Manager Management
Resume:
As an independent professional consultant, I provide medical practice
management services to physician's practices, medical groups, and
hospitals. Recently, contracted with an anesthesiology group, reviewing
and recommending improvements to financial management, operations
management, compliance, negotiating managed care contracts, credentialing
and strategic business development.
My expertise includes setting strategic direction working with management
interdependencies and project management within the healthcare field I
provide contracting perspectives, and operation/revenue cycle functions. I
possess proficiency in several data software packages utilize in
recommending appropriate analytic and statistical methodologies and
techniques to execute against an analysis plan or research objective. I
have developed innovative approaches evaluating new analytics tools and
methodologies for possible deployment.
I maintain a professional attitude comfortable working in any setting
populated by diverse types of people and I'm able to maintain poise and a
sense of humor in stressful situations. I have almost compulsive
organizational skills and obsessive attention to detail necessary to
provide on-going support in the generation and prediction of revenue.
At your convenience, I would be happy to have a preliminary discussion with
you to see if we can establish a mutual interest. Thank you for your
attention to these materials. I certainly look forward to exploring this
further. My resume is enclosed for your review.
Yours truly,
Shirley J. Howell
PROFESSIONAL GOAL:
Contribute to an organization that could benefit from my strengths in
revenue enhancement, economic analysis, product development, governance
system development, performance bench-marking, and other organizational
enhancements.
WORK EXPERIENCE:
2009-Current
Independent Medical Practice Consultant:
. Consulting services include new practice start-ups, creation of business
plans, practice management assessment, accounts receivable evaluation,
reimbursement analysis, medical coding training and updates,
documentation audits, physician fee analysis, contract negotiation,
credentialing with third party payers, and training in billing and
collection processes.
2008- 2009 HUMANA formally CARITEN
Manager Network Development:
. Managed daily operation and staff of Network Development Department.
. Recruited and contracted with facilities, individual providers, groups,
and ancillaries.
. Developed and maintained appropriate fee schedules and reimbursement
models for all providers.
. Maintained working knowledge of billing requirements, to include fee
schedules, coding standards, and claims payment to facilitate correct
contract preparation.
. Assisted other departments with provider contract interpretation,
configuration, and accuracy.
. Ensured process improvement and business development opportunities are
implemented through effective contracting processes.
2007-2008 DOCTORS MANAGEMENT, INC.
Medical Management Contracts Specialist:
. Managed single case agreements on behalf of providers.
. Co-developed contracting strategies that are aligned with organizational
financial goals.
. Performed contract management and payer relations activities and serves
as operational liaison between assigned payers and providers to ensure
payor payments are accurate and timely.
. Facilitated internal communication/education regarding contracted payers,
contract terms and ensures internal stakeholder input.
. Achieved company targets through aggressive primary care, specialty and
ancillary provider contracting and risk contract management.
. Identified potential new relationships for profitable growth.
. Monitored primary care and specialty risk arrangements for Medicaid, and
Medicare product lines.
. Worked with Network Development staff regarding contracting and contract
management inquiries.
. Assisted in the analysis of claims trend data and/or market information
to derive conclusions to support positive risk arrangements.
. Certified Medical Practice Manager (CMPM)
2000-2005 SUNSCRIPT / OMNICARE PHARMACY
Area Business Manager:
. Provided all phases of accounts receivable management.
. Accountable for the functional and operational management, to include day-
to-day office operations, of the Business Service Division of Sunscript
Pharmacy, which services long-term care facilities within the Southeast
Region.
. Developed effective / efficient use of resources to achieve deliverables.
. Identified operational processes requiring improvement and implemented
changes as indicated.
. Developed standard operational procedures for the office environment to
include knowing the strengths and weaknesses of staff, as well as the
required level of quality and time allotted.
. Effective recruitment and placement of qualified Billing Clerks and
Pharmacy Technicians.
. Coordinated business office support of several software systems.
1996-2000 COVENANT HEALTH
Business Manager:
. Responsible for all business office functions in the outpatient facility
and community mental health centers serving five clinics in a five county
region.
. Experienced with a diverse payer mix, including commercial managed care
and Medicare.
. Advanced knowledge and successful track record in the management A/R and
cash collections, including the management of information systems used to
support these functions.
. Responsible for resolving the reimbursement of Medicare, MCOs, and all
other third party accts.
. Ensured reimbursement agreed with the contracts that were negotiated
between managed care organizations and Oak Ridge Methodist Medical
Center.
. Evaluated the utilization management programs with all providers.
. Trained the customer service representatives, ensuring the patients were
assisted both professionally and efficiently.
1991-1996 HEALTHFIRST
Director of Central Billing:
. Provided direction for daily operations and management support in
overseeing billing services for all client rural health care clinics and
physician practices.
. Responsible for A/R and financial reporting.
. Involved in all phases of A/R management to include increasing clients
cash flow, tracking data for cost report settlements, balancing Medicare
PS&Rs, resolving third party accounts, supervising staff, and training in
bill coding / capture for collections, insurance processing, etc.
1991. DOR, P.C., ANESTHESIOLOGIST
Office Manager:
. Responsible for financial management and administrative control of the
medical office, including financial supervision, control of collections,
accounts receivable, cash flow, budget preparation, and supervision of
clerical personnel.
EDUCATION: BS in Business Administration, Finance concentration
University of Tennessee, Knoxville, TN.
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