Brigette Reid
Account Executive II at Prestige Health Choice- Claim this Profile
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Bio
Experience
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AmeriHealth Caritas Florida
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Hospitals and Health Care
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1 - 100 Employee
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Account Executive II
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Dec 2013 - Present
Manage recruitment and retention activities for providers including physicians and all ancillary providers. Review and maintain provider contract documents to ensure that documents submitted are accurate and complete and fee schedules are appropriate for specific specialty. Abides by all compliance requirements for the Department of Insurance (DOI), Agency for Health Care Administration (AHCA) and the Centers for Medicare and Medicaid Services (CMS) as these apply to the Provider Relations Department activities. Work closely with Claims, Quality Management, Member Services and other departments to resolve provider issues. Establish and maintain strong provider relationships with offices to assure stability and trust.
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Physicians United Plan "PUP"
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United States
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Insurance
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1 - 100 Employee
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Director, Hospital Contracting
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Feb 2013 - Sep 2013
Negotiate hospital and allied providers’ contracts that are favorable to the Health Plan business strategy and that will create new business opportunities. Developed plans to reduce unit cost for hospital and allied providers. Implement strategies for network and expansion markets. Negotiate hospital and allied providers’ contracts that are favorable to the Health Plan business strategy and that will create new business opportunities. Developed plans to reduce unit cost for hospital and allied providers. Implement strategies for network and expansion markets.
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UnitedHealth Group
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Hospitals and Health Care
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700 & Above Employee
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Senior Network Account Manager
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Feb 2008 - Feb 2013
Negotiated hospital and large specialty groups for all products, developed strategy for contracting FQHCs and RHCs for Medicaid expansion project, identified gaps in network to remain compliant with government regulations and Health Plan competitor for Medicaid filing. Negotiated hospital and large specialty groups for all products, developed strategy for contracting FQHCs and RHCs for Medicaid expansion project, identified gaps in network to remain compliant with government regulations and Health Plan competitor for Medicaid filing.
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Beech Street -A Viant Network
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Tampa/St. Petersburg, Florida Area
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Assistant Director, Network Services
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Sep 2005 - Nov 2007
Negotiated hospital, PHOs and IPA contracts to support Health Plan's unit cost and trend objectives. Conduct market analyses to implement network management actions. Conduct financial analyses to achieve targeted and budgeted results in support of network access objectives. Negotiated hospital, PHOs and IPA contracts to support Health Plan's unit cost and trend objectives. Conduct market analyses to implement network management actions. Conduct financial analyses to achieve targeted and budgeted results in support of network access objectives.
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Wellpoint Health Network/UNICARE Health Plans
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Greater Chicago Area
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Contract Manager
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1998 - 2005
Negotiated contract language and reimbursement rates for hospitals and PHOs, renegotiated competitive rates to assist Health Plan in meeting sale goals, acted as primary liaison for Network Management and Sales, Marketing, Legal and Operations. Negotiated contract language and reimbursement rates for hospitals and PHOs, renegotiated competitive rates to assist Health Plan in meeting sale goals, acted as primary liaison for Network Management and Sales, Marketing, Legal and Operations.
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Education
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University of Phoenix
BS, Business Management