Darrel D.

Consultant Manager - Healthcare Contracting Network Management - Nw Texas Region @Aetna, A Cvs Health Company

Dallas-Fort Worth, TX, US

Successfully managed and consulted with new and existing peers and processes. • Maintained successful results through evaluating and negotiate contracts in line with internal processes, reimbursement guidelines, and specific business and network needs within our organization while maintaining consistently high-performance results.• Consistency developed and maintained positive relationships, as a Network and Contract Manager, with physician and business leadership of key individual, physician groups, ancillary providers, and delivery systems all while maintaining the role of front line company contact for key providers.• Consistently achieved individual productivity goals 20% to 50% above performance objectives.• Managed large, high profile physician groups, IPAs, PHOs, and hospital systems contracts and resolve disputes, and found solutions that are mutually beneficial for both providers and the organization.• Superior knowledge and experience negotiating rates with providers while utilizing various techniques, internal market resources, healthcare management, medical cost drivers, and specific medical cost initiatives to support specific network-market objectives.• Consistently Executes above objective strategic components of a internal business plan for each market while coordinating with segment constituents on medical cost and membership growth and network fortification initiatives.• Extensive experience finalizing health care provider contracts and procedural recruitment arrangements with providers and external sources.• Experience utilizing various internal and external software applications including MS Office, Access, Adobe Sign (Echo Sign) design services, SCM (Strategic Contract Manager), EPDB/Mainframe, Fee Quoter, and MCM Pricer• Continuously demonstrates strong leadership and team-building skills by working independently or closely with others achieving superior objective results.

University of Oklahoma

Bachelor of Arts, Public Relations