MIA EMERY

***** ****** **** ***. *** Vegas, NV 89117 702-***-**** ac23rs@r.postjobfree.com

Result focused, critical thinker, and problem solver with excellent relationship building, communication, and managerial skills. I have a proven track record of implementing programs, forging strong business partnerships, and network growth and development, to succeed in a managed care setting.

EXPERIENCE

WellHealth Community Medical Group/DaVita (01/2017–6/2017)

9260 W. Sunset Blvd., Suite 200. Las Vegas, NV 89148

Manager Network Development

● Oversaw management of Contracting, Provider Relations, and Member Advocacy for a Network of 4,100

Providers including PCP’s, Specialists, and Ancillary Providers.

● Provided leadership in the implementation of provider service objectives to align with organizational goals.

● Responsible for advanced customer services for difficult clients/providers.

● Organized quarterly physician and office manager forums keeping providers and staff updated on organization and industry changes.

● Managed analytics for contracting and negotiating purposes.

● Understanding of Commercial, Medicaid, and Medicare contracting, ACA, Healthcare reform, HEDIS and STAR measures, MACRA, and MIPS.

Maverick IPA, ApolloMed ACO - (07/2012-8/2016)

700 N. Glendale Blvd. Suite 1400, Glendale, CA 91023

Sr. Manager Provider Relations, Manager Network Development, Network Development Specialist

● Four years IPA and ACO experience with increasing responsibility and title.

● Implemented procedures for in-servicing and on-boarding of physicians ensuring education of organization, CMS and stakeholder policy and compliance.

● Provided advanced customer services for difficult clients/providers. Including management of customer service for special projects to ensure retention and growth.

● Organized quarterly physician and office manager forums keeping providers and staff updated on organization and industry changes.

● Negotiated hospitalist contract, Palliative Group Orthopedic Bundling contract, and ACO recruitment agreement with Beverly Hospital.

● Established sub-IPA within my territory with key physicians representing growth of 600 senior lives.

● Developed new provider network including contracting of PCP’s and Specialists, Hospitals, hospital based physicians, and ancillary providers.

● Trained, coached, mentored, and supervised a team of Network Development Professionals. Training includes credentialing, contracting, and rate negotiation.

● Worked with Director of Operations and Performance Team Manager to ensure IPA achieves 5 Star rating.

● Worked with Insurance companies, community leaders, senior centers, and stakeholders to organize marketing events for IPA growth and awareness.

● In charge of reporting physician scorecard and HEDIS to network physicians, and assistance with improvement.

● Understanding of Medical, Medicare, ACA, Healthcare reform, HEDIS measures, MACRA, and MIPS.

Primary Care Associates of California - (01/2012 – 07/2012)

1303 N. Avalon Blvd., Wilmington, CA 90744

Network Development Specialist

● Network Growth and Development. Including Credentialing, Contracting and Compliance.

● Secured four exclusive contracts to physicians with over 1,400 senior lives combined,

● Development of specialty networks based upon Primary Care Physician needs to ensuring continuity of care.

● Marketing and Community Outreach to ensure IPA awareness and growth.

● Understanding of Medical, Medicare, ACA, and Healthcare reform.

Marshall Chiropractic Wellness Center - (02/2010 - 01/2012)

1055 N. Harper Ave., West Hollywood, CA 90046

Office Administrator/Director of Marketing

● Ran daily operations of a multi-disciplined practice offering Chiropractic Services, Acute Pain Relief, Wellness/Preventive Care, Massage Therapy, and Nutritional Counseling.

● Launched comprehensive marketing and business development campaign to revitalize existing client relationships, recapture more than 60% of lost business in 5 months.

● Restructured patient accounting operations and implemented policies and processes that improved collections, reduced outstanding debt, and strengthened bottom-line profitability.

● Identified niche markets and presented the services of the Wellness Center to physician those physicians and organizations creating cross-referral relationships.

CAREER HIGHLIGHTS

● Six years of IPA and ACO experience with increasing responsibility and title. IPA from inception.

● Increased revenue by 11% by leveraging my relationship with Beverly Hospital to include contracts with ApolloMed Hospitalists, ApolloMed Palliative Care, and ApolloMed ACO.

● Territory Lead for ApolloMed ACO which saved CMS $11.6M, half of which was distributed to our physicians after expenses. Instrumental in ApolloMed ACO being approved for Generation 2.

● Responsible for the addition of over 600 senior lives within a 12 Month period.

● Responsible for the development of new provider network including credentialing and contracting of Hospitals, hospital based physicians, PCP’s, Specialists, and ancillary providers.

EDUCATION & PROFESSIONAL DEVELOPMENT

Bachelor of Arts with a major in Health Care Administration

University of Phoenix

Associate of Arts – Business Administration

CUNY Burrough of Manhattan Community College

SKILLS

● Contracting ● Marketing / Community Outreach

● Credentialing ● Customer Service

● Provider Relations ● Growth / Retention

● Onboarding/In-servicing ● Managed Care / ACO experience

Microsoft Office, Office Ally, Exercise Pro, Constant Contact, ACT, Cerecons, Ascender, Par8O

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