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Health Mental

Location:
Baltimore, Maryland, United States
Salary:
65000
Posted:
November 29, 2018

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Resume:

Latia T. Mitchner

ac7twk@r.postjobfree.com

**** **** ****** ******

443-***-****

OBJECTIVES: Highly accomplished professional with a diverse background in provider network management, compliance audits, and event coordination in the healthcare Industry. With over 13 years experience in Medicare, Medicaid, EAP, and Wellness network management seeking to demonstrate my proven management, problem solving, analytical, and creative thinking skills. EDUCATION

Catonsville Community College

June 1995

Major- Public Relations

EXPERIENCE

Superior Vision • Benefit Management Network Development Specialist July 2015 – October 2018

● Developed and recruited providers to service the managed care and commercial vision network

● Applied market knowledge and evaluation of community, government, demographics and competitors to identify areas for recruitment expansion in assigned territory

● Achieved business goals, revenue and profitability objectives

● Served as a liaison between Medical providers including primary care clinicians, Accountable Care Organizations, and other healthcare organizations, states, and health insurers.

● Coordinated onsite health fairs, clinic and educational events in regions which were identified to have low utilization.

● Created gap data analysis to identify deficient service areas to ensure the provider network is sufficient

● Used targeted, effective telephone campaigns to recruit and grow the network

● Negotiated fee schedules with vision practices while preserving network

● Discussed contract issues with vision practices within assign territories

● Communicated process flows and make recommendations for improvement to vision groups and providers

● Established and foster strong, positive relationships with key providers

● Proactively identified provider needs and advised management so that action can be taken to address the needs before they are problematic for the provider Business Health Services• Provider Relation Manager November 2008 – November 2014

● Provided supervision to the Provider Relations/Onsite Services team.

● Develop and implement strategies for recruiting, credentialing, recredentialing, training and retaining Mental Health, Occupational Health/Wellness providers to offer onsite services to corporate organizations

● Assigned overall recruitment plans and project plans for short- and long-term goal achievement

● Coordinated structure, staffing, schedule and marketing necessary to reach departmental goals

● Contributed to the development and achievement of quality assurance for all services provided to contracted corporate clients

Latia T. Mitchner

ac7twk@r.postjobfree.com

5208 King Arthur Circle

443-***-****

● Identified trends within the Health and Wellness industry and outcomes as well as suggests specific topics to continually develop services

● Oversaw the communication between Onsite Services Coordinators and Program management teams in identifying providers to meet contractual time frame obligations or clients’ specific requirements

● Maintained updated content of provider manuals and content of provider orientation material

● Utilized proactive, creative and cost-effective recruitment methods to attract and source candidates including leveraging online recruiting resources

Heritage Health Systems Provider Relations Rep November 2007- November 2008

● Performed gap analysis to identify potential providers to add to network

● Performed duties to act as a liaison between providers, the health plan and corporate including investigating and resolving provider claims issue based on utilization of benefits.

● Performed training, orientation and coaching for performance improvement within physician practices

● Served as primary contact for providers serving as a liaison between the provider and the health plan

● Communicated mandated regulatory changes made by the state and or CMS

● Educated providers regarding policies and procedures related to referrals and claims submission; web site education, EDI solicitation and problem solving (liaison responsibilities)

● Performed provider orientations (includes writing/updating orientation material when necessary) Trailblazer Health Systems Health Care Managed Care (Medicare Part B) Provider Outreach and Education Specialist April 2003 – October 2007

● Conducted presentations regarding Medicare policy and procedures as well as proper coding Medicare Part B

● Developed and conducted training for Medicare facilities on methods for reducing claim denials, as well as training on specialty-specific services such as chiropractic, secondary payer and intro to being a Medicare provider

● Performed data analyses to determine the specific issues impacting the billing conducted by each mid-Atlantic site

● Participated in weekly conference calls with Medicare coding, billing and A/R staff to address Medicare issues and questions

● Researched program issues and developed the appropriate response that includes legal citations, CMS regulations, issuances, or other policy-related guidance to Medicare Part B providers.

● Reviewed health care policies and legislation in order to draft related policy documents, regulations, procedures and guidance to Medicare Part B providers. References Available Upon Request



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