Susan Wheelwright Email & Phone Number

United States

United States

Contract management for home infusion and specialty pharmacy providers

United States

Contracting

United States

United States

Utah

Greater Salt Lake City Area

• Post-acute network management consisting of Skilled Nursing Facilities (SNF), Home Health agencies, Long Term Acute Care Hospitals, Independent Rehab Facilities• Collaborate with Intermountain Healthcare, post-acute partners and other key stakeholders to reduce readmissions, lower length of stays, and ensure a quality network for SelectHealth members and Intermountain patients• Manage relationships with contracted providers including education of policies, procedures, contractual requirements, compliance, claims research and resolution• Compose and submit change requests for system configuration• Develop and negotiate complex contracts, review contracting language and reimbursement analysis for post-acute network• Create and present revisions to fee schedules and participates in the development of pricing methodologies• Audit fee schedule build and agreement configuration to ensure accuracy and appropriate claims payment• Collaborate with multiple departments and functional units to research, resolve issues and contract compliance

Greater Salt Lake City Area

• Drive sales and revenue by assisting customers in making healthcare decisions • Assist seniors to understand their insurance needs and enroll them to the right Medicare health plan or product• Remain current on products and processes in a multi-product environment

Greater Salt Lake City Area

• Extract and analyze state Medicaid reimbursement structures • Research, monitor and implement Centers for Medicare and Medicaid Services (CMS) rules and regulations• Identify systematic edits to ensure profitability for national client

Greater Salt Lake City Area

• Collaborate and negotiate contracts in Utah and Nevada• Evaluate proposals, the financial impact and present findings to relevant stake holders• Contract preparation and maintenance

Greater Salt Lake City Area

• Manage provider accounts while retaining excellent client relations• Claim analysis and system configuration resolution• Design education materials and present in provider forums