Rachel Geiger
Facility, Professional and Ancillary Provider Contracting and Negotiations to include Value Based Contracting
- Role
- Director Network Management at Elevance Health
- Location
- Holland, OH, US
- LinkedIn followers
- 500 followers
Experience
Director Network Management
Mar 2018 — Present
Responsible for leading a team to conduct recruitment, contracting and network adequacy reviews for Texas regions for Medicaid, Medicare, ACA and MMP, including Value Based contracting, negotiating and recruitment across Texas, New Mexico and Arizona to meet state and corporate requirements for value based and downside risk. Strategic focus to build relationships with health system and large provider groups while working to renegotiate agreements to meet cost of care targets. Negotiations include reimbursement rates and contract language. Review geoaccess and provider specialty gaps in all product lines and guide strategy to close or be able to respond to areas of concern. Collaborate with internal departments to complete agreements. Direct and guide team in growing their contracting knowledge and ability to negotiate or have difficult discussions with providers. Assist other Elevance states with contract negotiations including Nebraska and Kansas. All other duties as explained below.
Education
Concord Law School, Kaplan University
EJD, Executive Juris Doctorate
2008 — 2011
Medical University of Ohio at Toledo
BSN, Nursing
1991 — 1993
Kaplan University
Exective Juris Doctor Degree, Law
2009 — 2011
California College for Health Sciences, Independence University
MSHCA, Masters of Science in Health Care Administration
2006
Skills
- Healthcare
- Negotiation
- Hospitals
- Customer Service
- Healthcare Industry
- Microsoft Excel
- Customer Relations
- Quality Improvement
- Team Leadership
- Healthcare Management
- Case Managment
- Microsoft Office
- Provider Contracting
- Health Insurance
- Claims
- Managed Care
- Case Management
- Documentation
- Utilization Management
- Policy
- Auditing
- Health Policy
- Claim
- Process Improvement
- Excel
- Problem Solving
- Insurance
- Strategic Planning
- Hmo
- Contract Negotiation
- Provider Relations
- Analysis
- Medicaid
- Network Development
- Physicians
- Research
- Ppo
- Team Building
- Access
- Health
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