Victoria Matviiv

562-***-**** ad4vr2@r.postjobfree.com Huntington Beach, CA 92646 linkedin.com/in/victoria-matviiv-4305b245

Contracts Specialist Data Analysis & Validation Contract Management & Renewal Staff Leadership & Training

Administers and operationalizes lucrative contracts by generating, reviewing, and finalizing intricate agreements. Builds contractual relationships by facilitating seamless communication across multifunctional stakeholders. Mitigates risk, fosters transparency, and ensures compliance with legal and regulatory requirements. Mentors personnel by devising SOPs and operational guidelines.

Contract Performance Evaluation

Data Integration & Synchronization

High-Grade Customer Service

Contract Database Maintenance

Operational Efficiency Enhancement

Regulatory Research & Compliance

KPI Monitoring & Improvement

Cross-Functional Team Coordination

Issue Identification & Resolution

Professional Experience

ELEVANCE HEALTH 03/16 – 12/23

Senior Provider Contract Specialist 09/21 – 12/23

Supervised the onboarding of healthcare providers onto multiple networks, including PPO, Medicare, Medicaid, and workers’ compensation. Generated and processed value-based and fee-for-service agreements across varying databases; consolidated, analyzed, and forwarded pertinent documents to multi-practice teams. Verified contract processing and execution using HIPAA validation services. Trained 2 junior processors by delivering best practices, conducting performance reviews, and devising job aids.

Contract Review & Implementation

Supported the physician experience team by resolving issues while delivering agreements to submitters. Formulated pricing document verbiage by liaising with contract managers; updated changes to contract terms within internal systems.

Drove contract renewals by transitioning medical practices from individual to group credentialing; generated and delivered contract language with standard or negotiated rates.

Verified documentation, such as fictitious name permits (FNPs), articles of incorporation, and statements of information; ensured active status on the state website. Evaluated physician data throughout the contract lifecycle.

Cut turnaround time and solidified contract management by replacing the provider screening form with a personalized process.

Stakeholder Relationship Management

Furthered credentialing by submitting requests to the credentialing department and forwarding approved cases to the data management team; reverted rejections by working with the manager. Reviewed provider data within Apex using NPIs.

Populated the medical directory by addressing tickets on PEGA and conducting data validation and screening. Enabled physicians to transition and terminate networks by submitting requests on the provider lifecycle management (PLM) platform.

Supported company’s growth within Colorado by researching market needs on physician enrollment in HMO and PPO networks.

Built solid provider relationships by delivering standard guidelines and continually resolving queries and concerns via email.

Senior Network Management Representative 11/16 – 09/21

Executed provider enrollment in a new enterprise platform based on feedback from a change manager; assured accurate contract management and billing. Validated Medicare and Medicaid data using Facets.

Updated internal reporting throughout the provider data management process; revamped and resubmitted reports to the credentialing team. Inputted information into the medical directory using ePACT.

Resolved billing issues, physician disputes, and discrepancies by submitting tickets to pertinent teams. Consistently addressed inquiries from clients, contractors, and personnel.

Network Analyst 03/16 – 11/16

Facilitated the shift of paper-based provider management to an online process. Supported contract negotiations by coordinating network participation applications; analyzed and cleaned extensive data. Coached contractors by building training materials.

Tracked physicians throughout the end-to-end lifecycle by formulating an Excel spreadsheet; requested information, delivered contracts and fee schedules, and conducted follow-up. Indexed data and exported agreements using ePACT and FileNet.

Performed provider screening by verifying general information using a state database; forwarded requests to data management and credentialing teams. Assessed and validated physicians’ admitting privileges.

OPTUM RX 09/15 – 01/16

Process Analyst

Discerned trends across different business segments by performing in-depth analysis on pharmacy benefits data using a CRM. Approved and reopened cases by reviewing and verifying information using SharePoint.

Identified copay miscalculations across varying drug tiers; rejected cases and returned requests until issue resolution. Indicated and forwarded discrepancies to varying departments by building an Excel scorecard.

HEALTHCARE PARTNERS 03/15 – 04/15

Clinical Data Analyst

Enabled physicians to access client information by ensuring data accuracy and integrity during extraction from HealthFortis to an internal database. Supported the integration of a data mart and a data warehouse.

Implemented data cleaning and transformation by conducting workflow analyses to suggest process improvements; determined defects and enhancements by modifying Excel data to generate ad hoc reports.

OPTUM RX 08/14 – 01/15

Benefits Data Analyst

Assured data credibility while building and executing updates to standard benefits plans. Managed data releases to varying business segments and furthered the migration of information to downstream databases.

UNITEDHEALTH GROUP 10/12 – 02/14

Client Relations Manager

Developed electronic change requests within the pharmacy benefit management tool. Drove business requirements by interfacing with SMEs to validate departmental workflows and mitigate issues using Salesforce.

Education

Bachelor of Science in Computer Information Systems & Information Technology, California State University, Los Angeles 2012

Bachelor of Arts in Business Administration, California State University, Los Angeles 2010

Technical Skills

Healthcare Solutions: Contraxx; Availity; ePACT; Facets; PEGA; HealthFortis; Apex; PhBit; SmartCred; CAQH ProView; CACTi Observer; Wellpoint Enterprise Provider Database Solutions (EPDS).

Internal Platforms: RxCCR; RxConstruct; WGS Mainframe/RxClaim; Strategic Provider System (SPS); Provider Lifecycle (PLM) & Pricing Configuration Management (PCM); Enterprise Provider Intake Credentialing System (EPICS).

Other Technologies: Salesforce; FileNet; AS400; Microsoft Office (Excel, PowerPoint, Word, SharePoint, OneNote, Outlook).

Victoria Matviiv Resume Page 02 562-***-**** ad4vr2@r.postjobfree.com linkedin.com/in/victoria-matviiv-4305b245

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