Experience

ModusOne Health

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• VP Business Development

  • Oct 2023 - Present



Passport by Molina

• United States
• Insurance
• 100 - 200 Employee

• Director, Provider Network Management

  • Aug 2016 - Jul 2022

  Directs team of 21 provider relations professionals whose goal is to meet and exceed the Department of Medicaid Services (DMS) compliance criteria for network adequacy and service standards for over 32,000 providers across the Kentucky Commonwealth. Manages day-to-day department operations of a high performance team comprised of three provider relations managers who supervised provider relations specialists for Medicare, Medicaid, and Behavioral Health providers, a communications manager, a… Show more Directs team of 21 provider relations professionals whose goal is to meet and exceed the Department of Medicaid Services (DMS) compliance criteria for network adequacy and service standards for over 32,000 providers across the Kentucky Commonwealth. Manages day-to-day department operations of a high performance team comprised of three provider relations managers who supervised provider relations specialists for Medicare, Medicaid, and Behavioral Health providers, a communications manager, a strategy and value-based contracting manager, a business analyst, and a trainer.

• Manager, Provider Network Management

  • Sep 2013 - Aug 2016

  Managed team to onboard an unprecedented 32% growth in the company's statewide provider network, following the Affordable Care Act implementation on January 1, 2014. Ensured each new network provider was contracted, enrolled and claims issues resolved through our team's proactive interaction. Implemented departmental growth with additional managers from six provider relations specialists to 22, including the full range of interviewing, hiring and training, then serving thousands of… Show more Managed team to onboard an unprecedented 32% growth in the company's statewide provider network, following the Affordable Care Act implementation on January 1, 2014. Ensured each new network provider was contracted, enrolled and claims issues resolved through our team's proactive interaction. Implemented departmental growth with additional managers from six provider relations specialists to 22, including the full range of interviewing, hiring and training, then serving thousands of providers new to the Passport network. Utilized background in corporate training to help create onboarding program for new provider relations specialists, as well as initiated quarterly provider webinars. Initiated and oversaw accomplishment for new statewide provider relations team to personally visit every provider in the new statewide network.



Cahaba Government Benefit Administrators LLC

• Birmingham, Alabama

• Operations Provider Enrollment Manager

  • Aug 1998 - Aug 2013

  Held multiple managerial roles in the Medicare Division, Cahaba Government Benefit Administrators, of Blue Cross Blue Shield of Alabama over 15 years. Last held position in company: Operations Provider Enrollment Manager Oversaw and managed merger of two departments (75 associates) and supervised three managers. Led the establishment of a unified department workforce and management team capable of meeting and exceeding strict federal requirements for the Center of Medicare and… Show more Held multiple managerial roles in the Medicare Division, Cahaba Government Benefit Administrators, of Blue Cross Blue Shield of Alabama over 15 years. Last held position in company: Operations Provider Enrollment Manager Oversaw and managed merger of two departments (75 associates) and supervised three managers. Led the establishment of a unified department workforce and management team capable of meeting and exceeding strict federal requirements for the Center of Medicare and Medicaid Services (CMS). Show less Held multiple managerial roles in the Medicare Division, Cahaba Government Benefit Administrators, of Blue Cross Blue Shield of Alabama over 15 years. Last held position in company: Operations Provider Enrollment Manager Oversaw and managed merger of two departments (75 associates) and supervised three managers. Led the establishment of a unified department workforce and management team capable of meeting and exceeding strict federal requirements for the Center of Medicare and… Show more Held multiple managerial roles in the Medicare Division, Cahaba Government Benefit Administrators, of Blue Cross Blue Shield of Alabama over 15 years. Last held position in company: Operations Provider Enrollment Manager Oversaw and managed merger of two departments (75 associates) and supervised three managers. Led the establishment of a unified department workforce and management team capable of meeting and exceeding strict federal requirements for the Center of Medicare and Medicaid Services (CMS). Show less



Cahaba GBA

• Insurance
• 100 - 200 Employee

• Learning and Development Manager

  • Sep 2007 - Nov 2011

  One of several manager roles held in the Medicare Division of Blue Cross Blue Shield of Alabama, Cahaba Government Benefit Administrators LLC Developed and managed new Cahaba training department including supervision of three newly-hired corporate trainers. In 2008, company won a Medicare three-state jurisdiction. Hired to this position to create the first corporate training department in anticipation of the increased workforce. Created a comprehensive training program with… Show more One of several manager roles held in the Medicare Division of Blue Cross Blue Shield of Alabama, Cahaba Government Benefit Administrators LLC Developed and managed new Cahaba training department including supervision of three newly-hired corporate trainers. In 2008, company won a Medicare three-state jurisdiction. Hired to this position to create the first corporate training department in anticipation of the increased workforce. Created a comprehensive training program with opportunities for all employees with over 200 online and instructor-led courses. Implemented multiple training programs including Onboarding for new hires, Master Mentor “train the trainer” program for internal trainers, and job-specific training creation for 10 departments. Recruited to create and manage Provider Enrollment inventory reduction plan for six months while maintaining Learning and Development Manager Position. Successfully reduced backlogs and met CMS goals ahead of schedule. Show less One of several manager roles held in the Medicare Division of Blue Cross Blue Shield of Alabama, Cahaba Government Benefit Administrators LLC Developed and managed new Cahaba training department including supervision of three newly-hired corporate trainers. In 2008, company won a Medicare three-state jurisdiction. Hired to this position to create the first corporate training department in anticipation of the increased workforce. Created a comprehensive training program with… Show more One of several manager roles held in the Medicare Division of Blue Cross Blue Shield of Alabama, Cahaba Government Benefit Administrators LLC Developed and managed new Cahaba training department including supervision of three newly-hired corporate trainers. In 2008, company won a Medicare three-state jurisdiction. Hired to this position to create the first corporate training department in anticipation of the increased workforce. Created a comprehensive training program with opportunities for all employees with over 200 online and instructor-led courses. Implemented multiple training programs including Onboarding for new hires, Master Mentor “train the trainer” program for internal trainers, and job-specific training creation for 10 departments. Recruited to create and manage Provider Enrollment inventory reduction plan for six months while maintaining Learning and Development Manager Position. Successfully reduced backlogs and met CMS goals ahead of schedule. Show less