Darryl Vancleave

About Darryl Vancleave

Experienced leader with over 20 years of working in the healthcare and insurance industry. Skilled in Commercial, Medicaid, Medicare, Sales Operations, Sales Management, Medicare Product Design, Team Building, Population Health Management, and U.S. Health Insurance Portability, and Accountability Act (HIPAA). Strong business professional with a Bachelor of Arts focused in Management from Mercyhurst College. In my spare to I volunteer with Men of Quality mentoring program, Every1Reads, Board Member of YMCA, and Kentuckiana Basketball Officials Organization (KBOA).

Experience

1. Provider Experience Consultant

   Anthem, Inc

   Sep 2019 — Present · Louisville, KY, US

   Responsible for developing and maintaining positive relationships with providers and develop strategies for recruitment and contracting. Contact person for provider escalated issues in the Louisville Kentucky Market for Anthem\'s Commercial, Medicare, and Medicaid lines of business.My primary duties include, but are not limited to: •Develop and maintain positive relationships with the provider community by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues•Recruit providers to build a cost effective, high quality provider network•Research, analyze and recommend resolution for contract dispute, non-routine claim issues, billing questions and other practices•Coordinate communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns•Conduct seminars to support the understanding of managed care and plan policies and procedures•Identify network access and deficiencies and develops recruitment and contracting strategies•Coordinates and conducts provider training•Assist providers with credentialing and network related issues

Education

• Mercyhurst College

  Bachelor of Arts, Management

  1993 — 1997