Metal Fabricator

• Jun 2023 - Present

Founder

• Mar 2022 - Present

Outpatient Behavioral Health Contracting

• Nov 2021 - Apr 2022

Outpatient Behavioral Health Network Contract Manager for the Pacific Northwest region, with a focus on Idaho Medicaid (Medicare and commercial lines of business, additionally). Outpatient Behavioral Health Network Contract Manager for the Pacific Northwest region, with a focus on Idaho Medicaid (Medicare and commercial lines of business, additionally).

Provider Contract Specialist

• May 2020 - Oct 2021

Responsible for the implementation of standardized contracts and reimbursement rates. Monitor the adequacy and performance of multi-specialty provider networks. Ensure Blue Cross of Idaho networks meet the needs of its membership and operates in compliance with regulatory requirements. Maintain a positive, collaborative and effective relationships between Blue Cross of Idaho and the various health care provider communities. Responsible for the implementation of standardized contracts and reimbursement rates. Monitor the adequacy and performance of multi-specialty provider networks. Ensure Blue Cross of Idaho networks meet the needs of its membership and operates in compliance with regulatory requirements. Maintain a positive, collaborative and effective relationships between Blue Cross of Idaho and the various health care provider communities.

Contract Development Manager II (Western United States)

• Oct 2018 - Jul 2019

 Responsible for network development, recruiting for new business, contracting, and rate negotiations for the Western Region to include Idaho, Montana, Utah, New Mexico, Arizona, Nevada, California, Oregon, Washington, Alaska, and Hawaii.  Negotiate rates and contract terms with currently contracted Behavioral Health providers and facilities.  In conjunction with internal and external stakeholders, secure executed agreements with identified out-of-network providers for inclusion in the Beacon Health network.  Perform reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards, and develop strategies for cost reductions, member needs, and increasing quality.  Identify opportunities for cost savings and process improvements related to the contracting process.  Review, draft, document, and suggest language changes, and oversee resolution of all proposed changes to the provider services agreement.  Ensure contract language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.  Collaborate with other departments to address and resolve operational issues as related to negotiated contract language.  Identify opportunities to utilize value-based payments to aid in contracting providers with uncommon licensure into the Beacon Health network, and determine appropriate reimbursement structure and key performance indicators by which to incentivize.  Gather, review, and submit credentialing applications, as required, for network development and management to ensure complete coverage of the provider network.  Strategize with other members of the management team and client/plan to ensure access and availability of providers meets current standards and contractual obligations. Show less

Contracts, Program Specialist

• May 2016 - Oct 2018

 Monitor contract performance, ensure vendor compliance and quality assurance of vendor provided goods and services within the State of Idaho's Department of Health and Welfare medical care bureau.  Aid in the procurement and implementation of new large scale contracts.  Build and maintain healthy and cooperative relationships with medical care providers and vendors contracted through the State of Idaho.  Aid in the development of new policies and procedures related to the techniques and metrics by which contract performance is evaluated. Show less

Assembly Manager

• Jun 2013 - Mar 2016

 Assisted in the documentation and streamlining of a machine gun assembly line, leading to reduction in production processes and increasing daily throughput by roughly 30%.  Aided in the planning and procurement of large contractual manufacturing orders for the United States and allied governments.  Oversaw the general operation of four different machine gun assembly lines, with a main focus on the M240/MAG58 machine gun and its variants.  Created assembly process manuals in accordance with the ISO 9001:2008 Quality Management Standard.  Created technical manuals for multiple firearms, documenting the maintenance, disassembly, reassembly, and troubleshooting of each weapon.  Acted as an inter-department liaison to resolve issues or miscommunication between multiple departments.  Acted in a research and development role, which resulted in the discovery and renovation of multiple manufacturing and engineering errors.  Occasionally acted in a sales engineering position, providing product demonstration, presentations, and technical expertise which aided in the procurement of a multi-million dollar allied government contract. Show less

Infantry Team Leader

• Aug 2007 - Aug 2012

 Responsible for the physical and mental readiness of 4-8 personnel in order to endure long periods of time living and operating in austere environments.  Directed subordinates and superiors by providing tactical and technical guidance.  Communicated orders and directions effectively to a team of 4-8 personnel.  Surveyed and analyzed terrain to determine optimum placement of equipment and personnel.  Forecast and adjusted decisions in a high stress environment.  Operated and maintained equipment valued in excess of $500,000. Show less