Reagen Marting
Jesup,Iowa
Summary
As a highly accomplished Network Consultant with a Masters degree in business administration, I posses a unique business acumen that has contributed to my success in my current contracting role. My experience in government contracting, process improvement and negotiations has enabled me to excel in my career. I am a result oriented professional that bring talent in writing, presenting, and managing communications and relationships with others.
Overview
18
18
years of professional experience
Work History
NETWORK RELATIONS CONSULT SR.
WELLPOINT
West Des Moines, IA
07.2023 - Current
- Develop the provider network though contract negotiations (language and rates), relationship development, and servicing
- Recruit and develop network for medical groups, physician groups, hospitals, ancillary providers, and facilities
- Negotiate rates for single case agreements with providers and complete in-depth review of costs associated with care
- Initiated and lead single case agreement restructure, developed cost analysis documents for negotiating single case agreements and track ongoing financial gains positively affected from this process
LTSS CONCIERGE COORDINATOR
AMERIGROUP
West Des Moines, IA
11.2021 - 07.2023
- Partner with managers in 3 regions to triage and independently complete high priority tasks
- Complete statewide service plan audits and other quality assurance activities ensuring all NCQA requirements are met, utilization of services are appropriate, and desk top processes are followed
- Complete special projects as needed to meet deadlines and ensure outstanding customer service
LTSS SERVICE COORDINATOR
AMERIGROUP
West Des Moines, IA
08.2019 - 10.2021
- Follow process for writing person centered support plans, refer and work as a team with community agencies and healthcare professionals
- Ensure member services are financially appropriate following waiver caps and lowa Code, based off member need, and of the highest quality for the member
- Partner with provider relations and SIU to investigate provider issues including service delivery, contract requirements, and credentialing concerns
COMMUNITY BASED CASE MANAGER
UNITED HEALTH CARE
West Des Moines, IA
01.2018 - 07.2019
- Conduct annual service plan meetings and write incremental goals for members, make referrals and collaborate with other agencies to track member progress, identify gaps in services and plans of care
- Advocate for waiver members' needs and their long-term health goals while following lowa code and specific waiver benefits
IHH CARE COORDINATOR/FSRP CARE COORDINATOR
FAMILIES FIRST COUNSELING
Waterloo, IA
09.2006 - 01.2018
- Provide case management to children with a mental health diagnosis including evaluating appropriate services and programs for the client, implementing the services, and monitoring the services to establish progress and success and establish healthy case closure for services
- Develop safety and permanency plans with families to ensure children's safety and/or reunification in the home
Education
MASTER OF BUSINESS ADMINISTRATION -
WESTERN GOVERNORS UNIVERSITY
04-2023
BACHELOR OF SCIENCE - Child and Family Services,Criminal Justice
IOWA STATE UNIVERSITY
08-1999
Skills
- Strong written and verbal communication skills, ability to work through difficult situations with professionalism
- Ability to connect and build strong relationships with providers
- A genuine desire to achieve, excel, and evolve
- Well-developed skills in organization, attention to detail, ability to work independently and coordinate several tasks simultaneously
- Flexible team player willing to assist in different areas needed by the team in an ever-changing occupation
- Experience using Excel, PowerPoint, Publisher, Word, and Microsoft Teams in day-to-day work
- Knowledgeable in using programs such as Contraxx, ACMP, Facets, MACES, PCR, and SPS
Timeline
NETWORK RELATIONS CONSULT SR.
WELLPOINT
07.2023 - Current
LTSS CONCIERGE COORDINATOR
AMERIGROUP
11.2021 - 07.2023
LTSS SERVICE COORDINATOR
AMERIGROUP
08.2019 - 10.2021
COMMUNITY BASED CASE MANAGER
UNITED HEALTH CARE
01.2018 - 07.2019
IHH CARE COORDINATOR/FSRP CARE COORDINATOR
FAMILIES FIRST COUNSELING
09.2006 - 01.2018
MASTER OF BUSINESS ADMINISTRATION -
WESTERN GOVERNORS UNIVERSITY
BACHELOR OF SCIENCE - Child and Family Services,Criminal Justice
IOWA STATE UNIVERSITY
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