At UNITED HEALTHCARE, I analyzed and investigated claim issues for Government Plans, working exclusively in Medicare and Medicaid. I also contributed to physician portal usability efforts and identified network gaps for provider contracting.
At Apta Health, I managed a book of Stop Loss Clients, including TPAs and self-insured employers. I was accountable for renewals and retention and worked closely with internal actuary and underwriting teams.
At NATIONAL PHARMACEUTICAL SERVICES/PTI, I led a national client book of business for workers’ compensation PBM customers. I was also involved in state regulation updates and pricing requirements, and provided executives with industry pipeline items and customer initiatives.
Earlier, at OHARA, LLC, I selected, negotiated, and executed Regional PPO contracts. At CORVEL CORPORATION, I managed a multi-office bill review team, oversaw bill review across lines of business, and handled Nebraska PPO contracts.
