Manager Project

JULIE Z. CONWAY

Flower Mound, TX. *****

Cell 469-***-****

********@*******.***

Healthcare expert with a passion for improving the delivery of healthcare services to our community.

Strategic thinker able to leverage new strategies like narrow performance networks and broader value-based contracting initiatives. Hospital System, complex surgery center, large physician IPA/group contract negotiations, analytical problem solver, strong communication skills with the ability to build lasting strategic relationships.

EXPERIENCE

8/2010-4/2018

CIGNA HEALTHCARE OF TEXAS, INC

CONTRACTING DIRECTOR

Coordinate and support all Commercial managed care negotiation, contracting and reporting activities. Strategically partner with key provider practices (e.g., ACOs, MSOs, IPAs) for all segments, accountable for developing and maintaining provider engagement and networks. Managed complex relationships to achieve optimal pricing for Cigna Customers. Negotiated hospital system agreements and group agreements utilizing various reimbursement methodologies. Project manager for collaboration agreements with physician groups to help drive lower medical cost trends through an informational value-based Pay for Performance program which rewards physicians for improved quality outcomes. Managed annual health care budget. Responsible for the career development of the Contracting Managers and Network Analyst Specialist. Negotiate legal documents including specific legal terms to support both State and Healthplan’s required procedures.

2004-2010

CIGNA HEALTHCARE OF TEXAS, INC

CONTRACTING MANAGER

Project manager for the development and full operations of a single specialty network modal which goals were to maximize the delivery of specialty care within the Cigna physician networks. The single specialty networks included: cardiology, gastroenterology, urology, high tech imaging and physical therapy. Provided financial reporting to support the bundled payment program. Negotiated the complex capitated group agreements which included quality programs. Project Management of specialty networks to ensure financial viability by identifying and reducing excess medical expense through utilization and financial data management. Expanded the service area in the North Texas market through direct contracting and replacing a leased Third- Party Vendor Network. Network contracting and management of Medicare product.

1999-2003

CIGNA HEALTHCARE OF TEXAS, INC

PROVIDER SERVICES MANAGER

Lead a department of Provider Service Representatives with the responsibility for education and service for the network of health care professionals. Developed policies and procedures in support of NCQA accreditation. Implemented and managed networks to meet network adequacies in a 22-county service area.

1991-1998

CIGNA HEALTHCARE OF TEXAS, INC

Provider Service Representative

Provided training to practice staff to ensure customers received highest level of in-network medical benefits. Hosted educational seminars for large volume of healthcare employees. Responsible for a service area of healthcare professionals.

1985-1998

Office Services Assistant

General office responsibilities; appointment scheduling, receptionist and medical record management. Account receivable and banking reconciliation.

EDUCATION

LeTourneau University, Longview TX

Finance

SKILLS

Strong negotiating skills

Interpersonal savvy

Project management

Financial and budgetary knowledge

Word and Excel proficient

Highly motivated and customer centric

REFERENCES

Heather Clarke, VP Managed Care HCA *******.******@*************.***

Tammy McQueen, Director of Managed Care Children’s Medical Center

*****.*******@*********.***

ACTIVITIES

I enjoy a good workout at my local YMCA which includes indoor cycling and pilates. Volunteer for Minnie’s Food Pantry and the North Texas Food Bank. Golf gets my attention when I have an opportunity.

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