Khushbu Patel

Led all aspects of provider contracting, including redlining agreements, conducting financial analyses, and developing rate proposals. Negotiated and secured contracts with healthcare plans, expanding network capacity. Delivered data-driven insights by preparing competitive rate comparison reports to support strategic pricing and contract negotiations.

Negotiated, executed, and maintained provider contracts with hospitals, physician groups, and ancillary providers to support PACE participant care coordination and regulatory compliance. Maintained strong relationships with contracted providers, serving as the primary liaison for contract issues, credentialing, and performance-related concerns. Collaborated with interdisciplinary teams to ensure c

Created project plans, analyzed processes, and coordinated resources to improve home health aide performance by 5% over the span of 4 months. Reduced 90-day hospital readmission rates by 4% for Mercy Fitzgerald Hospital through the implementation of comprehensive discharge planning and improved hand off communication. Led performance improvement projects using lean six sigma methodology to investi

Audited CMS billing for skilled nursing facilities, identifying reimbursement errors that prevented regulatory penalties. Generated benchmarking reports using Zimmet's CORE analytics platform to identify performance outliers and revenue improvement opportunities. Prepared Medicare/Medicaid cost reports for hundreds of clients to assess financial outcomes.

Evaluated clinical documentation process for compliance with state regulations. Developed strategies in line with institutional standards to increase Joint Commission compliance above 80% in 15 high-risk areas.

Maximized reimbursement by ensuring accuracy of ICD-10 and CPT codes. Identified discrepancies in medical records to reduce risk and improve workflow efficiency.

Completed a Master of Healthcare Administration program, focusing on advanced topics in healthcare management and administration. Gained expertise in healthcare systems, policy, and operational leadership.

Obtained a Bachelor of Science degree, providing a strong foundation in scientific principles and research methodologies. Developed analytical and problem-solving skills applicable to various fields.