Diana Davis Email & Phone Number

Thousand Oaks, CA

Responsible for the day to day operational support for encounter data processing and related functions including the receipt, submission, analysis and correction of such data for Medicaid Business. Responsible for the analysis of end user needs and for translating those needs into sound detail business requirements. Develops project plans and identifies.

Woodland Hills, CA

Responsible for executing and delivering operational readiness plan for provider experience strategic initiatives. Monitors initiative impact to provide experience key performance indicators (KPI) and indentifies opportunities to improve KPI’s. Coordinates pre and post implementation claims audits with Inline Quality and Performance team. Oversee delivery.

Thousand Oaks, CA

Responsible for serving as the liaison between Claims Operations and IT in translating complex business needs. Works with programming staff to ensure requirements will be incorporated into system design and testing. Acts as a resource to address questions/issues regarding State Sponsored Business rules and regulations and billing requirements. Provides.

Ventura, CA

Collaborate with internal and external parties to facilitate Business Office and Admitting activities for both Ojai Hospital and Community Memorial Hospital. Successful implementation of Medibase Revenue Management system upgrade. Established productivity standards, developed training material and operations manual and trained staff. Provide management.

Ventura, CA

Identified and recruited provider contract nominations and performed contracting negotiations to maintain network adequacy.Resolved provider appeals and grievances, and claim issues while maintaining a positive relationship with provider groups and individual providers. Identified and reported on provider utilization patterns which have a direct impact on.

Greater Los Angeles Area

Managed the Customer Relations unit for a Los Angeles based MSO. Tracked customer service patterns/trends and identified training when appropriate. Responsible for the management of servicing 10 IPA and 9 hospital clients.

Greater Los Angeles Area

Performed direct physician contracting, network analysis and developed strategic plans and goals and to build and maintain a high quality contracted physician network while maintaining network adequacy.Responsible for overseeing and participating in all aspects of network development for a start up IPA.Managed recruitment projects from planning to.

Ventura, CA

Managed the Provider Relations staff for the Southern California division. Responded to RFPs and other requests for network development information from vendors, clients, prospects and business partners. Government program technical expert to Provider Network Management department. Interpret policy and contractual issues. Managed special projects.