Scott Walkiewicz Email & Phone Number

San Francisco Bay Area

Healthcare consultant with provider and payor experience, highly experienced with health plan operations.Recent client engagements include: Program Manager for a multi-state Health Plan expanding Medicaid services in Virginia to offer MLTSS and other Waiver Services for high-intensity members. DSNP product implementation support for a regional Medicaid.

Louisville, Kentucky Area

Responsible for all provider network operations including contracting & recruitment, provider relations, customer service, directories, credentialing, network access, and vendor services for newly created local PPO Network. Additionally, I managed leasing negotiations and the relationships with the TPAs that provide ASO services for our self-funded.

Louisville, Kentucky Area

Provided objective assurance, consulting, and business advisory services that evaluate and improve the effectiveness of risk management, control, and governance processes related to the Medicare segment.

Louisville, Kentucky Area

• Negotiated and administered contracts with hospitals, physician groups, and other healthcare providers.
• Responsible for maintaining a network of providers for commercial and Medicare products.
• Analyzed reimbursement proposals; maintained targeted trend goals. Achieved a.98% repricing factor in January 2009 & 2010.
• Administered contract terms and conditions, including inflationary adjustments, price protection, and terminations.
• Maintained working relationships with key… Show more Negotiated and administered contracts with hospitals, physician groups, and other healthcare providers.
• Maintained working relationships with key provider staff, consulting firms, and billing organizations. Troubleshoot claims issues and performance problems, added/removed providers from practices, and coordinated.

Louisville, Kentucky Area

• Negotiated and administered contracts with networks, insurance companies, and other payers.
• Held main responsibility for negotiating profitable contracts for health delivery system, including hospital, a multi-specialty physician group, urgent care centers, and other ancillary services.
• Collaborated with analysts to develop and maintain pricing models for reimbursement.
• Evaluated contract and payer performance; revised payment terms or methodologies as needed.
• Prepared… Show more Negotiated and administered contracts with networks, insurance companies, and other payers.
• Prepared credentialing and re-credentialing applications or other documentation to demonstrate compliance.

Louisville, Kentucky Area

• Held full recruitment responsibility for over 40 departments in a large community hospital.
• Coordinated web-based and traditional applicant flow to management for nursing, allied health, and service departments.
• Functioned as consultant for management in areas of candidate selection, position control, and employee relations.
• Customized HRIS (applicant tracking software) for enhanced reporting and measurement.
• Maintained positive relationships with academic, professional, and… Show more Held full recruitment responsibility for over 40 departments in a large community hospital.
• Maintained positive relationships with academic, professional, and peer organizations. Show less

Louisville, Kentucky Area

Coordinated functional activities of a service department within a 400+ bed community hospital.

Mba, Business Administration

Bachelor'S, Biology

Education record