Sharon P. Matthews, M.P.H.

Experience

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  Henry Ford Hospital

  Jan 1979 - Jan 1983

  Clinic Administrator

  Responsible for management of Department of OB/GYN, Medical Genetics and Birth Defects Center, Department of Pediatrics and contract negotiations for community based primary care physician services.• Negotiated physician contracts between the hospital and Detroit Health Department resulting in the Availability and accessibility of primary care physicians in medically underserved neighborhoods.• In collaboration with Departmental Chairman, operationalized the Medical Genetics and Birth Defects Center.• Consolidated clinic services which resulted in a quarter million dollar savings to the hospital. Show less

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  St. Joseph Mercy Hospital

  Jan 1983 - Jan 1985

  Director of Planning

  Responsible for development and implementation of long range and program planning for 531 bed teaching hospital and building consensus amongst Governance, Medical Staff and Management in setting five year organizational goals and strategic directions.• Researched and prepared market analysis to support hospital long-range plan.• Developed business strategies and set parameters for organizational direction and resource commitment.• Developed plans for ambulatory subsidiary and initiated development of the organizational structure.• Prepared a Certificate of Need and associated plans for a satellite hospital.• Assisted Vice Presidents and Department Heads with the translation of hospital goals into hospital services. Show less

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  St.Joseph Mercy Hospital

  Jan 1985 - Jan 1986

  Administrative Director for Professional Services

  Responsible for operations and financial management of the Departments of Anesthesia, Emergency Services, Ambulatory Surgery, Minor Procedures, Outpatient Clinics, Dental Center and Employee Health Service.• Managed Ambulatory Surgery Renovation Project to support growth of the Ambulatory Surgery department.• Developed a Service Plan for Emergency Services and Program Plan for Urgent Care Services to preserve and enhance market share.• Consolidated Outpatient Clinic Services resulting in decreased overhead expenses.• Established a hospital/medical staff sponsored Maternal-Infant Care Outreach Program to address the needs of uninsured pregnant women and teens. Show less

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  Matthews Consultanting

  Jan 1986 - Jan 1988

  Health Care Consultant

  Provided consultant services to the Health Facilities Division of the Health Alliance Plan (a subsidiary of Henry Ford Health Care Corporation). Responsibilities included analyzing market share trends and utilization patterns to support the development of options, recommendations and marketing strategies to favorably impact market share and service utilization.Provided physician office practice management services including billing, scheduling, staff development and day to day operations to physicians in private practices. Show less

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  The Wellness Plan

  Jan 1988 - Dec 1992

  General Manager of decentralized HMO satellite IPA operation. Responsible for day-to-day operation and financial management including provider contracting, IPA network development and management, provider and member relations, claims processing, utilization review, marketing and sales.• Expanded provider network by 25%, eliminating Plan and member reliance on a single delivery system.• Improved staff productivity by establishing operational standards and benchmarks.• Reduced claims payment turnaround from 120 to 45 days.• Streamlined enrollment and verification process resulting in timely distribution of health plan cards and benefit packages to members. Show less Responsible for provider contracting, network management and service support systems for the Wayne County IPA Network.• Improved Plan /provider relationships by establishing provider servicing standards and benchmarks.• Restructured provider contracts resulting in reimbursement rates consistent with premium revenue.• Increased provider network in targeted geographic areas resulting in improved provider access and availability to members.• Developed joint marketing / provider network strategies resulting in interdepartmental collaboration on marketing and provider network initiatives. Show less

  • Regional Administrator for Out State Operations

    Jul 1988 - Dec 1992

  • Regional Administrator for Wayne County IPA Network Operations

    Jan 1988 - Jan 1992
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  Mercy Health Plans

  Jan 1998 - Dec 1999

  Director, Operations Support and Provider Network Management

  Responsible for regulatory, accreditation and employer compliance standards, development, and implementation and monitoring of workflow processes, process improvements and financial /operational management of West Michigan region.• Developed and operationalized an infrastructure resulting in high level compliance with NCQA standards and governmental regulations (Medicaid, Medicare).• Developed work plan and managed withdrawal of a product line from a service area while preserving patient /physician relationships and reducing costs.• Restructured credentialing workflow resulting in reduced cycle time in credentialing process, increased provider satisfaction and increased staff productivity. Show less

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  University of Phoenix

  Feb 2002 - now

  Lead Faculty Area Chair & Associate Faculty in the College of Health Professions

   Teach bachelor’s level health administration classes Facilitate content area meetings with instructors within the College of Health Professions  Participating in College Campus Management Meetings with my College Campus Chair and Dean of Academic Affairs  Evaluating instructors within the College of Health Professions  Serving as a resource to faculty in finding resources and managing all aspects of class facilitation and instruction Responsible for the assessment aspect of curriculum and serving as a liaison between the Office of Assessment and the local campus Subject matter expert in health administration Show less

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  Integrated Care Alliance, LLC (Subsidiary of Molina HealthCare)

  Apr 2009 - now

  Manager , Provider Contracting & Provider Relations

  Responsible for negotiating all provider contracts, oversight of the implementation of all related administrative functions, internal and external provider relations, ensuring contract compliance and conducting short and long term planning to ensure that an adequate network of providers is maintained to serve the needs of plan members.• Manage contracting and provider relations functions for 140 providers • Achieved 98% provider satisfaction for four consecutive years• Maintain network adequacy via GEO access and other market-based approaches• Operates within and maintains compliance with contractual, corporate, accreditation, and regulatory standards.• Ensures compliance with quality and operational standards in collaboration with finance, claims, credentialing, and utilization review and utilization management. Show less