Network Manager
Aetna
Richmond, VA
2016 - 2025
Managed large key provider groups. Assisted with Aetna issues. Claims, fee schedule analysis, policy/contract interpretation network adequacy.
SUZANN JONES
Staunton,VA
Summary
Dynamic Network Manager with extensive experience at Aetna, excelling in claims resolution and network adequacy. Proven ability in relationship building and problem-solving, enhancing provider satisfaction. Skilled in network performance monitoring and team leadership, driving continuous improvement in service delivery. Committed to delivering quality results through effective communication and collaboration.
Work History
Provider Relations Consultant
Humana
Richmond, VA
2012 - 2016
Managed territory of participating providers. Maintained relationship, assisted with claims issues, policy interpretation, fee schedule analysis, maintained network analysis.
Provider Services Representative
New West Health Services
Billings, MT
2006 - 2012
Managed Eastern State Territory. Provided service and education to all participating providers. Represented NWHS at seminars. Also managed small regional office in Billings, MT.
Sr. Provider Relations Manager
Anthem
Richmond, VA
1985 - 2006
Managed territory of providers. Including claims issues, fee schedule analysis, policy analysis, contract interpretation, conducted monthly meetings with each provider group. Maintained relationships.
During my 21 years service I held multiple positions.
Customer Service, phone unit, personal interview and written correspondence areas.
Customer Service Trainer, senior correspondence representative included Congressional and all executive inquiries.
Broker Services,
Student Services.
Service Advantage Coordinator, represented Aetna onsite at key multi-specialuty clinic for six years.
Assistant Network Representative
Manager, Network Relations.
Medical Records Clerk
Waynesboro Community Hospital
Waynesboro, VA
1977 - 1985
Prepared records for microfilm. Yes, microfilm it was 1977!
Recorded all inpatient and outpatient visits. Reviews records for completion
Education
Wilson Memorial High School
Fishersville, VA06.1978
Skills
- IT infrastructure management
- Network access control
- Wireless networking
- Network performance monitoring
- Data backup
- Security protocols
- Project management
- Network security management
- Data center operations
- Cloud computing expertise
- Network architecture design
- Incident response planning
- Load balancing techniques
- VoIP systems
- Remote Access solutions
- Capacity planning
- ITIL framework
- Software-defined networking
- Virtualization technologies
- Network automation
- Disaster recovery planning
- IPv6 implementation
- Local area network
- Firewall configuration
- Wide area network
- Hardware installation
- Software upgrades
- Incident management
- Patch management
- Load balancing
- Mobile device management
- Information security
- Service level agreements
- Configuration management
- Traffic analysis
- LAN and WAN administration
- Network testing
- Business continuity plans
- Software installation
- Network configuration
- Technical troubleshooting
- IP addressing and subnetting
- Hardware troubleshooting
- System upgrades
- Risk assessment
- Application support
- System testing
- Program installations
- LAN and WAN control
- Workstation maintenance
- Permissions and Access control
- Cloud management
- PC diagnostics
- Data analysis
- User support
- Hardware diagnostics
- Virtual machine operation
- System updates
Timeline
Network Manager
Aetna
2016 - 2025
Provider Relations Consultant
Humana
2012 - 2016
Provider Services Representative
New West Health Services
2006 - 2012
Sr. Provider Relations Manager
Anthem
1985 - 2006
Medical Records Clerk
Waynesboro Community Hospital
1977 - 1985
Wilson Memorial High School