Heather Christine
Dental Contracting Manager @Molina Healthcare
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WORK HISTORY
Dental Contracting Manager @Molina Healthcare
NE, US
Negotiates dental contracts with the dental provider community to secure high-quality, cost-effective, and marketable providers. Responsibilities include contracting and amending agreements with large-scale entities, executing standardized Alternative Payment Method contracts, resolving escalated issues, ensuring network adequacy, and participating in Joint Operating Committees. Maintains ongoing relationships with providers post-negotiation.Utilizes PADU guidelines to focus on Value-Based Relationship Contracts and manages provider agreements through contract management software. Actively recruits additional providers to enhance member access and renegotiates rates and terms with existing providers to control costs.In this role, I maintain strong relationships with key providers, ensure network adequacy, review contract language for compliance, contribute to fee schedule determinations and reimbursement model development, communicate contract terms to providers, and participate in departmental and organizational strategic initiatives. Additionally, I engage in other contracting-related special projects as assigned.
EDUCATION
Upper Iowa University
B.S., Public Administration & Criminal Justice
Abraham Lincoln High School
Diploma, Business
ABOUT HEATHER CHRISTINE
Results-driven healthcare professional with over 25 years of experience in the health insurance industry, specializing in provider contracting, network relations management, and strategic project leadership. Skilled at negotiating and executing contracts, building robust provider networks, and advocating effectively for the provider community. Demonstrated success in exceeding expectations and delivering exceptional outcomes.Recognized for natural leadership abilities and a passion for cultivating and maintaining positive relationships within the healthcare community. With strengths in team building, relationship management, and problem-solving, I thrive in dynamic environments that require complex and creative solutions to drive business growth.Strengths & ExpertiseCore Strengths: Team Building, Relationship Management, Problem Solving, Account Management, Project Management, Conflict Resolution, Extensive Research, HIPAA Compliance, Fraud Investigation, Network Development, Claim Resolution, Member and Provider Advocacy, NSA/QPA, Contract Negotiation.Core Competencies: Relationship Building, Contract Negotiation & Redlining, Requirements Gathering, Target Mapping, Process Analysis, Excel Data Validation, Data Analysis & Extraction, Trend Analysis, Technical Writing, Business Development.Technical Skills:Proficient in Microsoft Excel, Word, PowerPoint, OneNote, Cactus, SharePoint, and Salesforce.16 Personalities type: Protagonists (ENFJ-A)
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