Tracie L. Jones

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

Keokuk, Iowa 52632

Phone: 407-***-****

Email: ad1okv@r.postjobfree.com

SUMMARY: Extensive Healthcare background on both the provider and payer side. Senior Executive Leadership abilities with Insurance Implementations, Network Building and Client Management. I understand and grasp the Value Based Methods of contracting. I have worked in Radiology, Oncology, Cardiology, Pain Management, Behavioral Health, Interventional Radiology Services, Workman’s Compensation and Auto Insurance Claims. Lines of business with in depth experience are Medicare, Medicare Advantage, Medicaid, Medicaid programs. Worked remotely for 18 years and have the ability to juggle the day and projects around the projects needed or completion on time. Certified Billing and Coding instructor. Medical Assistant training Prior to advanced degree that has been very helpful from the clinical side of contracting within the many types of insurance plans.

April 2022 to Present

Multiplan-Senior Network Development Executive- Building Client Networks, Rate Agreements with negotiation, handle regional service issues for clients.

January 2021 to March 2022

Bright Healthcare Group-Senior Network Ancillary Contract Management for 75 Clients. National Providers and worked with internal teams for network issues to be resolved. Contract language and rate negotiation. Provided support for Network Builds in multiple states and specialties.

2018 to 2021

Today’s Healthcare Consulting PLLC-Owner- Projects included startup ventures, Network Builds with major health plans, Aetna and UHC VA Implementation for 12 months.

Due to Covid 19 in March of 2020 I essentially had to shut down 2 of the 3 projects I was working on and started to make the effort to find a full-time position with a solid company.

2014 to 2018

SimonMed Imaging-Director of Network Contracting- California, Colorado, Nevada, Arizona and Florida

Managed the Insurance Department as part of my positon and had to organize this team and IT flow for contracts new and existing. This took 9 months of work to update fee schedules and locate documents. Then we set the next task to get Workman’s Compensation cleaned up and expand the network of providers on a National level. Within 2 years SimonMed Imaging had the best financial year to date. Handled 45 new site implementations over 4.5 years and was able to be cast positive in less than 60 days with top 10-15 payers.

2015-2016

Bay Care Health System-Clearwater-Florida-Negotiated Physician, Ancillary, Urgent Care contracts for the 600 member physician PHO. Merged and ran implementations for 17 individual Tax ID’s to be part of the Hospitals MSO to create the largest Medical Group on the western region of Florida-Tampa-Clearwater/St. Petersburg area.

2014-2016- Todays Healthcare, LLC –Owner

Consulting projects with Wellcentive, Inc. and HEOPS- networks built for Magellan Health Service Behavioral Health and United Healthcare Exchange products in multiple markets. High volume of successful geo access attained for goals meet on time.

2008 -2014-Magellan Health Services-National Imaging Associates-Sr. Network Development Executive

Remote Position-Managed 13 States for contract, network builds for new insurance products. Financial analysis, administration and negotiation of contract agreements to fill out geo access requirements for insurance plans: Medicaid and Exchange Market Products. Large group contracts for multiple markets that included Urgent Care, ASC’s and Radiology Centers. Annual Cost of Care projects that did meet goals for the region. Worked on New Innovation team to help develop MSK Interventional Pain Management Program that was approved by the Board of Directors and released in the markets for implementation. Largest project I had lead role in the Cigna MPD-Multiple Procedure Discount over a 9 month period for 36 States and the project did close on time and a savings of 18 million dollars was achieved.