Provider Relations Manager
CurrentResponsible for successful partnerships between providers and health plan. Liaison between CareMore Regional Medical Officer, General Manager, Nurse Practitioners, Care Managers and external partners to ensure quality care for senior population. Tracking / monitoring of programs and collaborating results with Anthem and partnered providers. • Successfully expanded the number of Skilled Nursing Facilities where CareMore was the admitting provider for the Anthem Medicare Advantage Patients; included expansion into following patients in the Long Term Care Setting• Led establishment of relationships with local hospital’s care management teams, PHO’s, Home Health Care Agencies, Hospice providers and DME providers • Liaison for the initial Anthem ER Intercept Program and Direct Admission to Skilled Level of Care from Home Environment resulting in hundreds of thousands of dollars in cost savings• Assisted in implementation of Independent at Home program• Secured staff access to multiple partnering facilities electronic medical records• Established relationship with Anthem Medicare Advantage Sales Department for participation in open enrollment presentations• Developed and maintained all written presentations and program descriptors; included Power Points, brochures and web site• Continued participation in the successful lowering of skilled nursing facility readmission rates to 9.5% (ALOS 14.5 days) vs 12.8% (ALOS 16.5 days) for comparable outside facilities .
