Gabriel Pomerantz

Key Accounts Senior Specialist @Healthfirst

NY, US

NYHER WAIVER IMPLEMENTATION | PROVIDER RELATIONS | CLAIMS DISCREPANCY RESOLUTION | PMPM PAYMENT ADMINISTRATION | QUALITY & COMPLIANCE ALIGNMENT | CONTRACT NEGOTIATION | PERFORMANCE DATA ANALYSIS | STAKEHOLDER ENGAGEMENT | NETWORK DEVELOPMENT | PREVENTIVE CARE IMPROVEMENT• Partnered with physician leaders at Social Care Networks (SCNs) to operationalize NYHER Waiver initiatives, guiding doctors on documentation and compliance for HRSN services. • Collaborated with individual providers and practice managers to resolve claims discrepancies, explain PMPM payment methodologies, and align billing practices with state requirements. • Engaged with physicians on performance data, highlighting quality gaps and discussing actionable strategies to improve preventive care and outcomes. • Served as a trusted liaison between doctors and Healthfirst leadership, ensuring provider concerns were addressed while advancing network compliance and member health goals. • Collaborated with internal teams, including clinical, compliance, and finance departments, to address program needs and resolve issues efficiently. • Supported contract negotiations and renewals, ensuring agreements reflect organizational priorities and program mandates. • Analyzed data to identify trends, develop insights, and create strategies for performance improvement. • Prepared presentations, reports, and dashboards to keep stakeholders informed of program status and key milestones. • Conducted regular meetings with key accounts to review progress, address concerns, and identify areas for collaboration. • Assisted in implementing quality improvement initiatives and aligning activities with Healthfirst’s strategic goals.