Clinical Research Data Analytics
Resume:
CHRISTINE (Tina) KAPLAN
West Chester, PA 19380
*******@*******.***
cell: 484-***-****
OBJECTIVE Looking to bring value, dedication, and energetic leadership skills to a company in need of someone with excellent communication and effective decision-making skills. I offer proven and measurable successes in strategic thinking, leading, and influencing change in the healthcare industry.
AREAS OF
EXPERTISE Ability to Drive Initiatives Forward to a Successful Conclusion/Relationship Management/Strategic Leader in Network Development and Enterprise-Wide Transformation/Proven Successes in Leadership and Team Management/Strong Negotiation and Communication Skills/Data Analytics and Reporting/Network Quality Performance
PROFESSIONAL EXPERIENCE
CLINICAL INTELLI-PRINT, LLC, Oaks, PA 1/1/2024-
Head Of Operations
Member of the executive management team directing all aspects of business strategy and execution for an automated publishing and printing solutions company for the clinical research industry.
Manage a team of 15 project coordinators/graphic designers and sales staff responsible for the day to- day management, growth strategy and market expansion of our printing services.
Developed the organizational structure, strategic business plan, policies and procedures, and operational procedures.
EVOLENT HEALTH, Arlington, VA 2008 - 2024
(Prior to being acquired by Evolent Health in 2023, worked for National Imaging Associates, Inc. (NIA), a subsidiary of (Magellan Healthcare)
Magellan Healthcare
Vice President, Provider Relations/Network Development
Manage and lead a global team of Managers responsible for the oversight of contracting and servicing of provider networks.
Leads the market's outreach and engagement strategy and planning in the successful development of the provider network including development, contracting and management of provider relationships and communications.
Plans, develops, and implements, a geographically competitive, broad access network.
Implement actions to build out network expansion markets and/or to close gaps.
Meets and services key providers to ensure service levels are meeting or exceeding expectations.
Leads and manages a high performing team who develop, negotiate, contract and enhance collaborative provider relationships, ensuring overall network competitiveness and profitability within market
Develop and execute a comprehensive outreach strategy for hospitals, physicians, and other key providers to increase education and awareness of available programs.
Contribute to the increase in the overall provider experience satisfaction rate by 5% in three years.
Meet with key stakeholders regularly to determine provider/network needs.
Direct, monitor, trend, routine, and long-standing provider complaints, claims, contracting, credentialing, and other network provider performance issues requiring educational and interventional initiatives.
Oversee the assessment of network needs to meet network adequacy and ensure quality networks.
Support new business development through contributions to the RFP process, keeping up with competition and new opportunities to grow our business.
Assist with the design and institution of new programs to add value to the current Magellan product design.
AETNA, Wilmington, DE 2003 - 2008
(Formerly Coventry Health Care, Inc.)
Director, Provider Relations
Oversaw the ongoing education, servicing, recruitment, and provider negotiations for over 25,000 providers in Delaware, New Jersey, and Maryland.
Responsible for the oversight of provider contracting, credentialing, servicing, and other delegated functions for high-tech imaging services, dental and behavioral health services provided by third-party vendors.
Managed, coordinated, and facilitated processes and procedures to ease administration for physicians and their staff.
Responsible for ensuring that Provider Relations goals were consistent with the Health Plan’s Cost Containment Initiatives.
Manager, Medicaid Program – Operations 2000 - 2003
Responsible for the day-to-day activities of the Health Plan’s Medicaid Product.
Developed and monitored the budget for the Medicaid Product.
Developed and managed the implementation of policies and programs as they related to state and federal mandates.
Responsible for the implementation and the strategic plan for growth for both Delaware and Maryland Medicaid.
Supervisor, Provider Relations 1996 - 2000
Managed Provider Relations field representatives responsible for the ongoing recruitment, servicing, and problem resolution for providers and staff.
Negotiated and implemented Medicaid provider agreements/contracts with ancillary and professional providers.
Oversaw the production and maintenance of the provider directories, bi-monthly newsletters, education materials, and satisfaction surveys.
EDUCATION
Masters of Science in Health Care Administration
St. Joseph’s University, Philadelphia, PA
Bachelors of Science in Health and Human Development
Pennsylvania State University, State College, PA
PROFESSIONAL ASSOCIATIONS/ORGANIZATIONS
Pennsylvania State University and St. Joseph’s University Alumni Mentorship Program
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