Ivana Pedre Email & Phone Number

Florida, United States

• Program manager for multiple Managed Care payor clients EVV programs including Anthem Fl, Anthem Virginia, United Fl, Aetna Fl, Florida Community Care and Highmark Wholecare of PA
• Account Manager lead over the state of Florida/AHCA contract for Electronic Visit Verification (EVV) for Behavioral Health Autism/ABA service providers
• Cross-functional project lead with oversight over meeting contractual service level agreements and monitoring contractual compliance.
• Technology Platforms: Zoho CRM, Netsmart Mobile Caregiver +, Salesforce, Jira, Confluence

Miami/Fort Lauderdale Area

• Strategized with C-Suite Executives and internal departments to develop a multi-state growth strategy plan for a national leading provider of Behavioral Health Autism/ABA services.
• Managing Payer Relations Specialist with Commercial, Tricare and Medicaid payers (Medicaid for Louisiana, California and Texas, Tricare for Virginia and Commercial and Medicaid for Florida)
• Effectively managed all aspects of intake operations with diverse behavioral health payers to maximize revenue
• Negotiated Single Case Agreements with out of state non-contracted payers.
• Increased new patient volume by 20% within first six months of hire.
• Technology Platforms: Central Reach EMR

Plantation, Florida

• Initiating, negotiating, and executing behavioral health facility contracts for both Commercial and Medicare behavioral health services and product lines. Products and services include delegated agreements, single case.
• Conducted market and financial analysis, red-line contract review, contract language and rate negotiations, contract implementation and maintenance, health plan delegated credentialing, and ongoing support of the.
• Established and maintained a healthy working relationship with hospital C-Suite executives and physicians to help create a stable network that achieves objectives for unit cost performance.
• Daily escalation point for resolution of complex, high priority issues.

Fort Lauderdale, Florida

• Managed all aspects of healthcare contract negotiations including targeting new health plans, as well as conducted successful rate negotiations for existing contracts to achieve rate increases and achieve increased.
• Responsible for designing, executing and directing successful business development strategies to generate a strong referral database for two acute care psychiatric hospitals (142 bed capacity).
• Managed a team of seven Business Development Coordinators spanning a tri-county market.
• Promoted from Manager role to Director role within eight months of date of hire.
• Technology Platforms: AS 400

Fort Lauderdale, Florida, United States

• Managed all aspects of healthcare contract negotiations including targeting new health plans, as well as conducted successful rate negotiations for existing contracts to achieve rate increases and achieve increased.
• Responsible for designing, executing and directing successful business development strategies to generate a strong referral database for two acute care psychiatric hospitals (142 bed capacity).
• Managed a team of seven Business Development Coordinators spanning a tri-county market.
• Promoted from Manager role to Director role within eight months of date of hire.
• Technology Platforms: AS 400

Cooper City, Florida

• Negotiated in-network commercial contracts with health plans and managed care organizations for inpatient detox and rehab substance abuse and mental health facility. Services included inpatient and outpatient substance.
• Created internal referral database of over 2,000 local healthcare professionals to generate business for a new 72-bed behavioral health facility.
• Promoted from Manager to Director within eight months of hire date. Promotion included absorbing management oversight over two additional hospital (Fort Lauderdale Behavioral Health Center and Atlantic Shores Hospital)
• Technology Platforms: AS 400