Nicole Cosgriff Email & Phone Number

• Primary responsibility is executing provider subscribing and relations strategy. This position promotes the advantages of participation in the Opyn Marketplace through effective recruitment/subscription, provider.
• Identify, recruit, negotiate, contract and maintain service to provider accounts.
• Execute on necessary provider education activities for subscribed providers to assure provider satisfaction and dispute management (and resolution).
• … Show more Primary responsibility is executing provider subscribing and relations strategy. This position promotes the advantages of participation in the Opyn Marketplace through effective recruitment/subscription.
• Assess operational needs to proactively identify opportunities for Marketplace improvements, provider education and training improvement, and operational manual enhancements in response to direct feedback from providers.
• Ensure compliance with federal and state regulations, as well as internal compliance regarding credentialing

Act as the primary resource for assigned profiles of larger and more complex providers (i.e. market/regional/national, large group of hospital systems) to establish, oversee and maintain provider risk management and positive relationships and support high value initiative activities. Drive the implementation of internal and external solutions to achieve.

Primary consultant between medical providers (Professional, Behavioral Health, Ancillary and Institutional) and all departments at Highmark. Proactively visit providers to present and support new initiatives within Highmark. Monitor, analyze and develop strategies for improving overall network participation and performance. Resolve critical problems by.

Developed an extensive provider network in Northampton County. Effectively negotiated and implemented competitive contracts with independent physicians, ancillary providers, large MSOs and hospital owned groups for a new plan, including HMO and PPO products. Negotiated discounts with nonparticipating hospitals and physicians, which resulted in savings of.

Wilmington, Delaware

Responsible for the initial and continuous education of hospitals, physicians, and their office staff. Resolved provider issues, questions, and conerns through ongoing telephone contact, scheduled meetings, and on-site orientations. Coordinated and conducted conferences and focus groups with health care providers and other professionals related to current.

Bachelor Of Science, Economics And Management

Education record

Health Insurance Association of America Highmark, Inc. 1997 - 2002 Successfully completed four courses of study including, "Managed Care.