Danielle Munoz Email & Phone Number

Pleasant Hill, California, Us

• Create market analysis looking for viable candidates to participate with contractually • Recruit, negotiate, and manage all provider contracts with insurance companies, clinics, physician groups, hospitals, and telehealth • Work with legal counsel to draft contracts and terms• Initiate the redlining process• Work with the CFO to coordinate the best form of reimbursement and rate• Managed the UM, QM, and Operational functions of state federal and private contracts• Make sure contracts are compliant with NCQA, CMS, DHCS, and DMHC • Prepare and send necessary paperwork to NCQA, CMS, DHCS, and DMHC• Implement/ manage major projects from start to finish that involve managed care, medi-cal, medicare, and access to care• Establish strong relationship with physicians, medical groups, and managed care organizations• Manage the credentialing process for necessary personal and facilities for contracts• Develop business and strategic account plans by performing strategic analyses of their local customers; identify issues and opportunities• Oversee the Anka’s Call Center and provide support when needed• Managed Account Manager(s) roles and responsibilities and provide support when needed• Work collaboratively with other functional areas using diverse and varied approaches to persuade, negotiate and influence operational decisions• Monitor operation metrics, project plans and implements outcomes and metrics• Implements corrective action plans where metrics are not meeting goals• Produce monthly, quarterly, bi-annual, and annual reports on key performance indicators, and assigned benchmarks • Develop and maintain strong working business partnerships with C-Suite and influential leaders in senior management with a goal of understanding unique business needs, model and strategic challenges

Pleasant Hill, California, Us

• Managed partner relations and business development team, creating goals, standards, and accountability measurements• Created and maintained necessary reports to track progress and partnership retention• Created and implements partner retention strategies appropriate to the marketplace• Recruited, negotiated, and managed all provider contracts with insurance companies, clinics, physician groups, hospitals, and telehealth • Work with legal counsel to draft contracts and terms• Work with the CFO to coordinate the best form of reimbursement and rate• Made sure all contracts were compliant with NCQA, CMS, DHCS, and DMHC • Handled all provider complaints and contract issues• Identified and provided necessary training and motivation to adjust to changing approaches to a changing marketplace• Established and maintained relationships with strategic partners• Identified needs for new programs and products based on feedback from partners and team, proposes and contributed to the development of new programs and products• Assisted with researching and writing grants for the affiliate• Developed and managed all partner relations projects from start to finish

El Segundo, Ca, Us

• Established productive, professional relationships with key personnel in assigned customer accounts• Contracted with providers and insurance companies that best suited market needed/level of care• Handled MOU, LOA, LOI between the company and providers• Worked with the finance department and providers to coordinate the best form of reimbursement and rate • Provided all contractual documentation needed to pass internal and external audits• Handled all client and provider complaints and issues• Worked with finance to address any contract/billing issues• Made sure documentation/coding for CMS reimbursement was provided• Coordinated the involvement of company personnel, including support, service, and management resources, in order to meet account performance objectives and customer’s expectations• Met assigned targets for profitable sales volume and strategic objectives in assigned accounts • Proactively lead a joint company-strategic account planning process that develops mutual performance objectives, financial targets, and critical milestones for a one and three-year period• Proactively assessed, clarified, and validated customer needs on an ongoing basis• Lead solution development efforts that best address customer needs, while coordinating the involvement of all necessary company personnel

Masters In Healthcare Administration, Health/Health Care Administration/Management

Bachelor’S Degree, Sociology, Psychology, Education