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Yyyyyy x. yyyyyy                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

xxx-xxx-xxxx                                                                             abc@xyz.com

 

Career Objective                                                                                            

Results-driven leader eager to contribute dynamic administrative operations management, business development and interpersonal relation skills toward actively supporting a progressive organization in optimizing operational and revenue performance.

 

Profile                                                                                                              

Ø  Offer over 14 years progressive experience in health care administrative operations management, with comprehensive background in HMO, EPO, and PPO administration.

Ø  Effectively define, develop and implement targeted action plans to maximize operational productivity, efficiency and profitability.

Ø  Proactive leader who successfully trains/develops, mentors and leads top-performing teams committed to providing superior service.

Ø  Exceptional ability to research and evaluate industry trends and use findings toward designing and executing innovative strategies.

Ø  Dynamic communication, presentation, relationship building and problem-solving abilities.

Ø  Excel at interacting with broad populations including senior management, medical professionals, staff and providers.

 

Key Achievements                                                                                            

Ø  Played an instrumental leadership role in expanding the value added benefits of Physician Associates of San Gabriel Valley s PCP exclusivity program, with a strong focus on expanding the number of PCP s with exclusivity.

Ø  Gained double-digit increases at Talbert Medical Group by successfully closing Health Plan HMO contract renegotiations.

Ø  Added 11 new contracts in one year and saved Ahi Healthcare Systems 35% of shared risk revenue by maintaining current structure and re-negotiating more favorable terms.

 

Professional Experience                                                                               

Physician Associates Of San Gabriel Valley - Pasadena, CA                                           2007 C 2008

Director of Provider Relations                                                             

  Contributed dynamic leadership skills in managing the Provider Relations Department, with full accountability for provider and ancillary network management, PCP network development, provider education and health plan relations.

  Proficiently oversaw all aspects of daily operations including provider assessment and approval processes for primary Care, specialist and ancillary providers.

  Effectively planned, coordinated and maintained the database to monitor provider visits, credential packets and implement contracts.

 

Talbert Medical Group, Inc. - Costa Mesa, CA                                                                 2001 C 2007
Director of Managed Care                                                                                

  Applied extensive health care management expertise toward supervising and directing overall contracting functions for Health Plan, Physician and Ancillary and Hospital contracting.

  Conducted comprehensive review and analysis to interpret and negotiate risk contracts and obtain favorable contract terms and rates, instrumental to boosting revenue.

  Oversaw all facets and phases of day-to-day operations of Provider Relations, Credentialing and Member Service, with strong focus on optimizing productivity, efficiency and quality.

  Design, develop and implement hospital and physician networks, as well as managed care contracting policies and procedures, demonstrating exceptional multitasking and organizational abilities in achieving operational goals and timelines.

Project Manager, EPIC Managed Care System Set-up

  Exhibited strong leadership qualities in directing, mentoring and motivating a team of nine staff members in coordinating and implementing the set-up of claims processing, utilization, capitation processing and insured services management system.

 

 

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Liillie Chambers                                                                                                            page 2 of 2

 

 

Presbyterian Intercommunity Hospital, Healthmed Services, Inc. - Whittier, CA                  1997 C 2001

Director of Contracting

  Maintained full accountability for leading, coordinating and launching key systems to tract the financial performance, payment time frames, and re-negotiation dates of all hospital contracts. 

  Relied upon to lend expertise toward supervising, leading and developing professional staff in contract analysis, negotiations, and administration.

Contract Manager, Project Manager, Managed Care System Set-up

  Spearheaded the planning, development and implementation of HBO & Company Pathways Managed Care claims processing, utilization and fund management system.

 

Ahi Healthcare Systems, Inc. - Downey, CA                                                                    1995 C 1997

Payor Contract Administrator

  Effectively applied advanced communication techniques and analytical abilities to negotiate, interpret and maintain over 100 risk contracts with 30+ health plans for 15 IPA s and Medical Groups throughout Southern and Northern California. 

  Ensured IPA Operations staff are properly educated and trained on contract terms and negotiation techniques. 

 

Education & Professional Development                                                    

Bachelor of Arts in Sociology - Trenton State College (Trenton, NJ)

Completed Computer Courses including Lotus 1-2-3, Excel, Access, PowerPoint, Dbase, Word - West Los Angeles College (West Los Angeles, CA)

Completed Business Law Training - University of Phoenix (Diamond Bar, CA)

 

 

 

 

 

 

 

 

 

 


Yyyyyy x. yyyyyy                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

xxx-xxx-xxxx                                                                             abc@xyz.com

 

 

 

 

 

 

 

 

Date

 

 

 

Hiring Agent Name

Title

Company Name

Address

City/State/Zip Code

 

Dear__________________:

 

I am currently seeking a challenging career opportunity and am submitting my resume for your review.  In advance, thank you for your time and consideration.

 

From leading high performance teams and facilitating superior employee development to reducing operating costs and negotiating favorable contracts, I have continually excelled in maximizing performance as a dynamic leader.  I excel in identifying and resolving inefficiencies, introducing solutions instrumental to boosting performance and strategically utilizing resources to generate optimal results.  As illustrated by my career background, I have continually advanced in health care administrative operations management, assuming increasing levels of responsibility.  Among my recent accomplishments, I gained double-digit increases at Talbert Medical Group by successfully closing Health Plan HMO contract renegotiations and played an instrumental leadership role in expanding the value added benefits of Physician Associates of San Gabriel Valley s PCP exclusivity program.

 

As a member of your staff, you will find me to be a driven team player committed to supporting you in achieving your objectives through superior performance.  I am confident that I could be a valuable asset to your organization, and look forward to interviewing with you in the near future.

 

Sincerely,

 

 

 

 

Yyyyyy x. yyyyyy

 


Yyyyyy x. yyyyyy                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

xxx-xxx-xxxx                                                                             abc@xyz.com

 

 

 

 

 

 

 

Date

 

 

 

Contact Name

Company Name

Address

City/State/Zip Code

 

 

 

Dear _______________________________:

 

I would like to thank you for providing me the opportunity to interview with you and discuss the exciting (TITLE OF POSITION APPLYING FOR) position currently available with your company.  Having gained a deeper insight into the job requirements and your objectives, I am confident you will find me a valuable asset in achieving your goals.

 

As discussed, I am an enthusiastic, disciplined team player eager to launch a successful career as a dedicated member of your staff.  I believe you will find my dynamic (LIST A FEW SKILLS/QUALIFICATIONS RELEVANT TO THE POSITION) skills vital to your operations and look forward to contributing to your success.

 

Should you have any additional questions, or to discuss future employment opportunities, please feel free to contact me at your earliest convenience.  Again, thank you for the enlightening interview.  I look forward to your response.

 

Sincerely,

 

 

 

Yyyyyy x. yyyyyy

 

 

 

 

 

 

 

 

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