Certified Professional Coder (CPC)Highly motivated professional with 28 years in the Health Care industry currently working as a Network Operations Specialist for OneCare Vermont, the largest Accountable Care Organization in Vermont. Past experience includes positions related to: billing, Human Resources Assistant, Workers Comp, Credentialing and Contract Analyst. Experience with quality assurance measurement abstraction for shared savings models for Medicare, Medicaid and Commercial business. Several years of experience as Manager for Network Operations with a focus on beneficiary and provider engagement, Shared Savings Opt Out processes and communication to network participants specific to network participation. Oversaw Participant contracting including & Regional Clinical Physician agreements and other vendor agreements affiliated with OneCare Vermont. Administer and maintain multiple software systems including enhancements, modifications, and all help desk functions. Accountable for document management and process and procedure development. Maintain annual compliance for all programs and systems currently owned by OneCare Vermont. Effective leadership, analytical skills, collaboration and use of excellent written and oral communication has allowed me to expand in my current role. Increased exposure to accountable care initiatives provides opportunity to become more involved in the overall health care reform for our state. Successfully maintain an active certification through American Academy of Professional Coders for professional and payer coding guidelines.My past experience has helped me to see the many sides of health care from both the professional, hospital and insurer's view point. This has allowed me to gain the knowledge and understanding of a very complicated healthcare delivery system in VT and the United States.
Listed skills include Healthcare, Managed Care, Healthcare Management, Hospitals, and 13 others.