Susan Waldman, Ms Hsa Email & Phone Number

Florida, United States

Broward, Palm Beach

Deerfield Beach, Florida, United States

Miami/Fort Lauderdale Area

Responsible for analysis of physician and hospital performance in full risk environment. Contract negotiation and process improvement for optimal patient outcomes and value-based cost efficiency.

Florida

Responsible for statewide Medicaid contracting and provider relations. Expand Value Based arrangements and manage provider performance and data analysis.

Sunrise, Florida

Negotiate provider agreements and manage network development department. Direct value based contracting, including risk arrangements. Manage Medical Loss Ratio (MLR), Medical Risk Adjustment (MRA) for appropriate medical spend. Design comprehensive reporting packages with analytics team for provider coaching and optimal performance. Participate in the.

Florida Regional Office

Physician Network Development and Quality Initiatives. Responsible for growth of Tenet's Accountable Care Organization (ACO) through physician contract negotiation and development of clinical quality Initiatives.

Nationwide Medical Recruiter/Account Executive.

Led physician credentialing and hospital privileging department, managing a staff of 20, for nationwide physician organization specializing in hospital based Neonatology, Maternal-Fetal Medicine, Pediatric Cardiology and Anesthesiology.

Manager of Insurance Services for affiliated physician practices nationwide. Developed and managed Medical Centers Of Excellence, a hospital based referral program with renowned organizations, including Memorial Sloan-Kettering Cancer Center, Cleveland Clinic, UCLA Health System, University of Miami Miller School of Medicine, Baylor Clinics, Hospital for.

Medical practice management, including payer contract negotiation, claims, A/R, financial reporting and analysis, staff training, medical triage, referrals and appointments.

Directed physician contracting, provider relations and credentialing for the southern region, negotiating fee for service, risk and and case rate contracts with hospitals and providers. Helped develop company wide credentialing standards in accordance with client needs and successfully lead the NCQA accreditation process for the region.

M.S., Health Services Administration

B.S., Psychology