Sales Representative
Resume:
Amy N. Mahen
*** ********** **., ********** **, *5108
********@*****.***
Objective
A challenging position within the Health Care Insurance industry which employs both my outstanding skills and solid
professional experience in Provider Relations, Contract Negotiations, and Managed Care Network development,
and in-depth knowledge of Medicare Advantage.
Professional Experience
2006-present
Humana, Inc. Pittsburgh, PA
Hospital Contracting Executive
Initiate and maintain long-term relationships with key Hospital, Ancillary Facility, and PHO
Administrators targeted for recruitment into Commercial and/or Medicare Advantage PPO Network
Negotiate complex Hospital, Ancillary and PHO contracts according to various reimbursement
methodologies at market competitive pricing
Direct contracting activities of Physician Contractors in support of Hospital recruitment goals
Manage Local PPO Network filing process through completion of HSD tables and narrative
exceptions submitted annually for CMS approval
Achievements:
Significantly expanded Commercial and Medicare Advantage PPO Networks throughout state of WV
and Central PA by contracting with 28 Hospitals including 2 PHOs, 80 Skilled Nursing Facilities,
6 Rehab Hospitals as well as numerous RHCs, FQHCs and Physician groups. Obtained CMS approval of
Local PPO product offering in 13 counties throughout WV.
2004
Aetna, Inc. Pittsburgh, PA
Contract Negotiator
Accountable for Hospital, Physician and Ancillary provider recruitment throughout Western PA into
Aetna Workers’ Comp Access PPO Network
Established and maintained relationships with facility and practice administrators
Conducted Network needs and financial analyses, developed rate proposals, negotiated contracts
Achievements:
Completed Agreements with West Penn Allegheny Health System, St. Clair Hospital, and Hamot Medical
Center as well as entered into positive negotiations with Mercy and Conemaugh Health Systems. Met or
exceeded provider and ancillary recruitment goals on a monthly basis.
Amy N. Mahen
142 Cranbrooke Dr., Coraopolis PA, 15108
********@*****.***
2001-2002
HealthSouth Rehabilitation Hospital Sewickley, PA
Marketing Liaison
Directed marketing activities of four outpatient rehabilitation clinics and the “WorkPerfect” work
injury management program
Generated Physical and Occuptional Therapy referrals through development of relationships with
Physician practices
Recruited hospitals and physicians to participate on Workers’ Compensation provider panels
Achievements:
Developed and implemented business plan resulting in expansion of referral base and 15% increase in
outpatient clinic PT/OT visits on monthly basis. Expanded network of providers available to employers
participating in WorkPerfect program for treatment of employee work injuries.
1999-2000
Gateway Health Plan Pittsburgh, PA
Provider Relations Representative
Responsible for managing relationships with and providing on-going service to assigned Hospitals
and Physician Groups participating in Medicaid Managed Care Network, and Network expansion
Conducted Physician office audits and both Hospital and Physician practice orientations
Resolved claims issues and member complaints
Achievements:
Retained 98% of network participating providers in territory as well as exceeded annual provider
recruitment goals.
1996-1998 CorVel Corporation Pittsburgh, PA
PPO Development Specialist/Account Executive
Developed Workers’ Compensation PPO Network for Managed Care Organization through
recruitment of Hospitals, Physicians and Ancillary providers
Developed relationships, negotiated contracts, and oriented providers to policies/procedures
Conducted sales activities including prospecting, delivering presentations,
developing proposals, closing sales, and servicing accounts
Achievements:
Built PPO Network throughout Western PA by contracting with hospitals, PHOs, physician groups and
ancillary providers. Added 11 hospitals including: West Penn Allegheny Health System, Heritage Valley
Amy N. Mahen
142 Cranbrooke Dr., Coraopolis PA, 15108
********@*****.***
Health System, Mercy Health System, Jefferson Regional PHO, and UPMC Physician Network.
Promoted to Account Executive upon outstanding performance as PPO Developer and secured 3
large accounts, Swigart Associates, Consol Energy and Johnstown America Corp.
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1995-1996 Consolidated Services Group, Inc. Pittsburgh, PA
Sales Representative
Developed business plan for start-up branch
Responsible for all components of sales cycle from initial contact through close of sale
Achieved 118% of sales goal
Education
1988-1992 Meadville, PA
Allegheny College
Bachelor of Arts i n Classical Studies, concentration in Pre-med sciences
Graduated Magna Cum Laude, inducted into Phi Beta Kappa
Amy N. Mahen
142 Cranbrooke Dr., Coraopolis PA, 15108
********@*****.***
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