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Skills

  • Process optimization
  • Organization
  • Team building
  • Interdepartmental collaboration
  • Problem resolution
  • Provider Dispute Resolution
  • KPI Monitoring and Report Generation
  • Business operations
  • Healthcare Economics Analysis
  • Process improvement

Work Experiences

  • Chaired standard committee.
  • Had an excellent attendance record and was always on time for work.
  • Achieved improvements over several months.
  • Achieved a 25% cost reduction.
  • Used Jira to create and update tracking spreadsheets.
  • Looked for industry trends on social media and through online sources.
  • Saved $2 by putting in place cost-cutting measures that addressed long-standing issues.
  • Co-designed a provider relations dashboard, improving key-performance-indicator visibility and strategic decision-making.
  • Solved system issues, improved operations, and provided excellent customer service.
  • Attended client meetings.

Summaries

  • Accomplished Senior Provider Relations Advocate with a strong focus on provider contract enhancements, resulting in a 44% reduction in service complaints within the past year. Adept at delivering provider education that boosts compliance and network performance.
  • Added 17 new providers to the network.
  • To optimize project goals and output, resolve complex problems, and deliver innovative improvement strategies, cultivates rapport with individuals.
  • Accomplished in resolving escalated provider issues with a 46% success rate, utilizing effective active listening and targeted mediation techniques. Demonstrated excellence in conflict resolution and provider retention.
  • Senior Provider Relations Advocate is a multi-talented Senior Provider Relations Advocate who is consistently rewarded for planning and operational improvements.
  • Adept at using data to drive network performance improvement.
  • Achieved 35% improved interdepartmental alignment.
  • HubSpot and Tableau are two of my strongest skills.
  • Achieved 40% improvement in regulatory compliance.
  • Senior Provider Relations Advocate with 3 years of successful workflow optimization and client relations experience.

Accomplishments

  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Co-hosted educational forums and workshops for provider networks, increasing provider knowledge and engagement by 59%
  • Exceeded key performance indicators (KPIs) by 27% through successful management and retention of key provider accounts.
  • Facilitated cross-departmental meetings to align provider dispute resolution strategies, leading to a 75% efficiency gain.
  • Enhanced provider relations communication model, resulting in a 41% improvement in net promoter score within 9 months.
  • Proactively identified and resolved complex inquiries for 9 provider clients, maintaining a satisfaction rate of 41% in 2019.
  • Conducted detailed analysis of provider performance metrics and presented actionable insights, driving a 16% improvement in overall service delivery.
  • Championed a custom-built provider dashboard, enhancing visibility of performance metrics, resulting in a 35% faster reporting process.
  • Resolved product issue through consumer testing.
  • Analyzed trends in provider claims data to predict future issues, implementing preventive measures that decreased claims reprocessing by 23%

Affiliations

  • American Medical Informatics Association
  • American Health Information Management Association (AHIMA)
  • Society of Healthcare Strategy and Market Development (SHSMD)
  • American Marketing Association
  • Toastmasters
  • Patient Advocate Certification Board (PACB)
  • National Association of Health Services Executives (NAHSE)
  • Lions Club
  • Society of Human Resource Management
  • Society for Healthcare Consumer Advocacy (SHCA)

Certifications

  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Expert in Medical Claims Processing (CEMCP) – Northwind
  • CompTIA Network+
  • Accredited Health Liaison Representative (AHLR) – Raleigh
  • Certified Healthcare Auditor (CHA) – Vantage
  • Certified Managed Care Professional (CMCP) – 2020
  • Certified in Healthcare Compliance (CHC) – Compliance Certification Board
  • Certified Professional in Healthcare Quality (CPHQ) - National Association for Healthcare Quality (NAHQ)
  • Conflict Resolution Certification Brightline 2023
  • Salesforce

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