Dynamic, results-driven professional with unique combination of patient advocacy, program development and public relations expertise. Substantial experience in progressively challenging, high-visibility hospital/healthcare administrative positions. Exemplary organizational aptitude, balanced by highly developed interpersonal, presentational and negotiation skills. Ability to communicate effectively with management and staff at all levels. Accustomed to managing multiple projects simultaneously, often within stringent time and budgetary constraints. Reputation for vision, diligence, follow-through and dedication to quality outcomes.
Coventry Healthcare of Georgia, IncJanuary 2006 to CurrentNetwork Operations Manager Atlanta, GA
Negotiate and renegotiate contracts with PHOs, IPAs, hospital systems, ancillaries and various physician groups.
Lead contracting, network development, network operations, consolidation and expansion efforts with various providers in the Atlanta area and throughout northern Georgia including a portion of South Carolina and Alabama.
Lead various network hospital and physician operations projects.
River Oaks Health System Includes River Oaks HosJanuary 1996 to January 2005Director MS.
Oversee all facets of Managed Care Department, developing and implementing system's Managed Care Strategic Plan.
Perform comprehensive research for strategic plan, including demographics for hospitals' primary service area, competitor strengths/weaknesses, targeted employers for potential contracting, recommended potential market partners, current contract arrangements, payer mix matrix, current contract performance and future contracting strategy.
Negotiate contracts for five hospitals, each with different managed care organizations; renegotiate contracts with minimum 10% net revenue increase and required thirty-day reimbursement clause.
Submit modeling reports on all new and renegotiated contracts.
Prepare monthly contract performance reports for hospital CEOs and CFOs, outlining each contract, volume of business and gross/net revenue.
Operationalize all new/renegotiated contracts with hospital staff, including UR/Case Management, Business Office staff and Managed Care Coordinator.
Chair all related co.
Apex HealthcareJanuary 1995 to January 1996Director of Development MS.
Held full accountability for obtaining HMO license, which was secured in record time.
Developed, negotiated and maintained physician/hospital network to increase HMO's licensed service area to over 10 counties in its first year of operation; process included collaboration with DOI and Mississippi State Health Department.
ACMG, IncJanuary 1994 to January 1995Account Executive MS.
Marketed newly formed PPO - Mississippi Physicians Care Network - throughout state; targeted employer groups, TPAs, insurance brokers and insurance companies.
Created and implemented marketing strategy; assisted with development of hospital network.
Consulted with Mississippi State Medical Association - developer and promoter of network - in marketing their physician group.
Complete Health of Arkansas United Healthcare ofJanuary 1992 to January 1994Development Representative Little Rock, AR.
Directed all functions of Physician Network Development and Provider Relations for Complete Health, including physician contracting, physician office staff orientation and ongoing educational programs.
Recruited physicians as providers with HMO, developing strong physician network in highly competitive area; contracted with 79 physicians within first month.
Negotiated contracts with non-physician providers, such as radiology, pathology and anesthesiology; played key role in contract negotiations with hospitals.
Secured service area expansion approval from Arkansas DOI, increasing licensed service area from 15 to 55 counties.
Maintained continuous communication with all contractors, ensuring knowledge of new groups who have chosen HMO.
Health Advantage - Baptist Medical System, HMOJanuary 1988 to January 1991Supervisor Little Rock, AR.
Managed Provider Relations staff in delivery of services, including physician telephone referral/ authorization system, production of physician quarterly/bimonthly newsletters and promotion of positive relations with participating physicians/office staffs.
Developed and coordinated wellness programs.
University of Arkansas - Little RockB.S: Health EducationLittle Rock, AR.
Elected Treasurer; term, May 2005 - May 2006.
Re-elected Treasurer; term May 2006 - May 2007. Served May 2006 - July 2006 due to job transfer out of state.
Mississippi Chapter Board of Directors - Healthcare Financial Management Association. (HFMA) May 2003 - July 2006.