MICHELLE R. GALLICE
Summary
Results-driven provider network and management operations specialist with over 20 years of experience leading operations for diverse companies and organizations. Skilled in negotiation, retention, and fostering strong relationships across all staffing levels. Demonstrates expertise in strategic planning aligned with organizational goals. Can oversee multiple projects simultaneously. Proven track record in provider and staff recruitment, retention, and training. Able to create budget and manage based on profit and loss analysis. Recognized as a dynamic public-facing spokesperson with a talent for delivering impactful presentations. Thrives in autonomous work environments, known for meticulous attention to detail and effective time management.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Provider Network Manager
Prospect Medical Systems
07.2024 - Current
- Develops, manages, and maintains the network of primary and specialty providers. Including provider relations, contracting, credentialing, compliance and quality with HEDIS and STARs measures. Conducts routine provider visits, reviewing internal issues and resolutions. Developed strong business relationships with providers and brokers with a focus of membership growth. Lines of business include Medicaid, Medicare and Commercial.
Provider Network Manager
Western Dental
09.2022 - 07.2025
- Network development, recruitment and retention within designated territories. Efficient, accurate and timely effective provider credentialing processes. Fee schedule negotiations with utilizing internal and external market data. Consulted providers on operational decisions to achieve financial objectives. Developed positive relations with providers and staff. Worked with department heads and Provider Relations administrations to analyze and improve provider and operational objectives within the Managed Care, DentiCal and Commercial lines of business. Created and implemented business development events.
Consultant
Self/Practice Management Consultant
01.2016 - 09.2022
- Provided advice and guidance for dental practices to improve in office management, policies, human resources, insurance, billing, accounts receivable, marketing and branding. Assessed improvements focused on Key Performance Indicators (KPI’s), staff development, staff training, monitored profit and loss statements and operational goals. Advised doctors when purchasing a new or additional dental practices, negotiated lease agreements, organized construction builds, office design and new equipment purchases.
Executive Director
San Diego Psychiatric Society
05.2016 - 05.2021
- Responsible for overseeing the administration of programs and strategic plans of the 501C3 non-profit organization. Provided Council with an annual budget and monthly profit and loss statements, coordinated fiscal management and operations within the approved budget, provided a consistent yearly increased budget profit average of 20%. Developed additional resources necessary to support council’s yearly missions and operational costs. Created and sustained all business relationships with external partners including hospitals and universities. Fundraising with through various non-profit networks. Planning and coordination for all CME, community and fundraising events, including organizing volunteers with attendance from 10-250 people. The position reported directly to the San Diego Psychiatric Society Council.
Technology Trainer
Benco Dental
05.2014 - 01.2016
- Prepare and conducted technical training programs, provided end-user onboarding, support and individualized training. Continuously enhanced and modified technical instructional delivery and presentations. Conducted online technical presentations and webinars for sales teams and end users. Training programs includes 3M Tru-Def Scanner CAD/CAM/certified trainer, OneView X-ray and Dental Management program training, ISOTS150 Mill Unit training.
Director of Operations
Carlsbad Dental Associates
08.2012 - 04.2013
- Temporary Project Position. Created organizational and offices budgets based on operating procedures through workflow management, training and staff development. Approval of all timekeeping logs and overtime and absences, through ADP WorkCentre. Established and monitored all new/existing Associate contracts and maintained Doctors credentialing. Reviewed and negotiated all third-party insurance contracts. Managed compliance audits from all external third-party Insurance companies. Created strategic plans to manage all patient issue escalations to ensure prompt positive resolutions. Developed and coordinated a Patient Referral program. Created social, traditional media marketing and outreach programs. Designed, coordinated website creation, revisions and updates working with outside web developer. Proficient with Dentrix management software, monitored all software upgrades, technical solutions and staff training.
Office Manager
Encinitas Family Dentistry
08.2010 - 03.2012
- Managed complete office operations for two practices. For a staff of 10. Mentored, coached and trained staff members. Identified inefficiencies in operations by monitoring KPI’s and made process improvements to increase growth by 30%. Monitored and improved revenue by development of new Internal and External Marketing Programs. Approved all staff’s timekeeping logs and overtime and absences, worked with ADP WorkCentre. Assisted in the purchase of additional practice location. Established personnel policies for both practices. Established and monitored all new/existing Associate contracts and established and maintained all doctors credentialing. Maintained a low combined Accounts Receivable and Insurance monthly collection balances. Completed all Insurance electronic billing. Utilized Eaglesoft software.
Office Administrator/Marketing
Solona Smiles
05.2008 - 08.2010
- Executed and Maintained Internal and External Marketing campaigns including Websites, Health Fair Events and all print material. Increased practice profits with Treatment Coordination and solid financial arrangements. Monitored all Accounts Receivable/Payable with a collection average rate of 98%, Negotiated all insurance fee schedules and contracting. Optimized customer relations and patient experience through employee coaching and training. Electronic Insurance billing for both medical and dental claims. Eaglesoft software, facilitated technical issues, new upgrades and training.
Regional District Manager
Smile Care, Inc.
11.2004 - 07.2006
- Increased revenue by an average of 50% for six multi-specialty offices in the first year by implimenting new operational management systems and monitoring KPI’s, staff development/training and budget Management. Monitored all Profit and Loss Statements for each office efficiency and cut operating costs for each unit by 20%-30%. Identified inefficiencies and made recommendations for improvements and changes. Performed human resource operations including employee onboarding, training and performance evaluations/reviews for all employees including Doctors and Union employees. Ensured adherence to all HIPPA, OSHA and state laws, regulations and company policies regarding employment and safety. Coached and trained 50 team members in customer service, patient relations.
Education
Bachelor of Science - Healthcare Management
Western Govenours University
Associate of Arts - Business Management
Orange Coast College
06.1986
Certificate - Dental Assisting
Southern CA Medical & Dental Careers
03.1983
Skills
- Effective communication and interpersonal skills
- Strategic business relationships
- Health plan operations
- Provider relationship management
- On-site visits
- Provider orientations
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Analytical thinking
- Conflict resolution
- Operations management
Certification
Registered Dental Assistant #22685, X-Ray License, CPR Certified, 3M TruDef CAD Trainer Certified, IOST150 Mill Trainer Certified, Apteryx X-Ray Software Trainer, EPIC/Nextgen Trained, Dentrix, Eaglesoft, Easy Dental, Sales Force, IDX, Aerial Care, Alexandria, Power BI and Payer 5.
Timeline
Provider Network Manager
Prospect Medical Systems
07.2024 - Current
Provider Network Manager
Western Dental
09.2022 - 07.2025
Executive Director
San Diego Psychiatric Society
05.2016 - 05.2021
Consultant
Self/Practice Management Consultant
01.2016 - 09.2022
Technology Trainer
Benco Dental
05.2014 - 01.2016
Director of Operations
Carlsbad Dental Associates
08.2012 - 04.2013
Office Manager
Encinitas Family Dentistry
08.2010 - 03.2012
Office Administrator/Marketing
Solona Smiles
05.2008 - 08.2010
Regional District Manager
Smile Care, Inc.
11.2004 - 07.2006
Associate of Arts - Business Management
Orange Coast College
Certificate - Dental Assisting
Southern CA Medical & Dental Careers
Bachelor of Science - Healthcare Management
Western Govenours University
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