Jennifer Stork Email & Phone Number

Livermore, Ca, Us

San Jose, Ca

Changed focus back to just contracting in October 2014 from both contracting and billing department management. Provide market analysis and strategic planning to address the changing health care environment with the implementation of the Affordable Care Act and now the possible repeal and replacement thereof.I was involved in the preparation of the organization and its staff for Covered California. Planned Parenthood Mar Monte was selected for the Covered California Outreach and Education Grant and as a Certified Enrollment Entity. I have prepared both internal education as well as outward facing communication.Build and manage the contracting for Medicaid Managed Care, Commercial, Exchange, and Pharmacy for a geographic region spanning 18 counties in California and Nevada.Manage the relationship with various payers in the areas of Pay for Performance, capitation and fee for service payments.My managed care experience has been valuable to Planned Parenthood Mar Monte. I have made a significant impact on their accounts receivables, expanding their commercial business as well as educating staff on the complexities of managed care.

Payor relations, contract management and building additional payer mix for Planned Parenthood's client base.Changed roles to contracting & medical billing in December 2009

Responsible for contracting of $25M in claims, service and relationship management of an assigned Northern California territory for HMO/PPO/POS/Open Access business of 44 Hospitals, 24 Medical Groups and IPAs, and thousands of individual physician practices. Negotiating Group, Hospital and Ancillary contracts with various models of reimbursement; Fee-for-Service, Capitation, Shared Risk, Per Diem + Stoploss, Case rates, Discounts with Maximums, ASC groupers, and Start-loss. Trouble shooting provider network issues for high profile employers. Accurate and timely loading of provider contracts to assure automation and correct payment. Managing one Contract Manager and two Provider Relations Coordinators and dotted line responsibility for two additional Contract Managers.

Responsible for contracting, service and relationship management of an assigned Northern California territory for all lines of business (HMO/POS & PPO) with all types of providers. Managed staff of 3 Provider Relations Coordinators.

Responsible for contracting (full risk, Medicare risk, shared risk, individual physicians and ancillary services), educating, and the relationship management of an assigned Northern California territory for all lines of business (HMO, Medicare Risk, POS, & PPO) of all types of providers and for managing Provider Relations staff. Coordinated implementation of pharmacy software and incentive program with Medical Groups. Performed quarterly Joint Operations meetings with assigned capitated groups. Performed analysis of the division of financial responsibility (DOFR) in full risk/shared risk contracts and associated costs of services, which was used to establish financial benchmarks for contract performance state wide.