Energetic, self-directed operations director with excellent project management, problem solving, and communication skills. Process-oriented healthcare professional with proven track record of motivating and managing cross-functional teams.
Managed all payment policy initiatives for Association, advocating for approximately 150,000 providers nationally. Performed outreach to accreditation organizations and insurance companies related to payment policy negotiations. Gathered state / national data for strategic initiatives. Managed payment policy marketing campaigns and development of resources for providers, their staffs and patients. As a member of leadership, led Payment Policy Team, to include: interface with committees, Board, and state associations; strategic planning; budgeting; presentations at national conferences; performance reviews; recruitment; and policy development.
Led Insurance Relations team through coaching, directing creation of resources, support for members, and advocacy. Some successes include:
Designed databases to quantify trends in payment policy and successfully collaborate with insurers, identifying areas of need and ensuring proper patient access to care. Supervised building of program to address fraud and abuse and to partner with insurers. Provided training for investigators and collaborated with International Association of Special Investigation Units to supply educational resources.
If you, like me have been wondering how the Exchanges are faring in the states with federally funded programs on HealthCare.gov, you might be interested in the following recent statistics from the Research Brief of the Office of the Assistant Secretary for Planning and Evaluation (ASPE) dated October 26, 2018:
• Issuer participation has actually slightly increased. This is good.
• 20% of current participants will have only one issuer from which to choose in PY 19 compared to 29% in PY 18....