Donna Ostrander Email and Phone Number
I am a healthcare professional experienced in managed care contracting and network operations. Early in my managed care career, I was the point person for five years, responsible for the evaluation and negotiation of managed care agreements on behalf of of Thomas Jefferson University Hospital and JeffCare PHO, which had about a 1000 physician members at that time. Once contracts were finalized, I communicated terms to internal constituents. As my career progressed, I became responsible for the negotiation and implementation of delegated credentialing agreements and oversight of annual delegated credentialing audits. If corrective action plans were required, I worked with team members to develop and administer. I also maintained JeffCare's credentialing policies and procedures, ensuring compliance with NCQA, CMS and applicable state requirements. An achievement I'm proud of is my initiation of a team project to meet a credentialing metric required by one of our delegated plans. As a result of my efforts, the metric was met by improving the initial credentialing processing time from greater than 90 days to 90 days or less.
Trinity Health Mid-Atlantic
View- Website:
- trinityhealthma.org
- Employees:
- 1618
-
Sr Managed Care Contracting SpecialistTrinity Health Mid-Atlantic Jan 2024 - Present -
Managed Care Contracting ManagerJefferson Health 1995 - 2023Philadelphia, Pennsylvania, United StatesContract Analyst, 1995-2000In this role, I was the single point of contact for the evaluation, negotiation and implementation of managed care contracts on behalf of Thomas Jefferson University Hospital and 1000 JeffCare PHO physician members. Responsibilities included communication of contractual terms to internal constituencies, facilitation and communication of annual contractual adjustments. Liaised with managed care representatives to resolve provider issues related to the agreements. Additional duties included contribution of articles to the monthly JeffCare newsletter and coordination of clinical program surveys with service line leaders for consideration of Center of Excellence designations.Managed Care Contracting Manager, 2000-2014During this time Jefferson Health System (JHS) was formed. I remained responsible for physician contracting, coordinating with JHS hospital contracting initiatives. Added responsibilities were the negotiation and implementation of delegated credentialing agreements, oversight of annual credentialing audits, corrective action plan development and implementation, and management of messenger model processes.Managed Care Contracting Manager, 2014-2023Jefferson Health System dissolved and Jefferson Heath began its expansion. Consequently, the payer contracting department expanded and my focus became physician network operations. I remained responsible for delegated credentialing agreements, audit oversight and corrective action plan development and implementation; I maintained and updated JeffCare's delegated credentialing policies in accordance with NCQA, CMS and state requirements; handled provider claims issues on behalf of community based PHO members. -
Senior Patient Account RepresentativeJefferson Orthopedic Associates Nov 1985 - Jun 1995Philadelphia, Pennsylvania, United StatesInteracted with patients and providers in operations of large surgery practice. Duties included front desk registration, back end patient check out, handling of billing processes, scheduling of surgeries on behalf of seven providers, which included obtaining prior authorizations, coordinating of pre admission testing procedures, and ordering specific equipment with operating room staff.
Donna Ostrander Education Details
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Elmira College, Elmira, NyEnglish Language And Literature, General -
Thomas A. Edison High School
Frequently Asked Questions about Donna Ostrander
What company does Donna Ostrander work for?
Donna Ostrander works for Trinity Health Mid-Atlantic
What is Donna Ostrander's role at the current company?
Donna Ostrander's current role is Managed Care Contracting | Negotiation I Delegated Credentialing I NCQA I Audit Oversight | Process Improvement I Provider Relations Management I Network Operations.
What schools did Donna Ostrander attend?
Donna Ostrander attended Elmira College, Elmira, Ny, Thomas A. Edison High School.
Who are Donna Ostrander's colleagues?
Donna Ostrander's colleagues are Michael Kernochan, Syed S. Sohail, Do, Jade Mchugh Bsn, Rn, Samuel Arcieri Md, Mha, Gustavo Escobar, Lisa Lighty, Raj Ghimire.
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Donna Ostrander
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