Dana Rainey Email & Phone Number

Newtown Square, Pennsylvania, United States

United States

Springfield, Pa

Conshohocken, Pa

Responsible for negotiation of hospital, physician, urgent care, ancillary, PCMH/ACO, and delegated credentialing agreements with third party payers; oversaw payer relationships and payment compliance for 600+ bed acute care hospital and their 600+ employed physician and ancillary provider group. Assisted with development of narrow network, co-branded benefit plan design marketed on and off exchange. Oversaw hospital charge master.

Healthcare contracts consultant, providing assistance in strategy development, contract analysis and negotiation assistance.

Led negotiations, oversaw contract implementation and monitored compliance of hospital, physician, ancillary, specialty and delegated credentialing managed care contracts for a nationally renowned 180-bed children's hospital and their 400+ employed physician providers. Negotiated and managed 120 contractual relationships with approximately 60 different third party payers, generating in excess of $900 Million in gross revenues.

Prepared and implemented $300 Million operating and capital budgets. Oversaw preparation of Medicare and Medicaid cost reports. Performed cost studies and profitability analysis by insurer, physician, DRG, service and product line. Prepared budget forecasts, monitoring and variance reports. Provided feasibility studies and profitability analyses for business development and strategic planning purposes. Assisted in the development of clinical pathways, re-engineering efforts, and CQI processes.

Master Of Business Administration - Mba, 3.8

Bs, Accounting, Business Management

Activities and Societies: Deans List, Omicron Delta Epsilon