Yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000 (xxx-xxx-xxxx Abc@xyz.com

Leadership Client & Public Relations Driving Revenue Growth

Community Engagement Regulatory Compliance Contract Negotiations

         Demonstrated strengths in admissions, contract negotiations, compliance, quality, risk management, staffing, training, billing, provider relations, insurance, client/account management, and marketing.

         Well-versed in Medicaid, Medicare, and third-party reimbursement regulations.

         Contribute dynamic communication skills toward effectively liaising between senior management and internal/external stakeholders in support of achieving or exceeding corporate objectives.

         Apply considerable business savvy to define goals, uncover challenges or gaps in service, swiftly drive corrective action, and bolster profitability.

         Foster, nurture, and maintain highly cooperative relationships with staff, physicians, government agencies, and business partners.

         Solid expertise in sales and marketing; constantly strive to meet revenue and profit targets while achieving outstanding levels of quality of care and patient/client satisfaction.

         Empathetic client advocate and fiercely committed to optimizing quality of life for residents.

         Extensive network of professional contacts in healthcare industry.

Molina Health Care, Columbus, OH, 2015 to Present

Contract Specialist II

         Spearhead complete spectrum of contract management operations including provider engagement, quality services, data collection, risk management, database administration, and strategic planning.

         Championed network development and ongoing expansion by researching, recruiting, and negotiating with providers.

         Proficiently manage complete life cycle for provider letters of agreement, contracts, and amendments from initial draft to full execution.

         Communicate contract terms, payment structures, and reimbursement rates to physician, hospital, and ancillary providers.

         Efficiently process healthcare claims, coordinate insurance benefits, verify credentialing and member eligibility, and play an instrumental role in steering admissions and contracting new and existing providers into managed care programs.

         Drive key quality strategies such as initiation and management of provider, member and/or community interventions (e.g., removing barriers to care), and Quality Improvement Compliance surveys.

         Prepare broad-based reports, accurately interpret regulatory specifications, explain programs and results of programs, and document department interventions.

         Serve as active member of cardiovascular core team charged with optimizing team effectiveness.

Continued ►

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Professional Experience continued

Crown Healthcare, Columbus, OH, 2014 to 2015

Branch Manager

         Launched new healthcare business in Ohio with full accountability for public relations, contract & pricing negotiations, budget administration, market research, recruitment, and regulatory compliance.

         Authored employee manual detailing disciplinary procedures, code of conduct, FMLA policy and benefits information, and coordinated HR functions spanning Workers Compensation, employee health & safety program, and safety accident investigation procedures.

         Established new division by standardizing and communicating policies, procedures, systems, strategic plans, and organizational development initiatives.

         Fueled organizational growth by 20% through exemplary leadership talents and recruitment of top talent.

MedStaff, Columbus, OH, 2012 to 2014

Regional Accounts Manager / Human Resource Generalist

         Governed portfolio of 30 accounts in three-state area comprising LTC facilities and hospitals.

         Conducted in-services for LTC facilities and oversaw full-scope human resources activities encompassing interviewing, hiring, onboarding, payroll, and performance management.

         Methodically conducted market research, negotiated contracts, controlled sales budget, and audited medical charts.

         Captured thousands of dollars in staffing cost savings by proactively implementing high-impact recruitment and retention policies to retain high-caliber staff and reduce need for contract personnel.

Health Care Solutions, Bryan, OH, 2007 to 2012

Pharmaceutical / Marketing Representative

         Oversaw portfolio of 250 healthcare clients, and maintained 8-10 new patient sales appointments for equipment and pharmaceuticals each week.

         Cost-effectively controlled $25K annual marketing budget and maintained up-to-date marketing collateral.

         Launched, persuasively promoted, and sold Ventolin, Atrovent, and Flovent to pulmonologists, general practitioners, and nurse practitioners.

         Winner of Achievement Award for outstanding sales performance and contributions.

Herzing University, Toledo, Ohio

MBA, Business Management with Healthcare Management (in progress)

BA, Business Management and Marketing

Southern Ohio College, Findlay, OH

Practical Nursing Certificate