Christine Lazott Email & Phone Number

San Diego, Ca, Us

San Diego, Ca, Us

San Diego, California, Us

Administer plan, including program planning and operations, policy and procedural development, administration, fiscal management, activities, and events. Direct oversight and performance of outsourced services such as claims administration, utilization management, physician credentialing, and quality. Manage all plan contract negotiations and maintenance, including partner plan, administrative, and network agreements. Compose reports and requests for information, draft financial and related risk analysis paperwork, and file Knox-Keene documents. Present performance and progress agendas, minutes, reports, and presentations to upper management and the board of directors. Unite with the MSO to establish administrative services and sustain operations. Coordinate communications between stakeholders, e.g., Rady Children’s Hospital-San Diego and the Children’s Hospital of Orange County. Liaison with the Partner Plan, UnitedHealthcare of California (UHC), and the DMHC, and build relationships with the DMHC. Forge connections with executives, management services, and regulatory agencies to initiate strategies and tactics for multi-regional and membership growth. Foster relations with the compliance officer to reach Knox-Keene requirements, and advocate for the organization in business, association, provider, and payor meetings.• Showcase top performer and/or leading performer designations for the role’s duties in manager and employee evaluations, and earn relevant credentials, such as licensure requirements with filings, surveys, and audits.• Achieve a restricted Knox-Keene license from the DMHC to collaborate with UHC and other partner plans to form a pediatric-focused health plan, simplify contracting efforts, and ensure access to an integrated delivery system.• Surpass or attain the payor contract budget targets, and ensure quality, membership growth, and financial success.

Escondido, Ca, Us

Headed the managed care department’s supervisory duties and operations, and the contract management and analyst team. Oversaw risk pool performance, the MSO vendor, stop loss recoveries, the contract provider network, and the group relationship, and instructed coworkers in order to improve performance.• Assessed the MSO’s vendor relations and formulated a new contract with enhanced performance metrics, boosted the business analyst’s productivity by 50 percent, reduced overpayments, and increased overpayment recoveries.• Persuaded the health plans, network providers, and vendors to devise new agreements, and saved $11mm.• Transformed the revenue cycle to streamline workloads, resolve payment issues, and expand collections abilities.• Revamped the department, and fostered exceptional talent management to accomplish goals.

Long Beach, California, Us

Managed contractual matters, including those that pertained to operations and activities; the IPAs; the Provider Contracts Department; and physicians. Complied with the Knox-Keene network access and availability regulations, California’s All Plan Letters, and guidelines, fiscal, and quality requirements, and introduced network strategy and initiative plans.• Unified with a partner and spearheaded a physician program that ensured there is a case manager for high-risk patients and to coordinate home services, and decreased emergency department nonessential admissions.• Arranged a contract with numerous federal health centers, and maximized service quality and accessibility by institutionalizing care and increasing funding when measures are reached.• Built communications channels and advocated for a policy alteration that overhauled the authorization process, improved provider satisfaction, and enabled necessary care.• Supervised the team through a force reduction and completed a smooth transition.

San Diego, California, Us

Handled contract negotiations for commercial and Medi-Cal lines of business for Rady Children’s Hospital integrated delivery system with health plans. Trained team members on managed care practices, payer and provider relationships, and other matters. Counseled on billing and reimbursement issue resolution, and conveyed communications between clinical and operations colleagues. Organized projects with administrative and clinical teams. Updated the Network Governance Contract Committee on the monthly status of negotiations.• Convinced health plans and payers to adopt contracts for the integrated delivery system, and secured fee-for-service and capitated agreements.• Led the negotiation for a multimillion-dollar Accountable Care pilot project for children enrolled in California Children’s Services, and achieved a global capitation agreement with the Department of Health Care Services which enrolled 350 high-risk patients.• Formalized the contracts for the Crisis Stabilization Unit which improved emergency room throughput and reduced inpatient admissions.• Managed the negotiation of three capitated contracts for the integrated delivery system, and oversaw coworkers in the implementation of the agreements.

Boston, Massachusetts, Us

Boston, Massachusetts, Us