Newsha Fardmanesh
Director, Managed Care & Contracting @NOR Healthcare Systems
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WORK HISTORY
Director, Managed Care & Contracting @NOR Healthcare Systems
Oceanside, CA, US
Oversight and management responsibility for all contract relations and negotiations with Payors for the California region and is responsible for developing and achieving an operating budget benchmark, and membership targets. Executes revenue-driven initiatives in a highly competitive marketplace and achieves membership growth goals via retention & new growth through both fee for service and capitated managed care contracts with payors. Responsible for ensuring compliance with company regulatory and credentialing requirements, mandates and ACA reform. Identifies technology and procedure improvements for increased efficiency, accuracy and continuous process enhancements.Provides leadership, mentoring and management of the Managed Care & Contracting team which includes Contracts Managers and support staff to advance team members, while developing metrics and tools to measure/effect progress on team goals: increase revenue and reduce unnecessary expenses; grow membership strategically; build strong relationships with providers and health plans, and achieve quality performance metrics. Ensures team\'s compliance with company policies, procedures and workflows and strategic use of tools and reports.Works with the executive leadership team to affect the development and management of the contracting process and is responsible for negotiation, analysis and implementation of agreements/contracts to meet the financial objectives of the company. Facilitates collaboration with internal stakeholders to ensure proper administration of the contracts through interfacing with department leaders in claims, configuration, case management, credentialing and other departments. Determines competitive rates and saving opportunities through analysis of cost comparisons and utilization data.Major contributor in the development and implementation of department strategies and initiatives.
EDUCATION
Tulane University Law School
JD
University of Southern California
Bachelor of Arts (B.A.), International Relations
SKILLS
ABOUT NEWSHA FARDMANESH
Over ten years of contract management and administration experience specializing in healthcare, including Medicare, Medi-Cal, Cal MediConnect, and Commercial contracts for hospitals and IPAs bringing in an average $3M-$7M additional revenue annually. Open to regulatory and compliance positions. I worked in loan servicing/foreclosures in the aftermath of the subprime mortgage crisis and worked in the healthcare industry as the Affordable Care Act and Cal MediConnect were being introduced. I handle working in highly regulated, constantly changing industries well. Project leadership skills include the ability to organize and manage multiple projects under aggressive deadlines and the ability to work independently on assigned or self-initiated projects with strong presentation, analytical, and problem-solving skills. I have my BA in International Relations and my JD and also have mediation training and am proficient in Salesforce/Apttus and MediTract.
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