Kim Calvo Email and Phone Number

•Founded and developed a non-profit dedicated to assisting those with visual impairments and vision loss. •Initiated a fund to assist children and adults with Aniridia for research•Oversee fundraising to finance low vision technological advancements•Advocate and educate regarding vision care and resources available for low vision and blindness

-Reinforce social, cognitive, emotional, physical and behavior instructional objectives-Assist in one on one or group setting instruction consistent with the mandated recommendation-Collect data, analyze and document student behavior for instructional purposes

-Researched and identified opportunities needed for organizations projects-Maintained compliance of quarterly tracking system for multifaceted reports-Assisted in generating funds for various community networks

Assisted in the creation of their Policies and Procedures to meet the NCQA and URAC standards.Assisted in the Credentialing of Providers for their new network.

Orthotics & ProstheticsDurable Medical Equipment (DME)

Radiology Services

Assisted HMS with various clients in regards to Provider Relations, Contracting, and Credentialing

•Member of the leadership team overseeing the integration of newly acquired subsidiary, Vytra Health Plans. •Assisted with the recruitment of 2,700+ providers to expand Vytra’s provider network. Created a tracking mechanism for recruitment database. •Consolidated company code databases, compared billing codes and implemented combined platform for company. Led project for cross-functional development of provider claim payment, provider updates and changes. Tested and implemented new platform for CAQH reporting. •Transitioned Vytra credentialing process meet HIP systems, workflows and review. •Prepared files for regulatory review (HFCA, DOH, DOI and NCQA) and NCQA roadmaps for Vytra 2004 audit. •Trained Provider Relations and Credentialing staff to evaluate and audit provider files ensuring compliance with NCQA standards for an “Excellence” rating. Delegation Manager: 2002 – 2003 •Conducted due diligence of prospective delegate entities and annual review of current (11) delegate entities.•Conducted periodic reporting and demographic updates for provider files. •Participated in regulatory audit for NYSDOH, HCMS and NCQA. •Implemented improvement action plans. Initial Credentialing Manager: 1999 – 2002 •Supervised a team of fourteen (14) professionals responsible for ensuring quality care levels of participating providers of health plan. •Conducted audits and production of operation reports. Assisted with the implementation of new information system. Maintained compliance with accreditation standards and led team compliance projects with guidance of senior management. •Maintained professional relationships with physicians and outside vendors to ensure a seamless credentialing process.•Developed and implemented efficient workflow policies and procedures. Trained new staff.

•Assisted in the recruitment of 3,000+ providers to expand the healthcare provider delivery system from 12,000 to 15,000 providers. •Initiated and developed a workflow policy and procedure manual. •Maintained provider utilization and quality service levels to ensure compliance with state and national regulations. •Performed product presentations and site reviews for physicians. •Investigated denied claims for payment resolution.

•Assisted with the recruitment of 2,700+ providers to expand Vytra’s provider network. Created a tracking mechanism for recruitment database. •Developed and maintained professional relationships with physicians and administrators with the Mt. Sinai, Lenox Hill PHO and NYU.•Evaluated and reviewed contractual terms for the negotiation of fees. •Supported the development of workflow policies and procedures.

•Assisted in the design and launch of The New City Guide Magazine. •Expedited the processing of all incoming contracts and advertising materials from production to print. •Coordinated the implementation of new and existing ads for each magazine issue. •Coordinated operations for monthly magazine distribution to advertisers and hotels.

•Compiled and analyzed demographic data for prospective advertisers. •Tracked and evaluated forecast media purchases for local and national advertisers. •Developed advertising prospect lists. •Prepared monthly budget summaries. Sales Coordinator: January 1993 – January 1994Sales Assistant: August 1992 – January 1993