Rj Santilli
Director of Operations Claims and Credentialing @MVP Health Care
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WORK HISTORY
Director of Operations Claims and Credentialing @MVP Health Care
Schenectady, NY, US
Responsible for strategic oversight and vision for Commercial Claims, Medicaid and Medicare claim teams, Provider Data Management and Credentialing teams, and Training and Documentation team. Lead department comprised of 4 direct reports, 3 managers, Associate Director, and 117 indirect staff. Drive operations performance against NYS and CMS standards. Work with MVP leadership on membership retention and growth and represent MVP during sales presentations. Accountable for claims efficiency and effectiveness programs and oversight of workforce management for Claims and Provider Data teams. Collaborate with Network on provider-retention and growth strategies. Meet with providers on escalated issues. Identify and drive cost-containment opportunities.
EDUCATION
Siena University
Accounting
Hudson Valley Community College
Associates, Business Administration
SKILLS
ABOUT RJ SANTILLI
Director of Operations Claims and Credentialing
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