Lisa A. Janis Dreilinger Email & Phone Number

New York, NY, US

New Hyde Park, NY, US

New Hyde Park, NY, US

New Hyde Park, NY, US

Wellesley Hills, Massachusetts, US

• Managed client contracts equating to $80,000,000 gross margin for states of New York, New Jersey, Connecticut, Massachusetts, Maryland, Pennsylvania, South Carolina, North Carolina, and Ohio.
• Oversaw all aspects of client lifecycle, including contracting, implementation, daily activities, and retention.
• Evaluated and renegotiated client contracts to meet market standards for key terms, SLAs, and profitability.
• Served as regional lead for operational projects and improvements companywide.
• Managed team of 26 staff and served as lead for market across operational counterparts companywide.
• Secured and recontracted with two largest clients for market, ensuring profitability.

Wellesley Hills, Massachusetts, US

• Oversaw New York/New Jersey/Connecticut market companywide for both providers and clients, equating to $45,000,000 in gross margin annually.
• Managed team of 20 with overall accountability and responsibility companywide.
• Established local New York presence and team to ensure all operational and contractual items met, as well as appropriate response to client items, utilizing corporate operational counterparts.
• Implemented quality program specifically to meet New York quality standards and increase quality scores two fold.
• Met and extended MLR and budgetary targets.

Bronx, NY, US

• Oversaw companywide provider and vendor network equating to over 35,000 providers and vendors, including provider relations department, credentialing department, and vendor management department.
• Ensured lifecycle of contracting, credentialing, training and education, as well as claims payments for provider and vendor network.
• Served as lead for network department on all provider items and issues.
• Developed and enhanced process improvements related to onboarding, contracting, credentialing, and provider setup across network.
• Worked across all departments at Affinity to ensure education of network providers on products as well as benefit and program changes.

Bronx, NY, US

• Oversaw and managed 40+ vendors critical to operations and member care.
• Balanced strategic goals, operational performance, and cost mitigation.
• Managed and monitored all aspects of implementation and contract lifecycle, including amendments and rate renegotiations.
• Facilitated auditing and review of vendor activities to meet regulatory guidelines.
• Evaluated and renegotiated vendor contracts to meet current market standards for key terms and SLAs.
• Spearheaded company consolidation and addition of 20+ vendors considered FDRs across all lines of business equating to over $100,000 in spend.

Bronx, NY, US

• Created department functionality while overseeing and managing 15+ vendors that had direct outsourcing impact on medically focused operations.
• Established auditing and report tracking process as well as monthly work team comprised of subject matter experts.
• Completed four audits in fourth quarter to ensure regulatory compliance.
• Developed companywide processes and protocols for department.
• Implemented new product lines through vendors for ACA products new to Affinity.

• Oversaw multifaceted revenue cycle and medical practice management company.
• Created and implemented new initiatives.
• Managed timelines to ensure projects remained on track and met deadlines and budgets.
• Sustained growth and established partnerships and opportunities.
• Negotiated 18+ enhanced contracts with managed care carriers, which increased revenues for practices and company by over 30%.
• Served as point person on projects with physicians and office managers to ensure successful transitions.

• Managed new departments, including managed care, credentialing, contracting, and human resources.
• Oversaw ten staff members, ensured contract lifecycle, and negotiated contracts.
• Handled onboarding of new clients and physicians, and met all time frame deadlines.

Minnetonka, MN, US

Oversaw all aspects of implementation and maintenance of operations, finance, regulatory compliance, and communication. Managed lifecycle of amendments, compliance, reporting, financial reconciliation, and membership growth. Functioned as lead for implementation of Medicare full risk and vendor arrangements, resulting in $60,000,000 savings for company.

Minnetonka, MN, US

Provided corporate oversight for credentialing department and provider services team. Established and implemented provider services team consisting of two teams and 30 members. Consolidated and centralized department within New York region, and coordinated files, policies, procedures, and data.

Minnetonka, MN, US

Supervised two teams consisting of 15 members. Ensured NCQA, NYSDOH, and NYDOI compliance.

Mba, Health Care Administration

Bachelor Of Arts - Ba, Sociology