Karen Fitzgerald Email and Phone Number

•Responsible for contracting on behalf Baptist Memorial Healthcare Corporation, to include all Joint Ventures and Partnerships via Messenger Model in TN, MS, and AR.•Responsible for developing and implementing contracting strategies for BHSG network of providers to include: facilities, ancillaries and physicians in TN, MS and AR. •Guide and manage daily Payer Contracting department operations• Negotiate and manage new Payer Contracts• Oversee development of Contract Renewal Process• Negotiate all existing Payer Contracts at renewal• Conduct Audits of current contracts • Contracting Matrix Responsibilities • Government Contracts (Medicare and Medicaid)• National Networks • Regional Networks• Carriers• TPAS • Transplants • Direct interaction with Senior Administration • Direct interaction with Business Offices • Co-ordinate and Maintain Operational Meetings with Payers• Key Liaison between entities and Payer• Guide and Implement Modeling Process• Provide support to HIM and Case Management • Conduct Financial impact analysis reports • Responsible for complex Payer Contract problems

• Direct contact with TennCare officials for implementation of new contract requirements • Member of the Operations’ Committee for implementation of new policies and procedures • Point of contact with TennCare, to include operating Unison’s business operations in compliance with applicable state and Federal laws and in compliance with Unison’s contractual obligations to TennCare, providers and others • Work on special projects with Medical Director’s on cost effective services • Financial negotiator for Transplant Cases (Heart, Liver, and Kidneys)• Oversee development of marketing materials for distribution to provider network• Responsible for quarterly reporting of Network Management Reports: ER Utilization, Out of Network Utilization, Specialty Updates, and Out of Plan Emergency Providers• Oversee both Provider Relations and Network Development• Responsible for Medicaid and Medicare standard and non-standard contracts, to include rate analysis, financial impact to the plan, language changes and policy changes • Oversee network expansion efforts, for new line of business Unison Advantage• Medicare Advantage operational in thirteen counties (AR,MS,& TN)• Development of BHO network for Medicaid line of business in the West TN Region

• Servicing/Contracting providers in Tennessee, Mississippi, and Arkansas• Performing site visits and chart audits for all office’s on a two year cycle to coincide with the Credentialing process• Conducting orientations, for new providers joining the health plan, as well as, large group orientations for new product roll outs• Creating contracts for providers to reflect their area of specialty or to reflect special exceptions approved by the network • Daily communication with physicians’ offices to resolve any open issues• Over seeing quarterly directory audits to be supplied to members as well as physicians through mass mail outs• Responsible for converting all providers in network to Aetna contracts and transitioning out Prudential contracts thru the buy out process• Responsible for reporting health care costs for 2 locations• Daily reporting for Provider Relations Department to include detailed information on claim activity per provider of inquiry• Involved in special projects requested by any Director or Executive officer• Responsible for producing all statistical information on spreadsheets as well as charts• Monthly Reports to include: Provider Profile Reports, Utilization Management Reports, Health Care Expense Summary Reports, Network Membership Reports, & Cost Analysis Reports• Quarterly reports submitted for Re-credentialing of Providers