Experience

Western Technical College

• Higher Education
• 1 - 100 Employee

• Medical Administrative Professional Advisory Committee

  • Feb 2017 - Present

  Participating committee member. Participating committee member.



SSM Health Care/Dean Health Plan, Inc.

• Contracting Specialist

  • Oct 2014 - Present

  • Function as main point of contact for assigned service area for all contractual matters related to specialty care physician groups, larger primary care providers, and all other providers needed to form a complete network.• Responsible for negotiating single case agreements from non-contracted providers.• Build relationships with providers by meeting face to face or utilizing other communication mechanisms.• Draft, distribute, negotiate and execute provider contracts, amendments, single case agreements and letters of agreement.• Independently negotiate specialty physician group, larger primary care clinic and ancillary limited services provider contracts, using financial modeling and contract language that meets business, regulatory and operational requirements that are within established guidelines.• Respond to inquiries and/or concerns received from internal and external parties regarding contract terms; assist in the resolution of contract issues, and obtain assistance from appropriate health plan staff and management, as necessary in order that any concerns are resolved in a timely manner.



Christ Episcopal Church

• United States
• Religious Institutions
• 100 - 200 Employee

• Senior Warden

  • Jan 2011 - Jan 2017

  Meet regularly with the rector to review the life and work of the congregation, planahead, anticipate and resolve problems,Provide leadership so that the vestry can help implement plans, assess progress andcelebrate achievements in line with the vision, mission and goals of the congregation.Provide leadership in the congregation by demonstrating a consistently positive attitudethat seeks to solve problems, recognizes accomplishments and gives thanks for thosethings that build community and further the mission of the Church.Be available to discuss any and all concerns with the rector; maintain confidentialitywhere appropriate;Be available to discuss any and all concerns with members of the congregations; avoidmaking hasty judgments; avoid triangles by encouraging complainants to speak to thoseinvolved;Foster understanding, forgiveness, and reconciliation, in cases where the rector, staff orvestry is beleaguered or unfairly criticized;Ensure that policies and procedures are in place and enforced regarding employee andvolunteer misconduct; take any questions, concerns, and complaints to the rector and/orappropriate authorities immediately;Support the rector in taking action when employees or volunteers are charged withmisconduct or inappropriate behavior;Take action to intervene promptly (with others as appropriate) in the event that the rectoris charged with misconduct, has problems with drugs or alcohol or is actinginappropriately; speak with the rector and the bishop;Petition the bishop in writing on behalf of the vestry to intervene in cases where conflictimperils the pastoral relationship between the rector and congregation;Encourage the rector to take corrective steps as appropriate in cases where the rector isoverworked, disregarding his/her health and well-being, or that of his/her family;Assist in identifying persons for leadership roles and participate in inviting them to servein those roles;



Group Health Cooperative of Eau Claire

• United States
• Insurance
• 1 - 100 Employee

• Network Development Manager

  • Jan 2008 - Jan 2014

  Non Profit Health Insurance Company. Primarily working with Medicaid and Medicare HMO products, however we have commercial and other government products. We partner with other Health Insurance companies to administer their operational and network development aspects in order to meet compliance recommendations for these products. I have over 20 years experience in all aspects of the health insurance industry. Non Profit Health Insurance Company. Primarily working with Medicaid and Medicare HMO products, however we have commercial and other government products. We partner with other Health Insurance companies to administer their operational and network development aspects in order to meet compliance recommendations for these products. I have over 20 years experience in all aspects of the health insurance industry.



Gundersen Lutheran Health Plan

• United States
• Medical Practices

• Provider Network Administrator

  • Jun 1996 - Jan 2008

  • Establish and maintain provider contractual relationships in order to ensure integrity and favorable financial agreements for Gundersen Lutheran and Gundersen Lutheran Health Plan.• Develop and implement provider compliance monitoring systems in order to ensure compliance with contractual agreements for Gundersen Lutheran and the Gundersen Lutheran Health Plan.• Design and implement educational campaigns in order to increase provider understanding of Gundersen Lutheran and the Gundersen Lutheran Health Plan.• Develop external contacts in order to identify providers with whom to develop mutually beneficial contractual relationships for Gundersen Lutheran and the Gundersen Lutheran Health Plan.• Develop and provide communication of new or changed terms of provider contractual agreements in order to provide current provider information for Gundersen Lutheran and Gundersen Lutheran Health Plan departments.• Analyze and audit provider profiles in order to develop effective contractual provisions for Gundersen Lutheran and the Gundersen Lutheran Health Plan.



Wisconsin Physicians Service

• United States
• Insurance
• 1 - 100 Employee

• Contract Services

  • 1991 - 1996