Suzanne Taylor

16 Arboleda Rancho Santa Margarita, CA 92688

st4de2ae@westpost.net * 949-709-4193 (H) * 949-680-5461 (C)

Healthcare Contracting Management

Team Leadership * Contract Negotiation * Vendor Management

Results-driven and customer-focused Senior leader with extensive experience in p

rovider contracting for hospitals, healthcare systems, physicians and allied & a
ncillary providers. Experienced in managed care and complex payer environments i
n local, regional and national venues. Dedicated to delivering "win-win" soluti
ons and promoting value-added partnerships. Proven success in the delivery of c
ompetitive contracts. Highly effective at working within matrix organizations a
nd communicating effectively with internal and external customers. Consistent t
rack record of increasing customer satisfaction, reducing workloads, and control
ling costs. Natural leader with a unique combination of clinical and business ex
perience, training, and expertise.
Core Competencies
Contracting Leadership
Financial Analysis
Project Management
Business Planning
Diverse Reimbursement Development
Vendor Management
Strategic Positioning
Customer Service
Relationship Management

Professional Experience
BEECH STREET, a Viant Network - Lake Forest, CA
Vice President, National Contracting 8/08 - current
Director, Western Region, Network Development 1/07 - 8/08
Oversee & manage contracting and network development activities for national pro
vider network of diversified services, including multi-regional hospitals; physi
cian groups, and allied &ancillary services, including laboratory, home health,
home medical equipment; infusion therapy, ambulatory surgery centers and imaging
& diagnostic centers; National contracting portfolio is >$600 million annually.
In these positions have managed and supervised teams of up to 30 staff, includ
ing senior contractors and Provider Relations team.
Key Achievements:
Successfully negotiating/re-negotiating national provider contracts, with averag
e savings of 20-30% over previous contracts. These negotiations involve develop
ment of national and regional fee schedules for a variety of procedure and treat
ment services, using CMS and industry standard pricing methodologies and analyti
cal measures for their development.
Leading development of key initiatives to modify national & regional network (as
Regional Director) to deliver more comprehensive scope, service delivery and va
lue for carrier clients who purchase our Network services. Regional responsibil
ities included states of AK; AZ; CA; CO; HI; ID; NM; NV; OR; UT; WA.
Oversee Provider Relations team of 20 who process >50,000 provider nominations a
nnually, as well as managed all individual and small physician groups (<25 docto
rs) contracting. Developed & implemented production measures and processes to r
educe cycle time for recruitment & pre-credentialing activities, with demonstrat
ed improvement of >20%.
Serve as corporate resource/subject matter expert for all ancillary service inqu
iries and contracting matters to our regional contracting teams; have assisted w
ith support negotiations with regions for key ancillary services and obtained gr
eater savings in rate concessions (averaging 20-40% higher savings).

FIRST HEALTH GROUP CORP - Sacramento, CA

Coventry Health Care
Director, National Network Management 10/05- 1/07
Oversee & manage contracting and network development activities for national pro
vider network of ancillary services, including laboratory, home health, home med
ical equipment; infusion therapy, ambulatory surgery centers and imaging & diagn
ostic centers; also responsible for several national specialty physician group c
ontracts, including emergency, pediatric and obstetric specialty physician servi
ces. Also oversee regional team responsible for contracting for physician servi
ces, both individual & groups; hospitals and ancillary services in multi-state r
egion. Contracting portfolio is >$500 million annually. Direct three teams of
24 staff, including three Directors.
Key Achievements:
Successfully negotiating/re-negotiating national ancillary contracts, with avera
ge savings of 15-30% over previous contracts. These negotiations involve develo
pment of national and regional fee schedules for a variety of procedure and trea
tment services, using CMS and industry standard pricing methodologies and analyt
ical measures for their development.
Oversee provider nominations/recruitment team of 15 who processes >35,000 provid
er nominations annually, which includes extensive interface with Account Managem
ent team for our Group Health & Workers' Compensation clients with provider nomi
nations/recruitment for national network.
Director , Network Quality Assessment 10/03 - 10/05
Oversee and manage quality management activities for national provider network o
f >450,000 physicians, hospitals, allied and ancillary service providers in 50 s
tates, Puerto Rico and Guam. First Health is the largest network services compa
ny in the U.S., with 6,000 employees and $900 million in revenue.
Productively direct multiple cost centers and teams of 23 reports. Oversee and
direct two managers and two locations. Responsible for overall strategic direct
ion of the business units, their individual and combined performance, and $1.2 m
illion budget management.
Oversee support for key corporate quality committees, including Peer Review, Net
work Quality, and Transplant Networks. Key interface with medical management, p
rovider contracting, account management and sales departments across the organiz
ation.
Key Achievements:
Successfully re-mediated team reorganization and process inefficiencies to impro
ve team performance, performance metrics and compliance management for Credentia
ling. Changes have resulted in significant improvements in internal/external cu
stomer satisfaction. Team has benefited from the development of improved monito
ring tools and implementation of streamlined process improvements.
Serve as subject matter expert (SME) for corporate activities related to network
quality management, both for internal projects as well as external responses fo
r client 'Request For Proposals', and sales presentations.
Also serve as lead representative for state regulatory compliance issues for pro
duct management and client performance in highly regulatory environments such as
Workers' Compensation and Group Health managed care.
PREMERA BLUE CROSS - Mountlake Terrace, WA 04/01 - 06/03
Manager, Network Development
Managed ancillary and dental services contracting and contract implementation fo
r 1.2 million covered lives for large NW Blue Cross Plan with 2,200 employees an
d $1 billion in annual revenue.
Productively directed multiple cost centers and teams of 8-22 direct reports. Re
sponsible for goal setting, performance management, and professional development
. Offered operational oversight for provider relations function with leading phy
sician practices, hospitals, and other allied health providers. Collaborated wit
h cross-functional team to resolve operational issues with providers. Managed ve
ndor relations with several key accounts including co-leadership of new Microsof
t account. Conducted informational presentations to executives, peer management,
and subordinate staff.
Key Achievements:
Successfully increased customer satisfaction and reduced workloads by identifyin
g process redesign opportunities, monitoring tools, and reporting of improved me
trics.
Served as segment lead for company-wide initiative to streamline and revamp paym
ent policies for claims payment decisions.
Participated extensively in business process reengineering and improvement relat
ed to selection and implementation of new provider information management system
.
Participated in 18-month HIPAA remediation for several key services and led proc
ess of educating company on changes required for timely compliance.
HEALTHCARE STRATEGIES - Phoenix, AZ 06/97 - 04/01
Independent Consultant
Provided professional consultative services primarily to healthcare organization
s. Served as transition and interim executive manager for turnaround engagements
. Directed project management activities for business planning, operational anal
ysis, and process reengineering. Oversaw daily operations for financially challe
nged organizations to move through bankruptcy, Chapter 11, reorganization. Provi
ded national level due diligence analysis for lenders considering initial fundin
g and expanded capitalization. Identified value-added business opportunities wit
h a focus on market and service positioning.
Education
Executive Master of Business Administration * Arizona State University - Tempe,
AZ
Bachelor of Science in Nursing * Arizona State University - Tempe, AZ
Additional Professional Development
Strategic Acceleration, August 2009
Negotiation Skills Training, September 2006
Senior Management Development, Summer series, 2004
Project Management, 2003
Performance Development and Leadership, 2002
Coaching High Performance Teams, 2002