Lynette Davidson Email & Phone Number

Dallas, Texas, US

Nashville, Tennessee, US

Hartford, Connecticut, US

Detroit, MI, US

• Developed and negotiated cost-effective contracts in compliance with company standards, reimbursement standards, and network adequacy. Negotiated contractual relationships, including incentive and risk-sharing models.
• Identified opportunities for network improvement and supports network efforts to achieve results with relevant support and metrics.
• Saved company money by implementing contract management system, as well as enacting software extension to existing PEGA CRM tool to answer internal and external emails in timely manner.
• Led multiple continuous improvement initiatives to stop waste.
• Drove development of strategies to ensure network adequacy.
• Directed departmental staff to include interviewing, new recruiting, training, developing, mentoring, coaching, disciplinary, evaluating, counseling and terminating in conformance with health plan policies.

Detroit, MI, US

• Negotiated various contracts, including incentives and risk-sharing models with key ancillary providers, facility-based physician groups, hospitals, PHOs, POs, and other providers to maintain competitive provider.
• Resolved complex issues related to contract implementation and contract adherence under tight timelines.
• Peer-reviewed contracts and financial analyses submitted by contract administrators.

Detroit, MI, US

• Facilitated provider-development strategic initiatives impacting all areas of company and affecting contractual arrangements with providers. Negotiated favorable contracts and built integrity in contractual.
• Assessed contract language for compliance with corporate standards and regulatory requirements, and reviewed language with assigned health plan attorney.
• Transformed department with process improvements through implementation of Change Health Contract Management system.
• Created efficiencies through automation, single contract depository, and tools to allow more efficient tracking.
• Developed online process that utilized SharePoint to submit single case agreements.
• Increased county network providers and expanded Medicare product to meet adequacy requirements.

Detroit, Michigan, US

• Established policies and procedures. Acted as contract and administrative coordinator between DMC and contracted managed care plans. Evaluated and negotiated managed care agreements (specifically for PPO/POS plans)..
• Served as liaison/problem solver between provider and managed care plan.
• Educated providers on various program requirements, policies, and procedures.

Center Line, Michigan, US

• Directed managed care, Medicare, all Medicare Advantage Plans, Medicaid, Blue Cross, all private/commercial insurance, workers’ compensation, and auto-related care. Facilitated revenue cycle management. Led provider.
• Led evaluation of employees’ performance.
• Saved company money by implementing new software to add customers, inputting orders and billing in one system.

Master Of Science In Administration, Human Resource Administration/Leadership

Bachelor Of Business Administration (Bba), Health/Health Care Administration/Management, Cum Laude