Network Relations Consultant Resume

SUMMARY

Results - oriented Sales Professional with exposure to business development, marketing, strategic planning, client relationship management, and customer service.
Motivated, goal oriented professional with excellent Interpersonal, organizational and problem-solving skills who meets people at all levels.
Proven success leading business development efforts, expanding customer base, and increasing revenue potential within organizations.
Skilled in improving customer retention levels within highly competitive markets. Exceeds customer’s expectations by maintaining effective relationships.
Exceptional leadership abilities who is a trainable team player.

PROFESSIONAL EXPERIENCE

Network Relations Consultant

Confidential

Responsibilities:

Participated in sales functions within various organizations. ConductedGroup/and or individual sales presentations. Closed sales on - site.
Led business development and marketing efforts, which expandedthe customer base and introduced products into specialty markets.
Represented company at community/employer/company sponsoredevents promoting company products and services.
Contributed to the implementation of promotional programs thatptimized revenue levels in a saturated market.
Demonstrated and maintained a healthcare network for a large payer.
Managed relations with assigned individual physician, medical groups, institutions, ancillary providers and plan administrators. Conducted routine and follow up visits to providers to provide a forum of information exchange, allowing oversight of contractual responsibilities. Ensured effective problem resolution, and facilitated communication between the network relations department and provider.
Applied medical terminology, CPT, ICD-10, Medicare/Medicaid rules,

Confidential

Health Facilities Inspector

Responsibilities:

Develops and maintains positive relationships with the provider community by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues.
Played a key role in increasing retention as well as satisfaction rates.
Conducts negotiations and leads contracting efforts with providers to build and maintain a cost effective, accessible provider network.
Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
Conducts seminars to support the understanding of managed care.
Identifies network access and deficiencies and develops recruitment and contracting strategies, strategic planning
Recruits providers to build a cost effective, high quality provider network.
Coordinates and conducts provider training.
Marketing, Lead generating Sales Specialist.

TECHNICAL SKILLS

MS Office Outlook, Excel, WordPerfect, PowerPoint, Access,
Software products-Expertise with DirectProvider.com, Physician Portal and (CRM) SalesForce.com, ACT Database Software, Emptoris, Macess, Facets and Availity, EDI and EMR systems.