Erin Mccowan Email & Phone Number

Atlanta, Georgia, United States

Atlanta Metropolitan Area

• Effectively supported the development and oversight of physician/provider network.
• Established and managed strong relationships with assigned provider groups (PODs) through superior communication skills.
• Facilitated monthly Joint Operation Committee meetings with provider staff, and/or physician leadership including creating and delivering power point presentations.
• Accountable for growth of assigned sub-market in terms of financial profitability, engagement of provider network and membership growth.
• Partnered with internal departments, including but not limited to Clinical Operations, Medical Economics, Stars & Risk Adjustment to develop solutions for strategic business needs.
• Applied comprehensive understanding of organizational objectives to drive improvements in provider engagement strategies.

• Managed the operational oversight of all procedures relating to provider network performance. Expertly developed an account management approach to critically analyze provider performances and implemented network.
• Took ownership and diligently executed the 100% end to end management of contractual relationships. Included new provider orientation, and onboarding for all health insurance product lines, education on policies and.
• Developed interpersonal and leadership skills to swiftly resolve and communicate effectively outstanding issues while simultaneously educating staff on problem resolution techniques.
• Successfully applied negotiations skills in securing favorable contracts with healthcare providers.
• Spearheaded and led internal job training initiatives on inclusion and diversity during monthly team meetings.
• Leveraged medical treatment knowledge to analyze and improve claim resolution

Atlanta, Georgia

• Business Segment: Optum (Risk Quality and Network Solutions)
• Conducted consistent outreach, supervising quality programs that improve the overall health status of the Medicare-Advantage enrollee. Independently traveled on a self-managed route across assigned territory and.
• Effectively managed 75 different medical groups for HEDIS quality programs. Expert organizational skills showcased daily, reducing potential problems from arising during later stages of operation, reducing associated.
• Professional operations have been proven by increasing chronic condition prevalence numbers by over 5% for more than 10 medical groups.
• Directly contributed to a 60% increase in electronic participation amongst key medical groups. This was achieved by leveraging interpersonal communication skills to successfully incite behavioral change in medical.
• Determined to continue my excellence proven by containing the clinical program rejection rate at levels below national average. Directly boosted departmental outcomes by approximately 40% over tenure.

Norcross, GA

• Maintain relationship with contracted facilities/medical physicians and providers in the GA market.
• Provided proactive education to operational staff for all new physicians and new billing office staff in skilled nursing facilities.
• Establish and facilitate regular meetings with Administrators of Nursing Home Facilities.
• Coordinate and conduct physician site visits for continued education and credentialing requirements.
• Assist in cross-functional problem solving with all departments within Evercare. Complete contract negotiations, development and implementation.
• Work with corporate office to resolve complex claim research issues