Summer Alayian
San Diego,CA
Summary
Adept at transforming healthcare access through strategic network contracting and provider relations, I significantly expanded United Healthcare's provider networks by leveraging my expertise in contract negotiation and relationship building. Achieved over 30% membership growth at Anthem, underscoring my ability to blend analytical prowess with interpersonal skills for impactful results.
Overview
20
20
years of professional experience
Work History
Network Contract Manager
United Healthcare
01.2022 - 01.2024
- Developed and implemented contracting strategies for innovative benefit designs and plans
- Analyzed network gaps
- Negotiated provider rates using financial models and actuarial analysis
- Analyzed network gaps, Built comprehensive provider networks, expanding healthcare access
- Fostered positive provider relationships and ensured network adequacy
Provider Advocate Account Manager
United Healthcare
01.2021 - 01.2022
- Addressed escalated provider claims and service issues to improve satisfaction
- Conducted provider training on Medi-Cal and health plan initiatives
- Acted as a liaison between the provider network and health plans, facilitating collaboration
- Analyzed network gaps and supported provider recruitment efforts
Provider Services Representative
Molina Healthcare
01.2018 - 01.2021
- Served as the primary contact for high-volume providers, ensuring satisfaction and education
- Delivered training and presentations to provider staff and executive audiences
- Promoted Molina initiatives, including quality programs and electronic solutions
- Resolved complex issues independently and escalated when necessary
Quality Management - Senior Outreach Specialist
Anthem
01.2013 - 01.2016
- Coordinated HEDIS project management and facilitated medical record collection
- Conducted provider education to improve compliance with quality measures
- Analyzed claims data to identify improvement opportunities
- Supported member access through home visits and orientation sessions
Marketing - Senior Outreach Specialist
Anthem
01.2004 - 01.2013
- Increased membership annually by over 30% through outreach and education
- Delivered presentations to healthcare providers, schools, and community organizations
- Organized community health events to enhance member engagement
- Strengthened brand identity through innovative marketing strategies
Education
Computer Software Applications Specialist -
Nordstrom Business Institute
San Diego01.2004
Certified Medical Assistant -
Maric College
San Diego01.1995
Skills
- Healthcare management systems
- Regulatory compliance
- Quality improvement processes
- Contract drafting
- Workflow planning
- Problem-solving abilities
- Self motivation
- Relationship building
- Attention to detail
- Contract negotiation
- Meeting coordination
- Task delegation
- Written communication
- Company representation
- Negotiation
- Problem-solving
- Document review
- Contract administration
- Professionalism
- Decision-making
- Strategic planning
- Interpersonal skills
- Team collaboration
- Problem-solving aptitude
- Task prioritization
- Verbal and written communication
- Active listening
- Business needs identification
- Contract pricing
- Terms and conditions writing
Certificationsandskills
- Certified Application Assister
- Proficient in Microsoft Office Suite and healthcare management systems.
- Strong public speaking and training delivery skills.
- Experienced in regulatory compliance and quality improvement processes.
Languages
English
Professional
Spanish
Professional
Arabic
Professional
References
References available upon request.
Timeline
Network Contract Manager
United Healthcare
01.2022 - 01.2024
Provider Advocate Account Manager
United Healthcare
01.2021 - 01.2022
Provider Services Representative
Molina Healthcare
01.2018 - 01.2021
Quality Management - Senior Outreach Specialist
Anthem
01.2013 - 01.2016
Marketing - Senior Outreach Specialist
Anthem
01.2004 - 01.2013
Computer Software Applications Specialist -
Nordstrom Business Institute
Certified Medical Assistant -
Maric College
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