Rena Harris Email and Phone Number

Manage payer contracting staff, assist in setting targets and priorities. Responsible for negotiation, re-negotiation and administration of Emergency Room Physicians, Hospitalists, Critical Care physicians, Intensivists and Anesthesiology physician group agreement’s staffed at various hospitals (hospital based physicians), clinics and office setting's throughout the US. Negotiate rates and terms with various Managed Care Organization's and Management Service Organization's for products which includes but is not limited to Commercial, Medi-Cal, Medi-Care, Exchange and Workers' Compensation. Conduct own revenue analysis and strategy from raw un-scrubbed data to determine positive revenue generating impact. Successfully negotiated multi year deals with auto escalators. Additional responsibilities include collaborating with billing centers and other various internal operations team on resolving billing and day to day issues.

Responsible for negotiation, re-negotiation and administration of Emergency Room Physicians, Hospitalists, Critical Care physicians, Intensivists and Anesthesiology physician group agreement’s staffed at various hospitals (hospital based physicians), clinics and office setting's in the states of AL, AR, AZ, CA, CO, FL, GA, HI, LA, MS, NC, NM, NV, OK, SC, TX, UT, VA and WV. Negotiate rates and terms with various Managed Care Organization's and Management Service Organization's for products which includes but is not limited to Commercial, Medi-Cal, Medi-Care, Exchange and Workers' Compensation. Conduct own revenue analysis and strategy from raw un-scrubbed data to determine positive revenue generating impact. Successfully negotiated multi year deals with auto escalators. Additional responsibilities include collaborating with billing centers and other various internal operations team on resolving billing and day to day issues.

Responsible for negotiating and administration of provider contracts for Centene Federal Services. Providers includes physicians, physician groups, hospitals, ancillary providers etc. Negotiate both technical and professional component. Additional responsibilities include collaborating with billing center and other operational departments with providers on resolving billing and day to day operational issues.

Responsible for negotiation, re-negotiation and administration of Emergency Room and Hospitalists physician groups Agreements staffed at various hospitals in the states of AZ, CA, CO, HI, ID, KS, NV, NM, OK,OR, TX, WA and WY. Negotiate with various Managed Care entities for products which includes but not limited to Commercial, Medi-Cal, Medi-Care and Exchange products. Additional responsibilities include collaborating with billing centers on resolving billing and day to day issues.

Responsible for negotiation, re-negotiating and administration of Long Term Acute Care Hospital, Skilled Nursing Facility and Home Health/Hospice contracts with Commercial, Medi-Cal, Medi-Care, Veterans Administration, Tricare, Workers’ Compensation and the Prison systems payors for our facilities in AZ, CA, CO, ID, MT, NM, NV, UT, WA and WY. Additional responsibilities include day to day provider relations operations and issues resolution. Collaborating with Central Business Office and key operators within our Hospitals, Skilled Nursing Facilities and Home Health/Hospice locations to discuss potential revenue opportunities and resolve complex issues with payors.

Responsible for negotiation and administration of Commercial, Medi-Cal and Vision Managed Care contracts, including Delegated Medical Group and Delegated Hospital contracts. Coordination and contract negotiation with out of area hospitals in transferring patients to and from CHLA. Additional responsibilities include staff management, day-to-day department operations. Collaborating with Patient Financial Services, Admitting and other internal hospital departments to streamline operational processes. Support hospital staff during governmental agency audits.

Responsible for negotiation and administration of Medi-Cal Managed Care contracts. Additional responsibilities include day-to-day department operations collaborating with Patient Financial Services, Admitting and other internal hospital departments to streamline operational processes.

Responsible for negotiation and administration of workers’ compensation contracts for entire California network. Oversaw provider contract negotiation and implementation of workers’ compensation for Colorado and Nevada. Additional responsibilities include day-to-day operational problem solving with internal departments including network management, bill review, customer service, account management, MPN Services, product development, complaints/grievances, and provider database operations for workers’ compensation network. SME for provider operations manual updates, quarterly provider newsletters, client RFP response and client audits.

Responsible for the negotiation and administration of 30 managed care contracts for CHW’s Ventura Region (St. John’s Regional Medical Center and St. John’s Pleasant Valley Hospital). Additional responsibilities included maintenance and development of positive internal and external relationships, troubleshoot complex contractual issues, and manage staff.

Act as a liaison between Pacificare of California and seventy-seven (77) Los Angeles area provider groups for the evaluation, implementation and development of disease management and healthcare quality programs.

Responsible for the day-to-day contracting and operational issues for ancillary/tertiary providers, medical groups and hospitals for over 80,000 commercial and Medicare assigned members.

Responsible for the day-to-day operational issues for medical groups and hospitals with over 40,000 commercial and Medicare members. Additional duties included network analysis, ad hoc projects, and provider contracting.