020

PCRS Supervisor

UnitedHealthcare
10.2011 - 05.2016

PPR Supervisor

UnitedHealthcare
04.2008 - 10.2011

Office Manager / Billing Administrator

Medical Resource Group
07.1991 - 04.2008

Certification/Diploma - Medical Management / Licensed Practical Nurse (LPN)

Frederick Community College

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