Lisa Rossics Email & Phone Number

Chelsea, Al, Us

Birmingham, Alabama

St. Louis, Mo

Develop robust and cost-effective provider networks for Centurion's correctional health clients which include several state departments of correction. Negotiate contracts with hospitals, physicians and ancillary providers for the provision of services to inmate populations. Work with the business development team to prepare responses to Requests for Proposals. Perform review and analytics of existing provider networks to determine areas for cost improvements.

Clayton, Mo

Negotiate national ancillary contracts for Fortune 500 company in the managed Medicaid field. Analyze costs, services and performance of various vendors and providers to determine best fit for company's needs. Manage the on-going daily activities between Centene and contracted providers and vendors to ensure their compliance with state and corporate reporting and performance requirements. Negotiate agreements for new commercial exchange line of business as well as Medicare dual-eligible population.

Negotiated cost-effective agreements with hospitals, large medical groups, physicians, ancillary providers, and purchasing vendors both at the local and national level. Helped develop corporate contracting strategy in developing networks for new and existing markets. Managed provider relationships to ensure effective implementation and operations for our clients. Managed a staff of five including hiring, training and daily supervision.

Renegotiated key national lab vendor agreement for annual savings of over $2M and facilitated the transition of sites not utilizing this vendor for additional savingsTerminated third party administrator agreement for statewide client and negotiated direct agreements which resulted in 7% overall savings or $450KNegotiated a third party administrator agreement for another statewide client that resulted in annual savings of $3MRenegotiated national dialysis agreements for annual savings of $500KNegotiated new hospital agreement for a statewide client that resulted in annual savings of $500K over the existing hospital contract and included a multi-specialty physician network; Network Development; Oversee negotiation of all provider contracts in the 27 states Corizon serves for more than 300 client sites and 300,000+ livesDevelop networks that meet access and unit cost requirements for new and existing clients, which has included developing complete statewide provider networks in as little as 45 daysAnalyze existing contracts to determine areas for cost savings (have renegotiated existing agreements for over $3 million in annual savings year-to-date 2012)Perform strategic analysis of provider markets to support Business Development team in response to requests for proposalsComplete financial analysis in order to establish reimbursement methodologies and establish standardized fee schedules by market and provider typeCultivate provider relationships and provide problem resolution to ensure lasting mutually beneficial associationsManage staff of three contractors and one administrative assistant

Analyzed provider claims history to determine areas for potential cost savings and quality improvementConducted financial analysis and research on current medical management issues and presented findings to Medical Management staff, including Medical DirectorsSupported contracting in analyzing economic impact of contract renewals or terminations and monitoring of on-going contract issues Provided upper management with quarterly financial results and trends on specialty costs and top ten diagnosesWorked in conjunction with other Corporate Decision Support staff in establishing standard reporting such as Hospital Profiling and Medical Cost Review

Pharmacy Services; Established financial reporting system for hospital pharmacies and analyzed monthly resultsCreated and updated drug utilization and market share tracking reportsPerformed special projects as needed

Provided financial analysis on client accounts Performed trending analysis and reviewed monthly invoices and Profit & Loss statementsPrepared PowerPoint presentations for managementAssisted in completion of annual budgets

Contacted insurance companies for pre-certification of all surgical proceduresResponsible for coding and billing of all proceduresFollowed up on insurance claims via letter and/or phone

Completed patient admission documents and provided financial counselingPrepared quarterly Medicare credit balance reports and month-end census reports for administrationEntered patient charges and performed insurance billing and follow-up

Bsba, Mba, Finance, General Management

Activities and Societies: Alpha Kappa Psi

Bsba & Mba, Finance - General Management

Mba, General Management

Education record

Finance