Responsible for provider data quality improvement across the organization through various projects and process implementations as well as ensuring compliance with provider directory audit activities.

Responsible for activities related to provider network data, including maintenance, reporting and improvements while ensuring compliance with regulatory requirements set by department of insurance.

Responsible for creation and implementation of credentialing workflows to decrease turnaround times. Also secured vendor contract for provider access reporting while developing templates and training materials to implement provider reporting.

Identify and manage projects and process improvement opportunities within network operations including network development and implementations across 18 market plans. Negotiated a contract with a national CVO to improve provider credentialing TAT’s and data accuracy. Built and Implemented an end to end provider onboarding workflow, including an online provider portal to increase efficiency and transparency of internal business process.

Negotiated and executed hospital, physician and ancillary contracts, yielding a geographically competitive, broad access, stable network across all lines of business.

Managed and supported employees in the development and maintenance of the behavioral health provider network in various markets while concurrently overseeing and supporting implementation activities. Directed cost saving initiatives.- Supervised a team who managed the Illinois, Indiana, Ohio and Wisconsin markets and were responsible for contracting and managing the provider network comprised of 13,775 providers and 400 facilities across all product types (Commercial, Medicare and Medicaid).

Analyzed, developed, and maintained a behavioral health provider network in Ohio, while concurrently developing and maintaining internal and external business relationships. Managed the Ohio network of 4000 providers and 110 hospitals across all products (Commercial, Medicare and Medicaid).Supported Medicaid and dual product implementations

Managed the front-end credentialing and recredentialing process while overseeing employees. Directed and supported business process implementations.- Led and supported multiple concurrent efficiency projects. - Maintained state-specific guidelines for credentialing processes.- Created workflow efficiencies aimed at reducing internal costs. Calculated and maintained vendor metric reports.

Processed front-end credentialing applications while supporting internal/external customers.