Contract Manager - Healthcare Partnerships & Negotiations

CHERYL SIMS

Contract Manager/Customer Service/Relationship and Team Building/Project Manager

***********@*******.*** • 410-***-****

https://www.linkedin.com/in/cheryl-sims-40a31645/ • Pikesville Maryland

Accomplished and result-driven Contract Manager with extensive experience in negotiating and structuring diverse contracts within the healthcare industry. Proven track record of spearheading innovative strategies to drive company growth and enhance market presence. Strategic thinker adept at formulating and executing contracting strategies to optimize partnerships and drive revenue. Skilled in collaborating cross-functionally to streamline workflows and expedite contract integration processes. Meticulous attention to detail ensures compliance with regulatory requirements and industry standards. Exceptional communicator with a talent for building strong relationships with stakeholders at all levels. Proactive leader with a demonstrated ability to pioneer new initiatives and drive successful outcomes. Recognized for expertise in developing pricing agreements and improving billing accuracy to strengthen payer-provider relationships.

Areas of Expertise

Contract Negotiation

Strategic Contracting

Contract Structuring

Claims Processing

Provider Network Development

Contract Analytics

Contract Lifecycle Management

Compliance Oversight

Data Entry/Management

Regulatory Reporting

Credentialing Management

Risk Management

Relationship Management/

Customer Service

Professional Experience

THESEEDS LLC. Baltimore, MD 2025-2025 Program Coordinator

Case managed clients in job development, job preparation, and job seeking skills. Negotiated contracts with Managed Care Payers

Openloop, LLC, Des Moines, IA

Contract Manager

2023 — 2023

Spearheaded the negotiation and structuring of telehealth service contracts with national insurance payors. Formulated strategic guidelines for contract objectives and partnered with the Claims Team to devise a claims payment algorithm aligned with various insurer systems.

●Pioneered innovative contracting strategies that bolstered the company’s national presence in the telehealth market.

●Developed a claims processing algorithm that improved billing accuracy and efficiency, enhancing payer-provider relationships.

Friday Health Plan, Denver, Colorado

Contract Manager

2022 — 2022

Orchestrated the negotiation and establishment of pricing agreements with physicians across Florida to develop a comprehensive network for Health Exchange patients. Collaborated closely with Finance and Credentialing departments to expedite the integration of 30 diverse provider group contracts within a three-month timeframe.

●Built physician network from the ground up, incorporating providers from all specialties to enhance healthcare accessibility for exchange patients.

●Streamlined cross-departmental workflows, significantly reducing the time from contract initiation to full implementation.

AMERITOX, LLC

National Contract Mgr

January 2008 — December 2018

Formulated and executed contracting strategies in collaboration with the management and finance teams. Directed the preparation, negotiation, and management of diverse contracts with insurance carriers, TPA's, clinics, employer groups, provider groups, and federal entities. Oversaw the entire contract lifecycle, ensuring compliance and timely reporting to CMS and other regulatory bodies. Spearheaded the credentialing and re-credentialing processes, maintaining stringent compliance with industry standards.

●Enhanced contractual agreements and pricing structures with existing partners, adding value through meticulous contract management and negotiation.

●Acted as the Project Account Manager for a significant laboratory contract with New England Veteran Health Centers, boosting service quality and patient satisfaction.

●Expanded a nationwide network of over 300 payors, enhancing the company's market presence over a decade.

●Headed the company's first Federal contract, establishing a foundation for future government partnerships.

Additional Experience

Manager, CAREFIRST BLUE CROSS BLUE SHIELD, Baltimore, MD

Network Manager, United Healthcare, Medicare Division (Evercare), Elkridge MD

Director Network Development & Physician Relations, BON SECOURS BALTIMORE HEALTH SYS, INC., Balto,MD

Manager, Provider Relations, TOTAL HEALTH CARE INC., Medicaid HMO, Baltimore, MD

Education

Master of Science in Health Care Administration

University of Maryland

Bachelor of Arts in Political Science

Howard University

Licenses & Certifications

Former PMP, Project Management Professional from 2005-2021 – Project Management Institute

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