Work Preference
Summary
Overview
Work History
Education
Skills
Timeline
Generic
Open To Work

Nicole Ross

New York

Work Preference

Job Search Status

Open to work
Desired start date: Immediately

Desired Job Title

Contract ManagerContract SpecialistProvider Relations AdvocateNetwork ManagerProvider Relations Specialist

Work Type

Full Time

Location Preference

On-SiteRemote
Location: Houston, TX
Open to relocation: Yes

Salary Range

$85000/yr - $200000/yr

Summary

Accomplished Contract Manager, Provider Relations Advocate and Network Manager with a proven track record in contract negotiation and compliance, provider relations and network management. Expertise in streamlining workflows and enhancing provider relationships to drive revenue growth and operational efficiency. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.

Overview

12
12
years of professional experience

Work History

Contract Manager

Comprehensive Psychiatric Services
Walnut Creek
02.2018 - 09.2025
  • Directed contract lifecycle with commercial payers, IPAs, TPAs, and government programs (Medicare/Medicaid), focusing on drafting, redlining, and negotiation in compliance with payer and regulatory standards.
  • Developed and implemented standardized contracting workflows, reducing turnaround time and improving operational efficiency across multiple markets.
  • Drove end-to-end payer procurement and negotiation, securing favorable reimbursement terms that increased annual revenue while minimizing denials and underpayments.
  • Led and developed a team of credentialing specialists, ensuring timely, compliant enrollment and recredentialing for multi-state provider networks.
  • Collaborated cross-functionally to resolve complex contracting and credentialing issues, strengthening payer and provider relationships.
  • Supported strategic planning and implementation of corrective action plans resulting in uninterrupted network participation and improved operational scalability.

Contract Specialist

Health Plan of San Mateo
South San Francisco
06.2017 - 02.2018
  • Managed network and vendor recruitment to meet plan goals and access requirements while adhering to state regulations.
  • Negotiated provider and vendor agreements, leading post-contract implementation for effective operational integration.
  • Conducted performance reviews with internal leadership using scorecards, utilization data, and provider performance metrics.
  • Streamlined contract approval process across departments, enhancing accuracy, compliance, and timely execution.

Provider Relations Advocate

Optum (UHG)
05.2013 - 06.2017
  • Negotiated and managed value-based and fee-for-service agreements with physician groups, clinicians, monitoring performance through data-driven quality metrics.
  • Served as primary liaison to address provider issues regarding credentialing, contracting, reimbursement, and compliance, enhancing provider relations.
  • Developed and sustained provider networks, aligning with cost, access, and quality objectives under TRICARE's managed care program.
  • Executed site audits and analyzed data to verify network adequacy and ensure compliance with federal and organizational standards.
  • Partnered with internal teams to implement new network initiatives, streamline provider onboarding, and enhance engagement through education and support.

Education

Master of Science - Health Services Administration

Barry University
Miami, FL
05-2000

Bachelor of Arts - Social Work

Lehman College
Bronx, NY
06-1994

Skills

  • Contract management
  • Contract negotiation
  • Regulatory compliance
  • Provider credentialing
  • Vendor relationship management
  • Provider network development
  • Network recruitment
  • Provider relationship management
  • Issue resolution
  • Cross-functional collaboration

Timeline

Contract Manager

Comprehensive Psychiatric Services
02.2018 - 09.2025

Contract Specialist

Health Plan of San Mateo
06.2017 - 02.2018

Provider Relations Advocate

Optum (UHG)
05.2013 - 06.2017

Master of Science - Health Services Administration

Barry University

Bachelor of Arts - Social Work

Lehman College
Nicole Ross