Develop and implement chapter performance plans that pertain to quality, efficiency, patient satisfaction, care retention and accurate coding while maximizing risk-based reimbursement for populations covered under risk contracts. Review individual physician performance in risk products and implement educational efforts and action plans as needed. Prepare and present at Network Management functions for all providers within the Local Chapter. Work with Managed Care, Enrollment and Analytics departments on issues such as provider database setup and maintenance, contracting, and PPAs. Ensure that new providers are effectively supported throughout the on boarding process and act as a central point of contact when issues arise that require escalation. Monitor the availability of in network service gaps that need to be filled in order to keep patient care services in the Steward system and proactively manage physician and key hospital leadership relationships, bringing critical issues needing attention to the Network and Chapter leadership teams. Communicate regularly through various communication methodologies, including one on one or group meetings with local providers and their staff consistent with the key messages disseminated from the Network Governance Structure at the direction of the Network Leadership Team. Develop and provide education to provider and office staff regarding initiatives of the local chapter and Network including health plan updates.

Generated weekly reports to enhance quality performance metrics of physician practices Collaborated with local chapter staff in process improvement projects and patient engagement strategies Accessed electronic medical record software to support reporting and monitoring of quality performance Traveled to physician offices to educate practice staff regarding interpretation and implementation of quality reporting

Develop and manage territory totaling over 200 accounts including Nursing Facilities, Provider Offices, Senior Centers, Housing Authorities, and other community resourcesConduct meetings, presentations, and daily account visits in order to gain qualified referrals for the Navicare program and achieve monthly sales goalsConsult with prospective members in their homes and assist in completing applicationsDocument daily sales activity in CRM software, generate weekly reporting, and complete annual training.

Gathered list of referral sources for telephonic outreach to build member populationMaintained relationships and provided services for up to 200 Medicare and Commercial membersCollaborated with Nurse Case Manager, Physician, Social Worker, and other internal departments to ensure health of members and decrease hospital utilization Documented case activity and tracked enrollment progress

Managed the enrollment and maintenance of two accounts totaling over 17,000 membersExecuted various administrative and organizational responsibilitiesUpdated and maintained numerous department reportsAssisted customers through daily phone calls

Generated and updated weekly and monthly financial reports in the areas of Product, State Management, Underwriting, and Marketing Participated in teams created in order to find solutions to specific industry needs Presented strategic project work to Senior level management Organized events and interviewed job candidates as member of a college recruiting team