About

About

Background

I am an experienced Director of Payer Contracting and Credentialing with a history of success working in the Healthcare Industry, more specifically, the Behavioral Health field for the last 12 years. I have worked with and for the following organizations:

  • Rosecrance Inc. (Aug.2019-current): Rosecrance has a long historyof leadership in substance abuse and mental health care, Rosecrance has grown to more than 60 convenient locations across Chicago, northern Illinois and central Illinois, Wisconsin and Iowa. Rosecrance is a private, not-for-profit organization offering comprehensive, nationally accredited, evidence-based addiction treatment and mental health treatment for children, teens, young adults and adults.

  • Meridian Behavioral Health (Jan. 2018-Aug. 2019): Based in the Twin Cities area of Minneapolis-St. Paul, Meridian Behavioral Health is one of the fastest growing, leading behavioral healthcare platforms in the country. Meridian provides substance use disorder treatment services across a broad continuum of care, including in-patient, residential, out-patient and medication-assisted treatment. For more than 25 years, Meridian has developed and refined an innovative, evidence-based care model focused on positive patient impact. Today, the 1,100 employees of Meridian’s network serve countless patients at multiple facilities. At this time of national crisis, Meridian continues to invest in new campuses and programs to better meet the needs of its patients.

  • The Hazelden Betty Ford Foundation (May 2008-Jan. 2018): The Hazelden Betty Ford Foundation is the nation's largest nonprofit treatment provider, with a legacy that began in 1949 and includes the 1982 founding of the Betty Ford Center. With 17 sites in California, Minnesota, Oregon, Illinois, New York, Florida, Massachusetts, Colorado and Washington, the Foundation offers prevention and recovery solutions nationwide and across the entire continuum of care for youth and adults.

About
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My Skills and Abilities

I am an excellent communicator with strong analytical skills. When it comes to developing payer relations and conducting contract negotiations, I have the expertise you require.

In addition to this, I understand the complexity of payer contracting management and its impact on other departments. I also have a robust knowledge of both facility and provider credentialing, and revenue cycle management.

Expertise in the Behavioral Health Field: Understanding the complex and multifaceted processes related to contracting, credentialing, revenue cycle management, and clinical criteria to achieve desired results.

Contract Negotiation and Management-Conduct successful payer negotiations based on payer strategy. Confirm both external and internal systems reflect accurate contract rates. Review, analyze, and ensure provider payments are correct based on fully executed contracts-Establish continued monitoring of contract performance throughout the year-Renegotiate as required via the terms of the contract

Communication and Organizational Skills: Ensure contract model, pricing, coding and clinical aspects of a payor contract are communicated effectively across all departments and provider locations. Build and maintain strong relationships with both internal and external stakeholders.

Analytical and Problem-Solving Skills: Utilize data to identify a problem and use this data as a basis for improving a process or developing a new one. This process improvement protocol is based on the Malcom Baldridge Criteria model of business excellence.

                                     

Education

UNIVERSITY OF PHOENIX
Phoenix, AZ  May 2013
Master of Business Administration, Executive MBA

UNIVERSITY OF PHOENIX  
Phoenix, AZ  May 2010
Bachelor of Science in Business Management

Achievements

  • Secured the renegotiation of several commercial payer contracts resulting in additional revenue year one amounting to $1,355,457.

  • Eliminated two full-time positions with estimated salary savings of $130K

  • Completed a contract inventory that includes all sites:

    • 51 different payers
    • More than 60 different contracts, including facility and group contracts
    • More than 40 different locations
  • Secured the second-year renegotiation of several commercial payer contracts resulting in the additional revenue of $450K

  • Negotiated and secured an additional commercial payer contract effective July 1, 2020, resulting in a minimum additional revenue of $518,361.

  • Fully executed a Supervisory Protocol contract that eliminates write off due to “non-credentialed provider” by an estimated $290K in billed charges

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My Process

I will effectively assess your organizations’ current payer contracting, credentialing and revenue cycle infrastructure and processes based on need. Based on your assessment, I recommend proven strategies that ensure your strategic goals are achieved. I will also assist in implementing recommendations and transforming your operations as required.

Get in Touch

Let’s work together in identifying opportunities and executing tactics to achieve desirable results! Contact me for more information about my services.