Manager, Institutional and Ancillary Contracting
Directed all functions of the Facility Contracting Department, responsible for contract negotiations for all Alabamahospitals and ancillary providers. Analyzed medical costs to identify re-contracting opportunities.
Managed a staff of four and met frequently with hospital leadership to advance positive relationships, focusing onaccurate claims payment, promp
t resolution of provider concerns, and education related to the company’s direction
Reported directly to the President and worked closely with the CFO and Medical Director to improve the providernetwork. I r
efocused the company’s contractin
g philosophy to align solely with providers that had a proven history of cooperation, resulting in a smaller but vastly more efficient network of quality providers.
Privately held company that owns and manages two multi-modality diagnostic imaging facilities located in central Alabama.
Chief Operating Officer
Maximized operational efficiencies to streamline patient through-put, billing and collections, RIS/PACS, payorcontracting, credentialing and marketing strategy. New patient visits increased by 11% under my direction.
Piloted the purchase and installation of a Toshiba 64-Slice CT scanner, successfully coordinating equipmentprocurement and delivery, room construction, financing, regulatory compliance and the sale and removal of the oldscanner. Referrals increased by an average 11% per month and first-time physician referrals were realized.
Managed the company’s payor relations to ensure contract compliance and accurate,
timely payments. By eliminatinga wasted step in the payment process, funds were deposited an average of four days sooner.
Established new markets via attorney
liens and workers’ compensation, increasing new referrals by 6% from
Private company based in Brentwood, Tennessee, that owns and manages 19 diagnostic imaging facilities in nine states.
National Director of Managed Care
Directed all aspects of
the company’s interaction with national, regional and local commercial payors, plus Medicare,Medicaid and other government programs. Continuously sought opportunities to establish or improve the company’s
relationship and financial position with its payor partners, negotiating an average 1.5 new agreements per month.
Developed and implemented the company’s first
-ever contract management system, involving document scanning,logging and file sharing of 400+ payor agreements to enable access by administrato
rs and Touchstone’s billing
partners. Efficiencies were immediately realized by eliminating the reliance on hardcopy documents.
Supervised and trained coordinators in four states, providing leadership to manage local payor applications,credentialing and claims payment issues. Routinely traveled to each market to foster teamwork, advance company
goals and further the team’s knowledge of managed care trends.
One of the nation
’s largest providers of rehabilitative healthcare services.
Assistant Vice President, Payor Contracting & National Accounts
Oversaw contract management and partnerships with national payors. Performed financial analysis of contracted rates for1,700 facilities, encompassing acute care hospitals, ASCs, imaging facilities, outpatient physical therapy centers andinpatient rehab hospitals. National payor contracts valued at $200M in annual gross revenue were systematically analyzedfor prompt payment compliance, regulatory issues, opportunities to maximize reimbursement rates, and overall value tothe company.
Initiated and led a company-wide overhaul of an inefficient contract approval process, streamlining it into a workable,centralized system where appro
val turnaround time was slashed by 47%. Trained the company’s 50+ field contracting
directors on contract language and financial analysis to ensure market-driven reimbursement levels.
One of only four field-based directors in company history to be promoted to officer level.