Experience

Valley Health Plan

• United States
• Insurance
• 100 - 200 Employee

• Program Manager III, Network Development

  • Jan 2022 - Aug 2022



Health Plan of San Joaquin

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Director Provider Contracting

  • Jan 2020 - Aug 2021



Blue Shield of California

• United States
• Insurance
• 700 & Above Employee

• Manager, Provider Services- Relations

  • Mar 2019 - Jan 2020



OUTZEN-SPICER GROUP, LLC, THE

• Arroyo Grande, California

• Director

  • Mar 2018 - Jan 2020

  Working with the Outzen-Spicer LLP leadership to define marketing opportunities for health care facility security assessments and marketing active shooter response training for health care facilities. Working with the Outzen-Spicer LLP leadership to define marketing opportunities for health care facility security assessments and marketing active shooter response training for health care facilities.



On Sabbatical

• Professional Sabbatical

  • Apr 2017 - Mar 2018

  After my last position ended, I made the decision to take a year off from working and delayed my search for my next role. I used this time to re-assess my career goals and skill sets to make sure I was focusing my efforts on industries where I could make best use of my skills and add value to both my future employer and myself. This was a great opportunity to reenergize myself, reconnect with family and friends, and to reaffirm my desire to continue working in the health and managed care… Show more After my last position ended, I made the decision to take a year off from working and delayed my search for my next role. I used this time to re-assess my career goals and skill sets to make sure I was focusing my efforts on industries where I could make best use of my skills and add value to both my future employer and myself. This was a great opportunity to reenergize myself, reconnect with family and friends, and to reaffirm my desire to continue working in the health and managed care fields. This time also provided the opportunity to refine my personal and professional mission of working to improve the lives and health of others, while continuing to become the best version of myself. Show less After my last position ended, I made the decision to take a year off from working and delayed my search for my next role. I used this time to re-assess my career goals and skill sets to make sure I was focusing my efforts on industries where I could make best use of my skills and add value to both my future employer and myself. This was a great opportunity to reenergize myself, reconnect with family and friends, and to reaffirm my desire to continue working in the health and managed care… Show more After my last position ended, I made the decision to take a year off from working and delayed my search for my next role. I used this time to re-assess my career goals and skill sets to make sure I was focusing my efforts on industries where I could make best use of my skills and add value to both my future employer and myself. This was a great opportunity to reenergize myself, reconnect with family and friends, and to reaffirm my desire to continue working in the health and managed care fields. This time also provided the opportunity to refine my personal and professional mission of working to improve the lives and health of others, while continuing to become the best version of myself. Show less



Stanford Health Care

• Hospitals and Health Care
• 700 & Above Employee

• Director Managed Care

  • Jul 2015 - Apr 2017

  Negotiate and manage capitated payer agreements on behalf of University Healthcare Alliance, a Stanford Health Care affiliated medical group. Support business and clinical operations in contract interpretation and dispute resolution. Analyze payer arrangements and provide strategic guidance for practice acquisitions,developing and executing project plans to maintain key payer relationships and patient base. Negotiate and manage capitated payer agreements on behalf of University Healthcare Alliance, a Stanford Health Care affiliated medical group. Support business and clinical operations in contract interpretation and dispute resolution. Analyze payer arrangements and provide strategic guidance for practice acquisitions,developing and executing project plans to maintain key payer relationships and patient base.



Sutter Health - Palo Alto Medical Foundation

• United States
• Medical Practices
• 700 & Above Employee

• Director II, Clinical Services

  • Aug 2008 - Feb 2015

  Leadership responsibility for special clinical projects impacting local and regional operations, pandemic flu planning and response, annual community influenza vaccination clinics, volunteer programs, float coverage, call center management, support of strategic growth initiatives, and the Mobile Clinic. Previously responsible for local Call Center and Operators, Practice Management team leadership and practice acquisitions supporting growth of the organization.

• Project Manager, Clinical Services

  • Jan 2007 - Aug 2008

  Led all aspects of assigned projects including creation of project charter, scope documentation, project planning, project team definition and project management. Examples of project work included development of PAMF’s Pandemic Response Plan, planning and facilitation of annual table top pandemic planning exercises to assure the organization’s ability to respond to a pandemic event, new practice acquisition planning and execution, and working with both clinical and non-clinical stakeholders in… Show more Led all aspects of assigned projects including creation of project charter, scope documentation, project planning, project team definition and project management. Examples of project work included development of PAMF’s Pandemic Response Plan, planning and facilitation of annual table top pandemic planning exercises to assure the organization’s ability to respond to a pandemic event, new practice acquisition planning and execution, and working with both clinical and non-clinical stakeholders in the development of medication refrigeration standards for the Palo Alto Division.

• Director, Contracting Operations

  • Oct 2001 - Dec 2006

  Provider and payer contract negotiation and contract management, internal/external relationship management, training, industry research and tracking, and operational support.



San Francisco Health Plan

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Director, Provider Relations

  • Feb 1999 - Sep 2001

  Overall responsibility for local (Medi-Cal) health plan contracting (payer and provider) and provider relations activities, management of compliance activities, including requirements of both state and federal programs which provided funding and oversite of organization. Responsible for business/product expansion documentation, including Department of Managed Health Care filings, and HIPAA compliance. Overall responsibility for local (Medi-Cal) health plan contracting (payer and provider) and provider relations activities, management of compliance activities, including requirements of both state and federal programs which provided funding and oversite of organization. Responsible for business/product expansion documentation, including Department of Managed Health Care filings, and HIPAA compliance.



Catholic Healthcare West

• San Francisco Bay Area

• Manager, Managed Care

  • 1997 - 1999

  Responsible for payor contract negotiation, strategic planning, financial analysis, marketing, research and consultant services for 45+ hospital system. Project responsibilities include development and facilitation of a revenue enhancement program, assist in system-wide home health/home infusion contracting strategy, development of reporting format for capitated and non-capitated financial data, and participation in care management program development. Responsible for payor contract negotiation, strategic planning, financial analysis, marketing, research and consultant services for 45+ hospital system. Project responsibilities include development and facilitation of a revenue enhancement program, assist in system-wide home health/home infusion contracting strategy, development of reporting format for capitated and non-capitated financial data, and participation in care management program development.



Pacific Health Alliance

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

• Director, Provider Relations

  • 1994 - 1997

  Managed and directed provider relations and contracting activities for local PPO organization, developed and managed credentialing program (applications, primary source verification, health plan auditing), recruited and contracted providers to form IPA networks, supporting organizational growth. Managed and directed provider relations and contracting activities for local PPO organization, developed and managed credentialing program (applications, primary source verification, health plan auditing), recruited and contracted providers to form IPA networks, supporting organizational growth.