Brandon Roach Email & Phone Number

Dayton, OH, US

• Perform gap analysis to ensure no gaps or sanctions while identifying and implementing solutions that mitigate risks then develop corrective action plans as needed
• Implement an effective process to on-board new providers, ensure network is adequate (access for members to initiate set-up and ensuring provider contracts are input into the system according to corporate compliance)
• Follow up with Health Partners to resolve any routine issues in the market utilizing department’s service level agreements/ expectations
• Execute the contracting strategy, develop provisions based on cost, quality/ analysis and monitor key metrics for the assigned market
• Responsible for provider recruitment, administering provider contracts, terms, reimbursement rates, and overseeing specialists
• Create contract language and review with legal team to develop approved contract templates specific to the assigned Market/ Maintain PR Customer Relationship Management

Saint Louis, MO, US

• Served as the primary contact for providers and liaison by providing education on health plans with innovative contracting strategiesProvided coaching and strategic overview to provider groups, on different ways to.
• Performed educational overview with staff and also conducted provider orientations as needed. Provided continual on ongoing provider education with different groups, which included: writing and updating new and current.
• Conducted monthly face to face meetings with the provider account representative documenting discussions, issues, attendees, action items, and research claims issues on-site, and routed to the appropriate party for.
• Received, investigated, resolved, and communicated provider claim issues and changes
• Completed data entry of provider-related demographic information changes and oversaw testing and completion of change requests for the network
• Educated providers regarding policies and procedures related the referrals and claim submission, website usage, EDI solicitation, and related topics

Saint Louis, MO, US

• Act as a liaison between network providers and the health plan, investigating various issues and resolving them in a timely matter. Perform provider trainings as needed, along with provider network performance analysis.
• Serve as primary contact for providers in assigned markets, serving as a liaison between providers and the health plan.
• Communicates all issues regarding provider related concerns, with internally leaderships while also resolving those issues.
• Provide strategic and operational leadership, while staying focused on network performance goals and quality metrics.
• Acts as data steward for provider data metrics, and provider network strategies to improve network performance.
• Partners with operational leaders to identify and prioritize meaningful opportunities for network improvement.

Saint Louis, MO, US

• Assist the health plan in establishing a presence in the community through home visits and community outreach imitative programs. The Primary focus in this position is to ensure that members are utilizing all the.
• Market the health plan by establishing a strong community presence, through community outreach events and member educational opportunities.
• Educate members on healthcare benefits and identifying accessing care Gaps and solutions.
• Perform home visits to members for care management noncompliance and benefit utilization education.
• Assisted in connecting members to community agencies, and Local community health department resources
• Coordinate and implement community events, including Start Smart Baby showers and Birthday Parties, school events, healthy life style events and various community initiatives

Assisted in coordinating and developing marketing support for the 2012 Cleveland Classic.Assisted the Cleveland Sports Commission in helping find and secure sponsorship funds for the 2012 Cleveland Classic.Determined quality assurance issues through interacting with managers, team members and clients to ensure that all goals and standards are being met.

Perform community outreach to various venues for ACA education to communities during open enrolment period.Track all community outreach contacts and ACA impact rate for Cleveland Team via excel, Google docs, and email communication correspondents.Compile and analyze daily productivity data in order to measure the penetration rate at each site.Provide.

Valley View, OH, US

Received calls from Vendors in an effort to provide on-site approvals for work per HUD guidelines through bid cost estimating softwareConducted negotiations with vendors to ensure that work on selected properties was completed in a timely manner. Reviewed current and past loan histories, documented information of various REO properties by using estimating.

Coordinated all necessary medical health care issues, while providing support to all clients helping them develop productive treatment plans for their personal success and mental well being.Provided counseling and therapeutic intervention support to 60+ clients facing issues with their treatment plan goals.Worked with clients who where mentally disabled.

Bannockburn, Illinois, US

Understanding of procedures and protocol when dealing with Biohazards waste materials and the proper disposal of Hazardous waste products based on FDA and HIPPA regulations.Acted as a liaison and educator to Nurses and Doctors about how to properly dispose of Medical waste products, and how these procedures relate to HIPPA and FDA Guidelines. Provided.

Quality Control experience in dealing with products and services relating to industrial swimming pool materials and blueprints.Ability to maintain a diverse work schedule traveling to multiple locations, and communicating with various staff and clients about company products and services.Great attention to detail along with people soft skills to be able to.

B.A. Communications, Business Administration And Management, General

Associate'S Degree, Business Administration And Management, General

High School

Education record