Toni Wetrich, Mha Email & Phone Number

Des Moines, Ia, Us

Des Moines, Ia, Us

Saint Louis, Mo, Us

• Fostered teamwork for remote-based employees. • Developed new and existing employee and provider training material, educational material, and provided oversight of the departmental training needs.• Developed and annually reviewed departmental policies and procedures.• Conducted training with providers, in-person and through Zoom, Go-To Meeting, & Zoom webinar platforms to enhance provider engagement, experience, and to elevate HEDIS measures and CAHPS Provider Satisfaction.• Worked directly with vendor organizations such as Evolent (formerly RadMD/NIA), Access2Care, Envolve Vision, PaySpan, Optum Pricing, and Change Healthcare.• Directed process improvement with P.D.S.A. (Plan, Do, Study, Act) Initiatives.• Conducted oversight of the posting, organization, accuracy, and relevance of provider pages on the website.• Directed and implemented strategies related to the development and management of the provider network.• Collaborated with the investigation team (SIU) with research in potential fraud, waste, and abuse cases.• Coordinated claims research and resolution of escalated issues that are generated from key stakeholders, utilizing SQL Benthic Golden queries, as well as Amisys and MicroStrategy software.• Redesigned processes to handle complex and escalated issues and streamline communication processes.• Acted as an escalated liaison between providers, health plans and corporate, and state Medicaid partners, including investigating and resolving provider issues.

Eden Prairie , Mn, Us

• Managed a provider network, analyzed provider performance, and created provider reimbursement arrangements.• Coordinated claims research and resolution utilizing Facets, COSMOS, and FIS Workflow Manager (formerly Macess).• Worked on end-to-end provider claim quality, ease of use of provider portals, training and development of external provider education programs.• Expanded the Medicaid market in 2016 and then furthered the expansion into the Medicare program in 2018 with D-SNP (Dual Special Needs Programs).• Onboarded, trained and assisted new teams implementing programs remotely for markets in Iowa, California, Nebraska, Texas, and Hawaii.• Identified gaps in network composition and prioritized contracting needs, including identifying and remediating operational short-falls and researching and remediating claims issues within the system.• Conduced on-site visits and training with providers as well as through Zoom meetings and webinars.• Worked directly with vendor organizations such as Superior Vision, Delta Dental, Access2Care, and Magellan.

• Conducted weekly staff meetings and delegated tasks pertaining to marketing, admission of patients, and staff/employee relations.• Directed cross-functional teams in executing comprehensive marketing strategies to drive growth and increase brand awareness.• Analyzed market trends, competitor activity, and consumer behavior to implement initiatives resulting in a 20% increase in business that was steadily maintained.• Designed compelling promotional materials, including website content, social medica campaigns, and print collateral to engage clients.• Participated in the development and implementation of policies and procedures.• Interviewed and trained staff throughout 7 facilities in Iowa and balanced the departmental budgets for one facility.• Met with patients and their families to discuss their healthcare options with their Medicare & Medicaid insurances.• Coordinated social service needs with nurses, physicians, and social workers.• Represented the organization at health provider network meetings, conference booths, and various presentations.

Carroll, Ia, Us

• Conducted various data collections for internal and external reporting including but not limited to cesarean sections, infectious diseases, Emergency Department utilization, and patient satisfaction.• Coordinated medical staff meetings and set agendas.• Conducted licensure verifications and credentialing for 500+ Active, Courtesy, Contract Courtesy, Allied Health, and Reference professionals ensuring compliance with local and federal laws and regulations.• Implemented patient satisfaction into a self-administered HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) program and then transitioned the program to Press Ganey Associates with oversight in 2012.• Created patient forms, educational material, PowerPoints, and newsletters utilizing Microsoft Office tools.• Trained in and served as a SME for Meditech (EHR), JotForm, and DocuSign.• Planned, organized and implemented human resource functions alongside human resource department.• While employed, also served as a volunteer on boards for the associated Wellness @ Work and the hospital auxiliary.

Jackson, Ms, Us

Planned and presided at 2 Regional Conventions; Served as a member of the Iowa Executive Board and attended meetings; Conferred regularly with the Iowa Regional Coordinator; Attended and spoke at several chapter meetings, induction ceremonies, and graduations; maintained communication with 29 chapters throughout the state of Iowa; traveled regularly throughout the state; developed and implemented an Officer training for Chapter Officers from the Iowa Region to attend, and installed the regional officers for the new term.Led the Iowa Region at the International Convention held in Grapevine, TX and attended the Honors in Action Academy.Attended the International Honors Institute held at the University of Richmond in Virginia.Completed the Phi Theta Kappa Leadership Studies: A Humanities Approach.Received the International Distinguished Regional Officer Award.

Provided inbound call and online chat technical support for Sony Tape Storage devices, Sony CD/DVD drives, and many different internet providers. Met with companies to obtain goal objectives to provide quality outcomes for both the company and its customers. Trained new employees on technical support, customer service, and verbal and written communication skills.

Provided pre-screening services for Ian Buchli, O.D., fit patients for glasses, provided education to patients on how to insert, remove, and care for contact lenses, and filed insurance claims”. Scheduled appointments, trained new employees, provided great customer services to the public, general office management.

Distribution of medication to residents as well as providing daily care to residents.

Mha, Master'S Of Healthcare Administration, Health/Health Care Administration/Management

Bhm, Healthcare Management

Aa, Liberal Arts

Cma, Certified Medication Assistant