Troubleshoot complaints and grievances from providers and members and following through to a resolution.Responsible for the administration of contracts which includes; claim systems set up, database loading, and preparation of contract materials. Analyze provider network, identifying gaps in network composition and services.Represent UUHP at Medicaid and Utah Health Information Network conferences.Negotiate contracts and letter of agreements to get the most cost effective rates.Participate on the UUHP Fraud and Abuse Committee.Manage credentialing for UUHP medical providers.Develop and maintain relationships with UUHP provider network consisting of physicians, hospitals, skilled nursing facilities, home health, and ancillary groups.Coordinate an oversee continuing education of providers via Provider Manual, Newsletter and bulletins.Maintain and update provider databases and directories.Conduct office site visits and office site audits.Produce bi-annual UUHP Provider Newsletter.Host provider luncheons and educational workshops.Assist in disseminating UUHP departmental information.Recruit specialty providers to strengthen and enhance provider network.Analyze fee schedule to negotiate contracts and resolve payment disputes.Create new forms and spreadsheets to streamline efficiency.Mentor new hires and provide guidance and support for co-workers.Educate providers on UUHP, Medicaid and Medicare policies.Administer "New Provider" applications including collection of required data to present to the Provider Relations Committee.Maintain a competitive, accessible and stable provider network.Produce provider satisfaction survey.Review and assess contract language to maintain UUHP compliance.Work with and exceed relations with Utah Medicaid Health Program Representatives.Assist Contracting Manager on special projects.

Coordinated flow of information between medical staff and hospital departments to maximize unit efficiency and patient care. Reviewed all physician orders and transcribed in the appropriate medical forms. Presented orders to nurse for accuracy and coordination of orders. Referred calls from laboratories and report lab results to the physician and nurse staff. Transcribed drug name, dosage, route and frequency on medical records. Coordinated all admissions and discharges with Charge Nurse and admitting office. Arranged for special blood draws, labs, X-Ray's, CT's and MRI's. Provide customer support for patient families.

Liaison for SLOC Ceremonies Department to State, Local & Federal Agencies. Supervised, trained and scheduled Olympic Ceremonies Cast Participants. Coordinated Olympic cultural entertainment at the Soldier Hollow Amphitheater. Developed the "Front of House" look for the Soldier Hollow Spectator Plaza & Promenade. Coordinated safety and security issues with the United States Secret Service. Performed special projects as requested from the Director of Ceremonies Production. Managed contract with the State of Utah Division of Natural Resources. Administered budget for Western Experience special event programming. Interfaced with SLOC departments to promote & produce Winter Olympic Games. Coordinated all facets of Western Experience Visual Arts and Performing Artists. Envoy for SLOC to the Northern Ute Indian Nation. Responsible for overall operation of the Soldier Hollow Spectator Plaza & Promenade, including cleanliness, snow-removal, security and maintenance.

Recruited Surgeons via exploratory phone conversations and at medical conventions. Established and maintained rapport with physicians to encourage long-term working relationships. Lectured to medical residents regarding malpractice insurance and career opportunities. Coordinated travel arrangements for locum tenens physicians. Requested and verified documentation and information pertaining to medical school, internship and residency, licenses, hospital privileges and recommendation letters. Facilitated placement of physicians into medical facilities by matching physician skill level, licenses, preferences, board status and credentials.

Referred IHC Health Plan members to the appropriate provider within the IHC Health Network. Assisted members in making appointments with their health provider using IDX scheduling. Promoted IHC TeleHealth services via phone, trade shows and expos. Resolved customer inquiries & problems for IHC Health Plan Members. Administered confidential files and correspondence with physicians and health clinics. Developed phone etiquette and customer service training for IHC Advocates. Rotated on "Nurse Triage" telephone line to assist in high volume of incoming calls. Traveled to IHC Health Clinics in Utah & Wyoming, to promote IHC Advocate service. Researched, resolved & adjudicated problems for health plan members and providers.

Hired, trained and supervised over 70 full time and seasonal employees. Tracked expenses, deposited checks and cash and oversaw personnel payroll. Developed marketing programs and pricing strategies for Spa. Managed spa reservation system and customer service desk. Monitored inventory and ordered new retail inventory for Spa Boutique & Salon. Responsible for the daily operation of 20 spa therapy rooms, 2 outdoor heated pools, 2 locker rooms, and 2 sauna & steam rooms and 1 exercise room.

Negotiated and settled automobile and property damage insurance claims. Investigated insurance liability and insurance fraud.

Responsible for operation of Taggart Student and Conference Center. Coordinated special event logistics: security, catering audio visual and public relations. Monitored and deposited daily revenues from the Gift Shop and Movie Theater. Hosted celebrity speakers and Gold Medal Olympians at Utah State Convocations. Managed banquet & meeting room set up staff.