Jennifer Anderson

Experience

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  Nemours

  Aug 1997 - Dec 2019

  Directs and coordinates the Reimbursement Contracts and Benefits Engine system management team. This includes maintaining appropriate Epic masterfiles (reimbursement contracts, networks, payors and plans, benefits engines, fee schedules, etc.) for both the professional practices and the hospitals to ensure proper calculation of accounts receivable and patient benefits. Coordinates system and process improvements for Managed Care. Participates in the negotiation process of managed care contractual matters as needed. Show less Directs and coordinates the Contract System Management and Provider Enrollment functional areas. This includes maintaining provider participation with payor networks and maintaining appropriate Epic masterfiles (reimbursement contracts, networks, payors and plans, benefits engine, fee schedules, etc.) for both the professional practices and the hospital. Directs and coordinates system and process improvements related to the above. Participates in the negotiation process of managed care contractual matters. Show less • Credentialed healthcare practitioners, enrolled these practitioners in managed care networks, and maintained an electronic file system for four clinics in various locations throughout the Florida, which included approximately 225 physicians and affiliate health practitioners.• Processed new managed care contracts, disseminate information regarding contracts to all pertinent staff. Worked with internal and external customers to resolve contractual issues.• Interacted with the Medical Staff and Management to assist in resolving managed care and hospital privileging issues as well as advised on renewal and maintenance of licenses and certifications.• Created training materials as needed to train staff on electronic reference manuals, managed care processes, credentialing, enrollment, and customized databases.• Coordinated special projects including automation of the managed care enrollment process, which allowed for a 300% increase in productivity; coordinated external audits for accreditation agencies and managed care companies, always scoring above 95%; and created various policies and procedures. Show less

  • Managed Care Manager, Analytics

    Nov 2017 - Dec 2019

  • Manager, Contract Modeling and Benefits Engine

    Apr 2012 - Nov 2017

  • Manager, Contract Management and Provider Enrollment

    Nov 2004 - May 2012

  • Provider Enrollment/Credentialing Coordinator

    Aug 1997 - Oct 2004
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  Computer/Software Consultants, Inc.

  Jan 1999 - Jan 2005

  Partner/Marketing Consultant

  Conducted marketing and research for this Central Florida-based partnership. Researched new avenues of business and marketing and developed new marketing ideas. Created and maintained company policies and procedures for employee relations, customer relations, and accounting. Also provided technical support as needed on various client software issues and created client-specific databases using Microsoft Access.

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  Lake-Sumter Community College

  Jan 2004 - Jan 2004

  Instructor

  Instructor for The Computer Institute and the School of Business & TechnologiesCourses taught: Microsoft applications (Word, Excel, Outlook) and Typing/Business Communication.

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  Girl Scouts of Gateway Council

  Jun 2016 - now

  Troop Administrator & Co-Leader

  Dedicated and motivational Girl Scout Troop 1480 Administrator and Co-Leader that brings activities designed to aid in healthy development for girls for our multi-level troop of 30 ranging in ages 5 to 12. Has a strong belief that girls can become leaders in society.

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  Nemours

  Mar 2022 - now

  Director, Managed Care Analytics