Stephen Ballinger Email & Phone Number

Tallahassee, FL, US

New York, New York, US

Hartford, Connecticut, US

• Improved the new Durable Medical Equipment (DME) compensation model by implementing a new Schedule B applicable across all operational markets and driving aggregation between all active contracts (by examining and.
• Managed partner/vendor relationships and negotiated fee-for-service/value-based contracts with large health systems/key provider partners while establishing improved workflows through best practices.
• Developed and proposed creative deals that balanced the provider’s needs and Aetna’s financial goals while maintaining high compliance with risk management standards.
• Collaborated cross-functionally to ensure consistency with all contracting strategies while meeting or exceeding accessibility, quality, compliance, financial goals, and cost initiatives.
• Provided network development, maintenance, and refinement activities/strategies supporting cross-market network management while assisting with designing, managing, and implementing strategic network configurations and.

Fort Lauderdale, FL, US

• Negotiated contracts to build Sunshine’s Product line, including commercial exchange while converting existing providers to shared risk agreements.
• Evaluated and monitored providers’ performance standards and financial performance of contracts while assisting/tracking credentialing activities and facilitating/overseeing contract configuration to ensure accurate.
• Identified and initiated contacts with potential providers while coordinating with internal departments and contracted providers to implement and maintain contract compliance.

Fort Lauderdale, FL, US

Developed and built a network for all all Products, including commercial lines. Worked on contracted negotiations, financial modeling and adequacy requirements. Leading and developing a team to help improve processes relating to operations and expansion efforts around Florida

Ashburn, Virginia, US

• Collaborated with the State of Florida and healthcare insurers to implement necessary adjustments to system configurations while supervising the team’s workload to ensure adequate client support and timely service.

Tampa, Florida, US

• Negotiated and developed WellCare’s Medicaid provider network and their MA Plan while overseeing physician contracting, network development, and provider relations and delivering services and education to network.
• Partnered with providers regarding Medicare/Medicaid reimbursement methodologies while liaising with medical management and sales to formulate strategies for achieving market growth and medical cost objectives.

• Executed a streamlined approach for reconciling payments with contracted providers by automating the entire process and consolidating all deliverables into a single document, reducing delivery time from 2 weeks to 24.

• Supported providers in submitting Encounter Data and ensuring compliance with their contractual obligations, as well as in OASIS and MDS data transmissions, while guiding them through Medicare/Medicaid compliance steps.

Tallahassee, FL, US

• Led all aspects of costly renovation and new construction projects while collaborating with third-party vendors to complete projects within budget efficiently.
• Worked closely with customers by applying active listening skills to deliver improved customer service while serving at the IT help desk, addressing and resolving a wide range of IT issues encountered by customers.

Bachelor'S Degree, Communication And Media Studies

Associate Of Arts (Aa), General Studies