OBJECTIVE

• To obtain a position that allows me to use my past & current professional employment experiences and education to further my career as an Provider Network Account Manager, Provider Relations, Provider Recruitment & Engagement, Dental & Medical Providers, Provider Network Development Manager, Medicare, Medicaid, Provider Enrollment and Re - enrollment. This position would afford rewarding challenges and maximum growth potential.

PROFESSIONAL EXPERIENCE

Confidential, Dallas, Texas

Network Recruiter

Responsibilities:

• Analyze geographic market data to include current and potential membership growth, Dental Liaison Specialist input, and competitor positioning etc.,
• Orchestrate solicitation mailings to desired expansion targets, maintain tracking of progress. Negotiate contracts with dental providers.
• Plan and execute a process to contact and contract Confidential 's dental plans to solo dentist, group dental locations and dental practice management companies, with timely and accurate documentation of results, and ability to travel within entire assigned territory.
• Presentation of Dental Health Managed Organization plan design, compensation processes, and claim / encounter submission, referral process in person and via the telephone.
• Review Dental Facilities for Confidential 's standards of quality, in both administrative and technical abilities for initial contracting.
• On site meetings for new office orientations, reorientations, new product training service, and contractual issues. Participate and conduct meetings, conferences, and seminars with sales, brokers, providers, support and other constituents.
• Presentation and demonstration of Confidential 's electronic capabilities for dental providers to achieve companies goals and targets, promote all EDI initiatives.
• Negotiate with external and internal source to obtain the commitments and contracts necessary to meet financial targets. Special Ad Hoc projects as assigned.

Confidential, Dallas, Texas

Network Physician Business Manager

Responsibilities:

• Developed leadership skills as theinterim manager during a period of transition within our team.
• Primary trainer for the PBM team and relationship owner for large groups and individual clinics, including on-boarding and training new physicians and staff through in office presentations.
• Nurtured and built positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers.
• Responsible for identifying and closing gaps in quality (HEDIS/STARS measures), increasing provider RAF scores, developing a preferred network of specialists for PCPs to contain cost/over utilization and assisting in resolving operational short-falls.
• Participated monthly in JOCs and facilitator of weekly claims and configuration team calls.
• Provided subject matter expertise to improve efficiencies and results.
• Investigated non-standard requests and problems through extensive research. Generated monthly quality and utilization reports. Identified and remediated claims and configuration of PCP/member load issues.

Confidential, Dallas, Texas

Sr. Physician Recruitment Manager

Responsibilities:

• Promote differentiating services to community physicians. Develop goals and timelines for closing new physician practices.
• Present and gain support and commitment from the development team and the Executive Director, as needed, for the sales plan. Execute sales strategies and plans; track activities; report on activities and issues; successfully close new business in accordance with predetermined targets and quotas.
• Complete face-to-face sales meetings with physicians and practice managers, ensuring that a thorough understanding is gained regarding the physicians' desires and needs. Complete follow-up meetings with physicians, practice managers, and/or other providers as needed to close new or additional business, ensuring that internal and external obstacles to business growth and retention are identified and minimized or eliminated. Insure that the credentialing, transition and on boarding processes are smoothly managed and ultimately handed off to the physician relations team.
• Prepare and present weekly sales reports, identifying trends, additional business opportunities, and obstacles to new business growth. Continuously modify sales strategies and plans to ensure optimal business outcomes and "win-win" results for physicians and my clients.
• Engage providers by identifying HEDIS gaps and STARS in their practice processes and provide as well as promote positive change. Recruit practices into the network to promote practice growth and compliance in order to raise revenue while lowering operational costs, and Dental/Medical Providers

Confidential

Sr. Financial Advisor/ Business Analyst

Responsibilities:

• Processed individual and business tax returns daily. Work closely with the accounting team to ensure that all taxes were completed in a timely manner.
• Monitored monthly spends per client by putting together a budget in excel. Trained employees on how to process a tax return correctly.
• Project manager lead on multiple business projects to better the company. Setup conference calls with Clients to make sure everything were completed on the issue log.
• Responsible for end-to-end business process activities - creating, controlling and improving business processes.
• Leads process design and project implementation teams in process improvement activities. Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools.