Jennifer S. Email & Phone Number

Gilbert, Az, Us

United States

Work with the Marketing P&L team to contract with new providers in existing marketsMeet with potential new clients/providers and negotiate contracts that match market standardsCollaborated with cross-functional teams to design and implement network solutions that meet business objectives.Complete projects such as SCA analysis for my assigned markets to determine network adequacy gapsResearch providers/groups to bring in-network, and identify new partnership and market opportunities.Assign task tickets to team members and assist with questions and troubleshooting areas of concern

United States

Work as an Account Expert managing day to day operations and communication. Provide direct support to Provider Services, Provider Relations, Network Account Management, Configuration Analysts, Data, Credentialing and Rosters teams.Work with the Profit and Loss department in Marketing to support the Central Region. Manage the Central Provider Relation email inbox and respond to time sensitive inquiries.Manage relationships with Network Partners and troubleshoot any issues that are reported to the partners.Act as a resource for the Provider Relations team.Identify systemic and trending issues in my region and escalate those issues to the appropriate department for resolution. Provide onboarding training to newly delegated Providers and Hospital based systems, advise on how to work with Oscar.Hold weekly office hours to assist provider relations representatives across all regions.Adhere to a solution focused plan of action for network partners and their providers.

United States

Work with a team of individuals to assess needs for out of network medical care for our members.Source for providers and specialists to provide necessary care for our members.Negotiate acceptable rates for reimbursement of out of network care.Process contracts and rate sheets that serve as authorization for out of network care. BcHelp ensure that contracts are executed quickly and carefully.Input terms of the signed contract to our claims team so that providers are paid properly.

Tempe, Arizona

-Assist a team of individuals with accurate processing of medical claims.-Process escalated requests to appropriate teams such as Eligibility, Provider Outreach, Provider Relations, Provider Contracting, as well as our contracted vendors. - Process and re-price any claims that are inaccurately priced, including Single Case Agreements for Out of Network care- Educate care guides on how to read claims so they are better equipped to provide detailed explanations to members- Provide training to new hires in areas such as Authorization, Payment Disputes, Out of Network Denials and Transplant cases- Provide back up to team leads as a subject matter expert- Assist with the development of workflows for several areas in claims such as Authorization. Payment Disputes, Denials and EviCore vendor relations

Tempe, Arizona

-Assist a team of individuals with servicing a specific region of New York members-Process escalated requests to appropriate teams such as Claims, Eligibility and Provider Education-Utilize internal resources to provide appropriate and accurate information to members-Educate members on how to read their claims and understand their care-Provide excellent customer service to our members -Facilitate the correspondence between the members and appropriate teams-Participate as a Teaching Assistant for new care guides -Shadow the claims team in an effort to be a subject matter expert for my team-Facilitate xonversations and connect members to the appropriate resources such as CVS Caremark and Optum-Advise members on the prior authorization process for procedures and medications

Tempe, Arizona

• Run reports and extract pertinent data to assist in professional presentations to management.• Audit student files to ensure all program requirements have been met. • Create a master schedule of all course offerings two years in advance. • Communicate with assigned campuses and centralized teams.• Maintain an efficient master schedule and proactively guide change management.

Tempe, Arizona

• Worked with the Director of Student Services and the Academics Department to supply students with advising needs. • Completed welcome calls for new students and maintained contact throughout their enrollment. • Acted as a liaison for students with various departments such as Admissions and Financial Aid. • Assisted students with processes regarding grade disputes, extensions and outreach to instructors. • Assisted VA students utilizing their GI bill to be certain that they meet the credit load requirement for full BAH benefits.• Managed spreadsheets to track student completion levels in all programs.• Maintained above requirements for quarterly retention rates. • Assisted in the processing of book orders for new and continuing students. • Managed students who were not meeting Satisfactory Academic Progress and worked with them on a weekly basis to ensure academic success. • Managed customer service for all existing and prospective students by utilizing our Live Chat software. • Participated in Live Chat (online) on a daily basis to service all new, continuing and prospective students.

Work with the Program Chair, Full-Time Faculty and the Student Affairs Department to supply students with advising needs for respective programs in the College of Education (doctoral and masters), College of Business (doctoral and masters) College of Health Sciences, as well as Forensic Psychology, Industrial Organizational Psychology and Sports Exercise Psychology.Assist with retention efforts by participating in Student Services team meetings to identify troubled students and explore ideas that will strengthen student success. Provide students with access to services such as Financial Aid, Student Accounts, Admissions, Counseling Services, etc. Manage student schedules, graduation information, program information. Coordinate and execute the annual commencement ceremony while maintaining the designated budget requirements. Provide students with detailed graduation course audits to determine that graduation requirements are met.Assist with registering students for upcoming terms, adding/dropping courses, and identifying pre-requisites for course loads. Track attendance in class for all students.Prepare spreadsheets to track student completion levels in all programs.Assist with determining the upcoming semester class offerings.

•Utilized my 8+ years experience to support a team of 9 individuals, comprised of VP’s AVP’s, Directors and Project Directors of the Development Group •Processed Service Agreement Contracts for contractors working with our respective communities.•Procured more than 35 change orders which impact each developments GMP.•Followed up with purchasing orders, design spreadsheets, edit and maintain all changes to the Development Departments Design Guidelines Manual.•Coordinated design control books for 2 new communities to date as well as existing communities.•Proactively enroll in classes offered on-site to further my knowledge and gain additional experience.•Participated in Business Orientation to gain a greater knowledge of the Sales Industry at CRbH.•Assisted with the coordination of holiday parties, event planning, including menus and venues.POSITION ELIMINATED-CORPORATE LAYOFF

•Supported the CEO & Senior VP of Business Development•Worked on specific billable projects as allocated.•Managed all vendor relations, accounts and billable expenses with outside vendors for 9 GaiaTech offices. •Managed daily functions with the Chicago office, assisted the Human Resource Department with the Orientation of 10 new employees during my term, and maintained all office supply orders while keeping in line with a quarterly budget. •Coordinated with the Office of the Building on repairs and with outside companies for office build-outs and expansions.•Maintained leases for 4 major GaiaTech offices and assisted in the preparation of negotiating new leases.•Assisted with the coordination of marketing materials for public events, coordinated office events, and event planning.POSITION ELIMINATED-COMPANY LAYOFF

Msed, Adult Education

Activities and Societies: Community Advisor, Hall Represenatative, Manager of Front Desk Operations for Housing Office, Graduate Assistant.

Real Estate

Ba, Sociology

Activities and Societies: President/Secretary Black Student Union, Choir, Hall Representative