Yvette James
@yvettejames
Seasoned healthcare professional with expertise in provider relations and management.
What I'm looking for
I am a seasoned professional with over 15 years of experience in the healthcare and insurance industries, specializing in managed care policy, contract negotiation, and provider relations. My journey has equipped me with a robust skill set in claims resolution, membership growth, and provider education, allowing me to drive strategic solutions that enhance productivity and efficiency.
In my current role as a Provider Engagement Account Manager at Centene Corporation, I manage physician networks and develop strong relationships to achieve business results. My analytical abilities enable me to provide valuable insights through utilization reports and analytics, ensuring that our network meets performance targets. I am passionate about educating providers and improving their satisfaction, which I believe is crucial for the success of any healthcare organization.
Throughout my career, I have consistently demonstrated strong leadership and organizational skills, earning recognition for my ability to identify problems and implement effective solutions. I thrive in collaborative environments and am dedicated to fostering positive relationships with colleagues and stakeholders alike.
Experience
Work history, roles, and key accomplishments
Provider Engagement Account Manager
Centene Corporation
Apr 2023 - Present (2 years 3 months)
Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area. Provides service and education to network physicians/providers to drive provider satisfaction.
Provider Network Specialist I
Centene Corporation
Jan 2015 - Apr 2023 (8 years 3 months)
Served as primary contact for providers and acted as a liaison between the providers and the health plan. Streamlined claims processing workflows, resulting in improved turnaround times and reduced errors.
Community Outreach Representative
WellCare Health Plan of New Jersey
Jul 2011 - Jan 2014 (2 years 6 months)
Oversaw marketing and membership activities for the Medicaid Community Plan. Coordinated and monitored provider's site visits, and was responsible for planning and coordinating health fairs and provider education.
Education
Degrees, certifications, and relevant coursework
University of Phoenix
Bachelor of Arts, Health Administration
Currently pursuing a Bachelor of Arts in Health Administration. This program focuses on the administrative aspects of healthcare, preparing students for leadership roles in various health organizations.
Unknown
Certification, Life Coaching
Completed a Professional Life Coach Certification, enhancing skills in guiding and motivating individuals towards personal and professional goals. This certification complements a background in healthcare by focusing on holistic well-being.
Unknown
Certification, Value-Based Care Analytics
Obtained a Value-Based Care Analytics Certification, focusing on data analysis and strategies within value-based healthcare models. This certification equips professionals with the skills to interpret healthcare data for improved patient outcomes and cost efficiency.
Passaic County Community College
Additional Education, General Studies
Undertook additional studies at Passaic County Community College. The coursework provided foundational knowledge in various subjects, contributing to a broad educational background.
University of Puerto Rico, Humacao
Additional Education, General Studies
Pursued further education at the University of Puerto Rico, Humacao. This academic experience broadened knowledge and skills in a diverse learning environment.
LMM High School
High School Diploma, General Studies
Completed high school education at LMM High School. This foundational education provided essential skills and knowledge for further academic and professional pursuits.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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