Lindsay Pirie
@lindsaypirie
I am an experienced healthcare contracting manager optimizing payer-provider relationships.
United StatesWhat I'm looking for
I bring 12 years of experience in Medicare/Medicaid managed care and commercial contracting, serving as a Manager of Contracting & Payor Relations and Network Manager. I focus on maintaining and enhancing provider networks to meet quality, availability and financial goals.
I negotiate, re-negotiate and execute hospital, physician and provider contracts and establish clear review processes to assess performance against expectations. I am proficient with Emptoris, SalesForce, SharePoint, Adobe and Microsoft applications and skilled at cultivating positive relationships with clients and colleagues.
I have designed, developed, contracted, maintained and enhanced relationships with hospitals, facilities, physicians and ancillary providers to grow Medicaid managed care products and meet network adequacy targets. I also analyze price proposals, financial reports and other data to determine reasonable contract reimbursements and support network improvement plans with targeted analytics.
I am a collaborative leader who pursues process and operational improvements, drives contract administration best practices, and partners cross-functionally to ensure timely, accurate implementation. I seek to apply my negotiation, network development and analytical strengths to improve payer-provider performance and member access.
Experience
Work history, roles, and key accomplishments
Manager of Contracting & Payor Relations
Premier Health Consultants
Feb 2020 - Present (5 years 9 months)
Leads commercial contracting with payers and provider offices, negotiating and administering contracts to meet network and reimbursement goals. Implements contract review processes and collaborates with leadership to analyze proposals and improve operational performance.
Network Manager / Contract Negotiator
Aetna Better Health of Louisiana
Aug 2016 - Feb 2020 (3 years 6 months)
Negotiated and executed hospital, physician, and provider Medicaid contracts to maintain and enhance provider networks and support Medicaid product growth. Collaborated cross-functionally on compensation, pricing development, and network adequacy initiatives.
Emptoris Application Specialist
Blue Cross Blue Shield of Louisiana
Aug 2015 - Aug 2016 (1 year)
Maintained contract tracking terms, clause and contract templates, tested Emptoris interview wizards, and served as a subject-matter expert for contract management. Supported contract records maintenance and administrator support to ensure accurate contract lifecycle processes.
Senior Network Manager
WellCare Health Plans Inc.
Feb 2013 - Aug 2015 (2 years 6 months)
Managed Medicare physician network by developing provider relationships, negotiating contracts, and addressing network gaps to drive regional business results. Provided analytics and education to support Network Improvement Plan targets and provider performance.
Provider Relations Representative
WellCare Health Plans Inc.
Oct 2010 - Feb 2013 (2 years 4 months)
Provided service and education to network providers, conducted site visits, completed new provider orientation, and handled credentialing and claims inquiries to resolve provider issues. Maintained sales and marketing documentation to support provider onboarding.
Education
Degrees, certifications, and relevant coursework
Denham Springs High School
High School Diploma, General Studies
High School Diploma from Denham Springs High School, graduated May 2003.
SUStrayer University
Some College (No Degree), Business Management
Completed coursework in Business Management through Strayer University's virtual program; no degree awarded.
Louisiana School for the Deaf
Attended Louisiana School for the Deaf in Baton Rouge; no degree listed.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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