Sindy G. Ausmer

Shiners Children's Hospital Northern CA 2/20/2020- Present

• Establish strong relationships between Shiners Children's and our referring physicians, other healthcare providers, and physician offices through office visits, electronic media, professional meetings, continuing education or any other appropriate methods to effectuate new referral growth
• Maintain complete and comprehensive SalesForce record on existing and potential referring provider activity to increase effectiveness of communication and to serve as a basis for strategy development and new business opportunities.
• Cultivate relationships with community provider offices to promote outreach initiatives and increase awareness of services offered.
• Maintain a high degree of professionalism at all times, representing the organization with integrity in both internal and external interactions
• Establish and meet outreach activity production goals, as set forth by Market Director, and documents trends, successes, and problems to assess and analyze yield, driving process improvement.
• Use Salesforce data provided, analyzes and identifies primary, secondary, and tertiary referral sources and geographic opportunities to prioritize efforts and target meaningful new relationships in an effort to increase referral levels.
• Analyze demographic and clinic activity linked to referring providers through market intelligence, to create strategic referral goals and determine outcomes and effectiveness.
• Collaborate with market directors, Marketing & Communications to provide a consistent and effective marketing program through distribution of marketing collateral, alignment with marketing campaigns and communication of intelligence from the field.
• Collaborate with other physician referral liaisons across the system to execute the standard process for referral management, eliminate duplicative work, and share best practices.
• Maintain accurate record of referring physician complaints/issues in the CRM and works to ensure corrective action is taken by collaborating with facility partners and report results to market directors, facility leaders and the impacted physician.
• Participate and confer with market directors, local facility department heads and various departments (Intake, HIM, Medical Staff, etc.) on process improvement in support of increased physician satisfaction concerning the referral process from first contact through patient discharge.
• Develop tools to improve knowledge and understanding of EpicCare Link to efficiently implement into provider offices.
• Provide onboarding training with new Liaisons sharing best practices and developing a strong knowledge base of the organizations and effective workflow process.
• Collaborate with multidisciplinary teams to optimize patient outcomes and streamline processes.

• Lead and train a team of 20 state leads, network development staff and project managers to ensure efficiency and maintain compliance with company policies and standards as well as government laws and regulations while driving success for the team, region and company
• Responsible for recruitment and contracting of provider networks in new and prospective markets, and existing market expansions to several states
• Lead contract negotiations, review redlines for new contracts within large group practices/hospitals
• Develop and maintain communication with internal executive leaders
• Support new business launch in diverse markets by considering individual market circumstances, provider, community, budgeting constraints and available resources
• Perform complex analyses to identify opportunities
• Develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
• Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
• Ensure accuracy and completeness of provider demographic information by working off the lead list to gather provider and contact information via web or phone.
• If a lead list is not provided, work with management to create a leads list.
• Coordinate the appropriate steps of communication to introduce the plan.
• Send out the cover letter to providers introducing the plan and the steps to send in the information to request a contract. (Pending plan approval for this step.)
• Send out contracts / applications to prospective providers upon requests of management.
• Utilizes a system to track and follow up with providers who have not responded to phone calls, contracts and / or applications sent as directed by management.
• Receive calls from prospective providers and answers questions as directed by management.
• Forward requested information / documentation to prospective providers in a timely manner.
• Maintain database of all contracts and specific applications sent to prospective new providers.
• Participate in redline contract review with providers and senior management to resolve contract negotiations.

• Health plan representative at key stake holders' meetings (Community Advisory Committee, General Managed Care, Covering Kids and Families Statewide Coalition and Partners in Health School Initiatives meetings)
• Prepare and deliver MOU's to partnering community organizations and provider offices for events and patient presentations.
• Develop and maintain strong relationships with state and federal agencies, local and political leaders, city school districts and faith-based organizations to implement marketing campaigns that result in membership growth and brand awareness.
• Present reports on state and county meeting outcomes for senior leadership.
• Support community partners in development of marketing strategies or healthcare events to increase brand awareness and membership growth.
• Develop internal relationships to better facilitate as a liaison for external community partners and providers with compliance and membership issues.
• Create and present PowerPoint presentations to 100 contracted providers, community partners and influencers (Promotoras, Community Healthcare Workers, Patient Navigators and CEC's) on access to healthcare insurance and navigation to healthcare services.

• Managed clinical and administrative operations of 30 Employees, 6 Providers with 3 Specialties.
• Implemented innovative ways to obtain HEDIS measures with patients to be compliant with Health plan criteria.
• Increased patient growth and financial revenue by developing patient acquisition, retention strategies and on-site corrective action when the patient wait time exceeds Clinic standards.
• Oversee inventory control of supplies and Immunization Vaccinations
• Implemented a training program for staff on regulatory standards, including HIPAA, compliance and risk management as well as all functions of Medi-Cal Manage Care and Medi-Care.
• Managed clinic patient and member grievances in collaboration with respective departments.
• Develop a patient referral system with community resources and patient access to clinical services
• Function as the clinic liaison with patients, specialists, hospitals, and health plans
• Streamlined clinic operations to enhance patient flow and reduce wait times.

• Responsible for developing, implementing and evaluating a strategic plan for the health plan's community relations activities to drive growth, membership retention and increased brand awareness.
• Developed and implemented an Emergency Department Conversion/Navigator Program for the health plan to reduce inpatient hospitalization of membership
• Created and maintained strong relationships with state and federal agencies, community and political leaders, city school districts and faith-based organizations on a one-on-one basis to identify effective enrollment opportunities. Provided navigation and access to resources focused on Maslow's Hierarchy of needs. (Healthcare, Food, Clothing, Shelter, Mental Health).
• Provided educational presentations to contracted providers, community partners and influencers on the health plan line of business (Medicaid, CHIP, Medicare SNP, Market Place, CHDP, Family PACT) and the healthcare delivery system as well as state, federal policy, legislative and regulatory activity that would impact their business.
• Established a coalition group consisting of Certified Enrollment Counselors, Enrollment Agencies and community partners with the goal of growing health plan membership.
• Functioned as the liaison for external community partners and providers with membership issues and provided direction to our internal department to resolve issues.
• Implemented realistic performance expectations to new staff through a hands-on approach consisting of product training, goal setting, encouragement, motivation, feedback, recognition, passion for the work and love to help others.
• Organized and implemented all details pertaining to the health plans Regional Annual Community awards gala which identifies and recognizes heroes in the community with an award and a grant to the nominating agency at the same time growing attendance to nearly venue capacity of 500 people.