Consultant, Provider Enablement
CurrentEnsure provider organizations implement capabilities to deliver on key cost, quality, and patient experience outcomes as well as, maintain key stakeholder relationships; resolve business issues; capitalize on development opportunities; and manage internal associates, contractors, and vendor partners.• Streamline operations by providing recommendations for improved knowledge-based processes and procedures. • Create project proposals, provide recommendations, and deliver spreadsheets and PowerPoint presentations to leadership.• Collaborate with senior leadership during executive decision-making process, generating documentation to support corrective action and recommendations. • Drive communication across teams with competing priorities and facilitate executive meetings.• Facilitate collaboration between resources, leading effort to develop member eligibility file incorporating Medicare and Medicaid enrollment data.• Reduce expenditures and drive savings by negotiating favorable vendor and service contracts. • Serve as SME on EMR and other quality data, supporting clinical teams, translating regulations, and resolving issues.• Build and maintain long-term relationships with clients, delivering outstanding service.• Point of contact for escalated matters concerning data integration with FIGmd vendor. • Represent CareFirst as expert on interoperability and clinical data sharing during meetings. Noted Accomplishments:• Spearheaded a 2-year project from concept to implementation, integrating network provider groups and extracting valuable clinical data. The organization has expanded from 0 to 11,666 providers and clinical data extraction for 1.2M members.• Managed development of enrollment file for 7 lines of business, completing a previously unsuccessful project.• Created a proposal in response to the clinical data initiative, approved for a 5-year budget of $6M annually by the Health Services Department Senior VP and company CEO.