Sara Randolph Email and Phone Number

Manages activities related to payor relationships and contracting for both the Institute and the Institute’s Clinical Practice Plan. Conducts financial analysis, builds relationships and acts as liaison with payors, coordinates activities related to contract administration, implementation and operations and is the primary Institute authority on all aspects of payor contracts and managed care. Acts as the primary product manager for new programs or initiatives, working closely with the Finance team, Clinical Administrators, Patient Access, Financial Counseling, Case Management, and Senior Leadership.• Assists in negotiating the facility and MD’s agreements for the Roswell Park Cancer Institute.• Successfully manage relationships with consultants to obtain longitudinal care/cost information.• Collaborate with various departments on ongoing and new projects for Roswell Park Cancer Institute.• Maintain successful relationships with internal and external resources.

Manages activities related to payor relationships and contracting for both the Institute and the Institute’s Clinical Practice Plan. Conducts financial analysis, builds relationships and acts as liaison with payors, coordinates activities related to contract administration, implementation and operations and is the primary Institute authority on all aspects of payor contracts and managed care. Acts as the primary product manager for new programs or initiatives, working closely with the Finance team, Clinical Administrators, Patient Access, Financial Counseling, Case Management, and Senior Leadership.• Assists in negotiating the facility and MD’s agreements for the Roswell Park Cancer Institute.• Successfully manage relationships with consultants to obtain longitudinal care/cost information.• Collaborate with various departments on ongoing and new projects for Roswell Park Cancer Institute.• Maintain successful relationships with internal and external resources.

Responsible for hospital, ancillary and physician contract negotiations. Responsible for the development of provider fee schedules including community and provider specific fee schedules. Responsible for yearly budget setting for providers. Meet one on one with providers to understand their reimbursement issues and concerns. Work collaboratively with providers and health plan staff to address provider issues. Participates and represents regional Network Management team in various inter-regional committees. Collaborate with regional and corporate departments to develop new provider contracts and reimbursement and incentive models. Routinely perform analyses to meet customer needs including financial performance analyses. Create and utilize utilization trend documents for provider contract negotiations. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.

Person Centered Services of Western New York (PCSWNY) is a collaborative organization established by a group of local nonprofit service providers for people with developmental disabilities. Associate Vice President/Director of Business Development Coordinated all aspects of a new project initiative that resulted in a new corporation. Reported to the Board of Directors on all activities of the start-up corporation, including financial activities. Developed annual budgets and monitored costs. Coordinated all marketing activate including, social media, website, parent and provider meetings and additional collateral. Researched similar state programs across the country.• Successfully handled the development of a new organization which was a result of the collaboration of eleven developmental disability provider organizations in response to state changes. • Identified and created design and planned construction of the project and monitored project systems.• Consistently met project milestones and provided comprehensive on-going problem solving.• Effectively developed, negotiated and maintained relationships with outside consultants.

Responsible for hospital, ancillary and physician contract negotiations. Responsible for the development of provider fee schedules including community and provider specific fee schedules. Responsible for yearly budget setting for providers. Meet one on one with providers to understand their reimbursement issues and concerns. Work collaboratively with providers and health plan staff to address provider issues. Participates and represents regional Network Management team in various inter-regional committees. Collaborate with regional and corporate departments to develop new provider contracts and reimbursement and incentive models. Routinely perform analyses to meet customer needs including financial performance analyses.Create and utilize utilization trend documents for provider contract negotiations.Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.

Worked on the implementation of a corporate pricing and modeling integration project. Utilized Microsoft Solutions Framework to work through the various phases of the project.Worked with all areas of the company to ensure proper use and function of the project.

Responsible for developing Training and Education seminars for a large corporate project. Prepared Hospital, Physician and other contract models for use in contract negotiations. Analyze utilization data to set pricing structure. Developed an intricate database for Fee Schedule Modeling. Day to day maintenance of physician and ancillary fee schedules. Worked in conjunction with a national vendor to negotiate fees for services performed by out of network providers. Analytical work related to premium protection projects. Maintain database for network providers for various lines of business.

Prepared Client Income Tax Returns. Assisted in the preparation of financial statements. Implemented and maintain a time and billing system for internal operations. Preformed various accounting and bookkeeping functions for clients including input of data to accounting systems, preparation of trial balances and reconciliation of cash accounts. Prepared and processed weekly payrolls for outside clients. Prepared analysis of various general ledger accounts for clients.