Angelita Coleman, Mha Email & Phone Number

Assist clients with deploying scalable provider network solutions for the healthcare and insurance industries. Skilled at deploying network development solutions, launching new products, pursuing and delivering on large-scale contracts, efficiently managing networks and effectively responding to the expanding requirements of a geographically dispersed customer-base.

Fulton, Maryland, United States

Skilled in the advancement of Episodes of Care as a value-based approach for specialty care. Responsible for the overall direction, strategy, design and oversight of Capital Women’s Care’s Episodes of Care/Bundled Payment Program for obstetrics and gynecology, and other contract negotiations. Well able to advocate for Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that rewards providers for excellent outcomes and patient experience, while reducing the overall cost of healthcare

Nationwide

INDEPENDENT HEALTHCARE CONSULTANT Direct teams in managing network development and provider operationsDevelop and maintain a provider network strategy for value-based purchasingWork in concert with medical management and sales to develop strategies to meet market growth targets and medical cost targetsProvide service and education to network providersRenegotiate existing agreements lowering cost and improving quality scores

444 Liberty Ave Pittsburgh Pa 15222

INDEPENDENT CONSULTANT Direct teams in managing network development and provider operationsDevelop and maintain a provider network strategy for value-based purchasingWork in concert with medical management and sales to develop strategies to meet market growth targets and medical cost targetsProvide service and education to network providersRenegotiate existing agreements lowering cost and improving quality scores

3000 Fall Road, Suite 1 Baltimore, Maryland 21211

Developed and implemented from scratch entire provider relations, credentialing and contracting departments for the 1st Health Cooperative opened in Maryland under the ACAResponsible for all facets of network management and provider relationsResponsible for oversight of vendor relations Assisted with the development, implementation and day to day administration of 4 PCMHs

Lowered cost by expanding freestanding ambulatory surgery network moving services from outpatient hospital setting to freestanding community sitesDeveloped an adequate network to support New York State's new Health Home product Negotiated gain share, bundled payment and full risk agreements

Managed provider contracting functions for Maryland and the District of ColumbiaCollaborated with Medical Management to develop case management agreements designed to prevent repeat admission, improve health outcomes and acquire cost savingsSuccessfully participated in the implementation of a new contract and payer delivery system

Successfully participated in the re-bid process securing a 5 year Agreement with the Medical Assistance Program in the District of ColumbiaSuccessfully developed, implemented and managed the provider networkServed as direct liaison between the Health Plan and the Medical Assistance AssociationCollaborated with Medical Management to develop case management agreements designed to prevent repeat admission, improve health outcomes and acquire cost savings

Successfully negotiated ancillary contracts expanding and stabilizing the network for Medicaid and dual-eligible product linesRe-contracted with entire freestanding ambulatory surgery network to align with the then current CMS payment methodologies at an annual cost savings of over $634K Supported development of recovery packages collaborating with analytics, policy analysts and SMEsManaged 8 direct reports

Successfully re-contracted provider network following major acquisition acquiring substantial cost savings each quarterFacilitated providers’ understanding of contract language, products, policies and proceduresManaged Provider Network staff of 5-9 personnelExpanded and stabilized provider network for commercial and government products

Recruited, developed and maintained an adequate network of providers in assigned geographic areas.Re-negotiated current contractual agreements with Ambulatory Surgery Centers, Skilled Nursing Facilities and physicians Facilitated providers’ understanding of Plan products, objectives and policies and proceduresMonitored and ensured provider contract compliance as well as adherence to administrative Plan protocols

Planned, developed and implemented operational policies and procedures designed to improve the flow of communication in a collaborative manner and to enhance the overall health care delivery systemAnalyzed and designed educational products to accomplish goals as directed by the local Care Advocacy Council utilizing physician profile reporting, patterns of treatment, clinical profiling, and other tools Managed the implementation of the Health Plan’s reimbursement and recruitment strategies in conjunction with the Medical Expense Team, using tools such as geo access reports and financial reports Analyzed and evaluated the effectiveness of managed care programs, constantly evaluating performance against industry standards and making recommendations on how to improve current programs

Masters Healthcare Administration, Healthcare Management And Finance, 3.9

Activities and Societies: Upsilon PHI Delta

B.A., Health Science And Policy, Health Services Administration Concentration

Activities and Societies: Health Science and Policy ForumHospital Payment Appendicies, April 2006 Contract Language Development, March 2005