Independent Consultant - Atkinson Contract Consulting, LLC - Sarasota, FL
(2022-05 - 2026-06)
Delivered strategic contracting, negotiation, and reimbursement advisory services that strengthened financial performance, operational efficiency, and provider relationships.
- Advised on contract structure, negotiation strategy, reimbursement terms, risk exposure, provider relations, and internal contracting workflows.
- Supported healthcare organizations in developing contract strategies, preparing for negotiations, reviewing reimbursement methodologies, and structuring sustainable agreements.
- Evaluated contract language, pricing methodologies, payment models, and operational impacts to identify risks, gaps, and strategic opportunities.
- Provided expertise across provider, payer, physician group, ancillary, value‑based, capitation, and risk‑based contracting arrangements.
- Guided organizations through negotiation readiness by clarifying priorities, assessing tradeoffs, identifying leverage points, and aligning cross‑functional stakeholders.
- Translated complex contracting and reimbursement issues into clear, actionable recommendations for executive decision makers.
- Advised on process improvements related to contract tracking, approval workflows, documentation standards, compliance requirements, and implementation practices.
- Applied senior‑level healthcare contracting experience across Medicare, Medicaid, Commercial, and Alternative Payment Methodologies.
Provider Contracting Executive - Humana - Vancouver, WA
(2018-05 - 2022-05)
- Spearheaded strategic contracting initiatives for high‑profile health systems, IPAs, and large primary care groups across Oregon and SW Washington, expanding Humana's network footprint into Southern Oregon.
- Negotiated multiyear agreements featuring value‑based incentives across primary care and inpatient/outpatient services.
- Directed end‑to‑end contracting processes with Market Finance, Legal, National Network Operations, Value‑Based Contracting, and Claims Integrity teams.
- Guided contracting professionals in negotiating nonstandard specialty, ancillary, and FQHC agreements.
- Ensured contract accuracy, operational readiness, and compliance through collaboration with national resource group.
- Leveraged multiple contracting systems to manage contract lifecycle, performance, and provider engagement.
Manager, Provider Network Contracting - CareOregon - Portland, OR
(2014-08 - 2018-05)
- Directed the negotiation and lifecycle management of Medicaid, Medicare, Commercial, fee‑for‑service, capitation, and risk‑based agreements across a diverse provider network.
- Developed and executed financial and risk‑sharing structures, collaborating with Finance, IS, Medical Management, Operations, and Analytics to evaluate provider performance and drive quality‑incentive and value‑based initiatives.
- Cultivated strong clinical and provider partnerships to enhance care quality, improve member outcomes, and maximize network value and financial predictability.
- Developed sophisticated financial models to support high‑stakes negotiations, scenario planning, and executive decision‑making.
- Resolved complex payment, reimbursement, and contractual disputes while maintaining trusted, collaborative provider relationships.
- Operationalized contractual agreements and Memos of Understanding (MOUs) for chemical dependency treatment initiatives and pilot programs; initiated Single Case Agreements to support member access and continuity of care.
- Ensured network adequacy across multiple Coordinated Care Organizations (CCOs) by securing strategically critical provider contracts, including Oral Surgeons in Jackson County and a high‑priority PCP clinic in Yamhill County.
- Spearheaded the development and rollout of CareOregon's 2015 regional Fee Schedule Update, ensuring cross‑departmental alignment, operational readiness, and financial accuracy.
- Directed the successful transition of Oregon's Health CO‑OP contracts to a new third‑party administrator, safeguarding compliance, continuity, and provider satisfaction.
- Provided leadership, mentorship, and hands‑on training to Provider Services staff, elevating contract management capabilities and strengthening organizational bench strength.
- Fostered a culture of professionalism, collaboration, enthusiasm, and high performance across the contracting organization.
Senior Contract Negotiator - Moda Health - Portland, OR
(2013-06 - 2014-08)
- Managed and negotiated multiyear commercial agreements with major health systems throughout Oregon.
- Achieved underbudget outcomes on a three‑year agreement incorporating performance incentives and case rate structures, generating projected savings exceeding $500K in the first year.
- Led complex, multistakeholder negotiations integrating shared‑risk and incentive‑based provisions.
- Implemented shared‑risk agreements for a new regional network, presenting financial models across 12 counties and securing provider participation.
- Negotiated agreements supporting a newly acquired commercial book of business across a multistate corridor.
Provider Network Executive - LifeWise Health Plan of Oregon - Portland, OR
(2008-02 - 2013-06)
- Developed and maintained strategic provider relationships while executing contracting strategies aligned with corporate financial objectives.
- Designed contracting strategies that incorporated risk, market needs, and performance metrics to achieve unit-cost budget goals.
- Led cross-functional analytic projects utilizing PARADE (Provider Analytic Reporting & Data Enterprise) to support strategic negotiations and renewals.
- Reformed the ESRD (End Stage Renal Disease) payment methodology, generating $1M in annual savings.
- Executed contracts across diverse reimbursement methodologies including RBRVS (Resource-Based Relative Value Scale), APCs (Ambulatory Payment Classifications), DRGs/AP‑DRGs (Diagnosis-Related Groups/All Patient Refined Diagnosis Related Groups), Per Diems, and Case Rates.
- Managed multifunctional workgroups responsible for implementing annual Standard Fee Schedule Updates from 2009–2013, delivering projects on time and within budget.
- Developed comprehensive reporting frameworks to track milestones and facilitate senior leadership decision‑making.
- Applied Lean methodology principals to streamline contract management operations.
