SANDRA ADKINS

• Developed and scheduled internal training program for regional Healthcare Economics staff to include StrengthFinders.
• Consulted with Directors to increase employee engagement scores.
• Coordinated with internal departments to obtain market intelligence and competitor reimbursements.
• Analyzed claims data to develop reimbursement proposals and identify medical expense trends.

Position was responsible for management of $1 billion in medical expense unit cost trend

• Partnered with Network Management for negotiations with hospitals, physicians, and ancillary providers regarding contract structure, financial parameters, competitive positioning and price points.
• Managed relationships with Sales, Network Management, Finance and other internal partners.
• Established market level strategies and policies and procedures
• Managed unit cost budgets, performance reporting and financial modeling with goal of minimizing cost increases
• Managed a staff of 7 in multiple locations

• Responsible for improving Network Pricing infrastructure and coordinating national project analytics
• Managed the pricing analysis for the national expansion project of select products
• Coordinated with various acquisition companies to obtain data to support national negotiations
• Assisted with validating national lab vendor proposals.

• Provided pricing and analytic support for the Northeast Region and select markets (Philadelphia, Maryland/DC)
• Analyzed hospital, physician and ancillary contracts for unit cost and financial impact using both Corporate and self-developed tools
• Negotiated with Network Management staff to develop alternatives as appropriate
• Coordinated with Network Management to produce the monthly unit cost forecast and annual budgets for submission to Corporate
• Ensured that forecasts were accurate and that underlying assumptions were valid
• Participated in a national workgroup to develop Cognos Cubes self-reporting tools for Network Pricing
• Contributed to a national fee schedule standardization initiative
• Analyzed CMS based fee schedules and hospital charge master trends.

• Responsible for providing financial, contract and sales analysis for senior management and internal and external customers
• Performed pricing, impact and feasibility analyses for physician and hospital contracts including policy and/or rate changes.
• Identified cost drivers and estimated savings based on medical expense reduction initiatives
• Streamlined operational processes to reduce turnaround time and improve customer service

• Responsible for financial and statistical analysis for the company’s risk products and assigned medical offices
• Reviewed monthly financials and coordinated with Accounting to ensure reporting accuracy and provided monthly commentary
• Coordinated the budgeting, forecasting and long-term planning processes
• Analyzed and reported variances and recommended assumption changes as necessary
• Redesigned the company’s long-term planning model
• Developed/produced key financial indicator reporting, breakeven and utilization analyses; and calculated provider excess insurance premiums

• Responsible for managing the company’s pricing and financial/marketing analysis functions
• Established standard and promotional product pricing for domestic and international operations, with approval authority up to $5 million
• Analyzed information relating to product and customer profitability, industry trends, competitors and sales statistics
• Developed underlying assumptions to implement a consistent customer & profitability measurement
• Provided financial support to the company’s Marketing department by developing all relevant financial models including cash flow analysis and loan amortizations