Robbin Smith Email & Phone Number

Sullivan, MO, US

Minnetonka, MN, US

Saint Louis, MO, US

• Provide leadership and process structure to health plan / affiliate vendor contract builds.
• Built health plan / affiliate vendor contracting reporting platforms to support regulatory compliance and financial risk reduction. Additional support included:
• Lead conversion of affiliate vendor agreements to new license business entity platform across multiple Centene health plans.
• Managed 200-250 annual transactions with an average docket of 250 pending transactions.
• Assist health plan customers in formulation of responses to state regulator objections to health plan affiliate vendor regulatory filings.
• Lead affiliate vendor contracting in new markets including efficient hand-off to new compliance and vendor management teams.Lead projects to close compliance gaps in national agreements.

Saint Louis, MO, US

• Built operations infrastructure and audit capabilities to improve end-to-end administration of National fee-for-service agreements across 19 Centene health plan platforms.
• Audited and corrected inherited 15 agreements across Centene health plan platforms
• Improved contract administrative build accuracy and turnaround time through negotiated service line agreements with Centene health plans and corporate administrative functions
• Built claims project process to resolve identified claims payment inaccuracies and increase provider satisfaction.Completed National contracting and administrative build for 15 new markets/products.Lead emergent.

Saint Louis, MO, US

• Focused on identified network gaps remaining after early 2013 health plan launch.
• Met management goal of implementing fixed/capped hospital ER rates on 15% of deficient contracts.
• Met management goal of implementing charge master protection on 20% of deficient contracts.
• Moved 3 of 4 assigned network gap non-par hospitals to active negotiation status prior to moving to corporate position.Added ACA Exchange product to targeted key hospitals in preparation for product launch.

Columbia, MO, US

Spearheaded client development for start-up product line providing medical records abstraction services to acute care hospitals. Target audience: Director-level and C-suite in hospital quality departments. Sales cycle: three months to one year. Annual per client revenue range: $40,000 to $200,000.Marketing: Promoted product line brand through multiple.

Developed and maintained ancillary, medical group, IPA, PHO and hospital agreements for multi-product health insurance organization in a 90-county service area covering Eastern Missouri and Southern Illinois.Developed cost-effective new contractual relationships as well as negotiated rate concessions in new or previously underdeveloped service areas to.

Irvine, CA, US

Developed and maintained a preferred provider organization for designated territory with $45 million of provider billings and $1.6 million in company revenue primarily in the workers compensation sector.Developed over 250 new contracts and renegotiated 150 contracts to move PPO discounts from an average 13% to 18% and customer PPO penetration from 69% to.

Performed financial and market analysis as part of larger strategic planning and business development engagements, primarily for hospital and physician group practice clients.Presented results to the consulting team in the home office and to clients on-site.

New York, NY, US

Sell a variety of financial products including life insurance, annuities, mutual funds, disability income and long-term care insurance.

Developed and implemented goals/action plans for provider network development and provider relations in five-county St. Louis metropolitan area including rate and contract development. This included contracting 100 physicians and several hospitals in a 12-month period, re-configuring provider policy and procedures, developing a provider relations.

Network development for 60+ county area.Completed HMO network development and state certification for several northeast and central Missouri counties.Negotiated cost-efficient contracts with volume hospital providers as well as primary care capitation and multispecialty group risk contracts.

Bachelor Of Arts, History And English Literature

Masters Degree, Health Administration