Kc Schaefer Email & Phone Number

Dayton, Oh, Us

Kettering, Oh, Us

Responsible for Managed Care Payer portfolio performance for contracted payers for Kettering Health hospitals, employed physician practices, clinically integrated network, ancillary providers, Centers of Excellence and Direct to Employer contract types. Manage staff to ensure appropriate contracted rates and language provisions are negotiated within established deadlines and consistent with organizations goals and objectives and operationally obtained. Lead out in development and management of contracting strategies, including but not limited to market analysis, revenue strategies, professional services initiatives, and value-based and risk contracting for the Kettering Health entities and ensure implementation of strategies through contracting activities. Oversee communication and resolution of operational issues between Kettering Health and contracted payers. Oversee payer contract compliance, reimbursement variance activities for Kettering Health. In accordance with the mission of Kettering Health the Director of Managed Care and Contract Management is responsible for leading the Network’s third-party payer contracting activities including but not limited to negotiation strategies, revenue recovery, modeling, reporting, planning communication internally and externally and acting as the primary liaison for Kettering Health to managed care plans. Primary responsibilities include leading Kettering Health’s development and activities with third-party payers, including developing and implementing contract strategies around network payer contracts and acts as the primary liaison for all Kettering Health entities and affiliates to managed care plans. Performs other duties as assigned

Kettering, Oh, Us

Kettering, Oh, Us

The Network Physician Compliance Manager is part of a team in the office of Corporate Integrity and Ethics that is responsible for assuring system physician arrangements, policies and procedures are compliant with the legal requirements and guidelines issued by the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The Manager will lead, also as a member of, the Physician Compliance Committee (PCC) in reviewing and approving contracts with other Committee members. The Manager is particularly responsible for managing the workflow of supporting documentation that backs the necessity and appropriateness of Commercial Reasonableness and Fair Market Value (FMV) for each physician arrangement; this includes researching and summarizing FMV data, utilizing specialized business principles as well as discerning when to use third party resources for additional support. The Manager will be involved in policy and procedure development. The Manager will periodically review all physician contract templates for compliance with legal requirements. The Manager will support and advise, when appropriate, KHN executives in the recruitment process of new physicians. The Manager will be responsible for developing a process that demonstrates that payments under the contracts are accurately paid. The Manager will work closely with legal counsel and KHN administrators. The Manager will engage in any other projects as requested by the Vice-President for Corporate Integrity; works closely with Network VP, Presidents and CFO's on special projects.Coordinating with finance, and payment services, helping with accruals, schedules, and budget planning of contracted physician expenses.

Kettering, Oh, Us

Coordinate all physician and service agreement arrangements between the Network facilities and Legal Services department. Reviewing and managing the physician and service contracts - review Stark/AKB compliance, FMV and review business necessity of proposed arrangements and updates. Manage/review physician payments and reconciliations for accuracy.

Kettering, Oh, Us

Review and management of physician and service contracts - review Stark/AKB compliance and FMV. Manage/review physician payments and reconciliations for accuracy. Review of fiscal budgets for many departments. Worked with PIC council on contract tracking for quality and accreditation standards for clinical services requiring it. Any other side projects and reports asked to work on.

Cincinnati, Ohio, Us

San Francisco, California, Us

Personal Banker - managing customer accounts and services.Service Manger - managed a team of 8-9 tellers everyday for service and sales.

Master Of Business Administration (Mba), Health/Health Care Administration/Management

Bachelor Of Business Administration (B.B.A.), Marketing

Education record