Experience

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  Highmark blue cross blue shield

  May 1991 - Jun 2021

  - Serves as the project lead on all hospital and provider terminations. Responsible for leading an inter-departmental project team to plan and execute all tasks on the terminations plans. This would include establishing work groups, project plans, timetables, and coordinating with other internal and external departments. Communicates with all project team members and stakeholders on all issues, updates and changes, as needed. - Serves as project manager on various projects under the direction of the Director of Provider Contracts Development which includes identifying the project scope, objectives and key deliverable dates. Also responsible for developing project plans, managing tasks, project timelines and project progress reports. - Utilizes Six Sigma training and skills to identify and recommend process improvement projects within Provider Contracts Development and other internal departments.- Participate in and leads Six Sigma rapid improvement projects. - Serves as liaison for Provider Contracts, Provider Contracts Development and other internal departments with the PA Department of Health and PA Insurance Department.- Coordinate and develops written policies, procedures and training documentation for all projects within department. Show less - Responsible for the development of detailed/comprehensive project plans to support medium/large scales projects related to Provider Information Management and Provider Contracts Support.- Served as the Project Lead to implement a new contract management system for the Provider Contracts department. - Provided supervision and oversight to Business Analysts and Specialists on projects related to Provider Contracting.- Trained and mentor Provider Contract Specialist on new processes and procedures. Show less - Responsible for defining business requirements, system enhancements, system specifications, process improvement, quality assurance, system and integration testing and resolution or problem solving for projects related to the Operations area.- Responsible for the coaching and mentoring other Business Analysts on new process and systems enhancements.- Responsible for developing the policies and procedures and training materials for new or existing systems. - Responsible for utilizing various project management tools to support and communicate project work plans.- Served as the liaison between ISG departments and business units. Show less

  • Associate Strategy Analyst

    Jul 2019 - Jun 2021

  • Sr. Project Manager

    Jun 2005 - Jun 2019

  • Business Staff Analyst Consultant

    Apr 2002 - Jun 2005

  • Business Staff Analysis Specialist

    May 1991 - Apr 2002
• 

  Highmark inc.

  Jun 2021 - now

  Leads a cross functional team of 11 employees of the Provider Contract Development Operations team, who are responsible for drafting, tracking, and storage of provider contracts (ancillary, facility, and profession) within all Highmark’s footprints.Responsible for strategic planning, resource management, and talent development and other operational needs.Responsible for identifying and leading process improvement activities that will help standardize and streamline contract administration and development processes.Serves as one of the project directors for the implement of a new contract life-cycle management (CLM) software. Show less Responsible for direct oversight of the day-to-day operations of the department.Supported contracting development needs for facility, ancillary, and professional multi-market provider contract for Commercial and Medicare Advantage lines of business covering Pennsylvania, Delaware, New York, and West Virginia. Managed the regulatory approval process for submission of health insurance contracts with federal and state insurance regulators.Collaborated with contracting, compliance, legal, and regulatory departments regularly to provide timely and accurate responses to contracting inquiries and requests. 98% percent of all requests are reviewed and resolved within three business days. Show less

  • Director Contract Management

    Dec 2023 - now

  • Manager, Provider Contracts Development

    Jun 2021 - Dec 2023