Livecareer-Resume
Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Skills
  • Experienced contracting professional with superior skills acquired during lengthy career in health care.
  • Contract Management
  • Rate and Language Negotiation
  • Financial and Operational Analysis
  • Strategy and Business Development
  • Drafting Contract Language/Narrative Writing
  • Staff Management (5 years -5-7 administrators)
Work History
Managed Care Contracts Manager, 02/2015 to Present
VisaAustin, TX,
  • Manage all aspects of health plan contracting for over 200 business units in assigned region including skilled nursing, home health, hospice, and assisted living operations.
  • Currently responsible for over 80 health plans in 13 states.
  • Ongoing collaboration with Executive Team and Business Development to focus priorities on areas with highest impact to return on investment.
  • Evaluate business unit's financial performance; target new health plans and rate renegotiation for existing agreements.
  • Annually over 45 new business contracts closed and average rate escalation of 15% resulting in increased revenue and profitability.
  • Work in partnership with corporate departments, field locations and leadership on compliance, credentialing, and reimbursement matters to resolve issues.
  • Ensure coordination of care across business lines with health plans within market capabilities.
Manager, 01/2011 to 02/2015
QuantitechArnold Afb, Tullahoma,
  • Direct oversight and hands on management of key managed care accounts.
  • Oversee, train and direct contract administrator staff including: Development and maintenance of staff training material, ongoing assessment of department processes, staff evaluations and quality assurance activities.
  • Development and ongoing maintenance of both internal department and field operations training manuals regarding contract department functions.
  • Lead data management/technology initiatives for contract management.
  • Strong collaboration with billing, finance, regulatory, business development, compliance, risk management and legal.
  • Represent contracts department in cross departmental company initiatives.
Senior Contracts Administrator, 01/1997 to 01/2011
Apex SystemsBristol, CT,
  • Mentored department staff on process and procedures; company operations; legal, compliance, licensing and regulatory requirements.
  • Performed all duties and responsibilities of contract administrator.
Contracts Administrator, 01/1993 to 01/1997
Bickford Senior LivingLincoln, NE,
  • Review, evaluate and negotiate contract terms with local, regional and national managed care payers, government agencies and other clients to ensure compliance to company requirements.
  • Analyze operational/financial feasibility of contract terms.
  • Elevate requested variations to standard policy to company leadership as appropriate.
  • Ensure all non-standard terms and rates have documented approval in accordance with company policy.
  • Redline customer agreements, draft various standard and non-standard agreements as well as contract amendments/addenda.
  • Prepare narrative responses to Requests for Proposals and ensure timely and professional submission of the final proposal including any required budgets.
  • Coordinated contractual billing terms with financial services unit to ensure proper billing.
  • Strong collaboration with various company departments to assess financial, compliance, legal, regulatory, clinical and liability issues.
  • Ensure physicians and subcontract vendors meet all required conditions for contracting with organization.
  • Prepare accurate and complete credentialing applications to achieve customer network status.
, 01/1991 to 01/1993
Gentiva Health ServicesCity, STATE,
  • Prepared contract documents based on company approved templates.
  • Reviewed contract renewals in accordance with company guidelines.
  • Credentialed and processed contracts for subcontracted vendors and non-revenue accounts.
  • Completed credentialing applications and develop standardized sales proposals.
Education
Emory University Certificate Programs: , Expected in 2013
- ,
GPA:
Essentials of Leadership for Managers Emotional Intelligence Classified - Internal use: , Expected in
- ,
GPA:

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Job Titles Held:

  • Managed Care Contracts Manager
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  • Senior Contracts Administrator
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Degrees

  • Emory University Certificate Programs
  • Essentials of Leadership for Managers Emotional Intelligence Classified - Internal use

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