Summary
Overview
Work History
Education
Skills
References
State License
Timeline
Generic

Staci DeBus

Owatonna

Summary

I have developed and maintained excellent working relationships at each level of employment. This has allowed me to help the company achieve and maintain the goals and objectives that have been established. I have dealt with many complex and challenging situations where I have been able to assist with the resolution through consultation, effective listening, and development of plans that can meet the objective all while achieving a professional and ethical outcome. In every role I have held, I have worked effectively and have established great working relationships with external partners and all departments within the company. If you were to ask my co-workers what my strengths are they would tell you that I am self-motivated, organized, deadline driven, energetic, an excellent communicator both verbally and written and that I am able to manage my time and tasks with the frequently changing environments and priorities. They would also tell you that I am funny and bring a positive attitude to the work environment.

I have developed a comprehensive understanding of member needs from my roles working in the hospital, Nursing Home, Public Health and Managed Care Organizations. I also have experience working with healthcare contracts, products, benefits and regulations. I have experience writing policies and procedures and have been actively involved in many levels of oversight through both internal monitoring and regulatory monitoring for audits at both the state and federal level. I have been involved in audits by DHS, MDH, CMS, financial audits, internal auditing and external delegation audits. I am proficient in interpreting, analyzing, and trending reports. My skills include paying high attention to detail, independent decision making, and creating resolutions for difficult problems. I am skilled in working with Microsoft Word, Excel, PowerPoint, SharePoint, JIRA, and Microsoft Outlook. Resourceful professional in administrative management, known for high productivity and efficient task completion. Possess specialized skills in strategic planning, process optimization, and team leadership. Excel in communication, problem-solving, and adaptability, ensuring smooth operation and organizational improvement.

Overview

29
29
years of professional experience

Work History

Senior Provider Contract Manager

UCare
01.2024 - Current
  • Managed the provider contract networks for PCA, Home Health, Hospice, Counties, Physical Medicine and Rehab, and Pain Management.
  • My contracting roles include managing all aspects of contracting from intake to termination when necessary.
  • I have experience negotiating contract terms in accordance with regulatory requirements, analyzing claims data, reimbursement methods, documentation and amendments, and have participated in internal workgroups and committees, ensuring compliance and advising on business strategies.

Provider Contract Manager

UCare
05.2022 - 01.2024
  • Managed the provider contract networks for Skilled Nursing Facilities, Hospice, and PT/OT/ST.

Quality Manager

South Country Health Alliance
01.2020 - 05.2022
  • Leadership team member responsible for the design, implementation, and operations of the Quality Assurance program.
  • Management and oversight of the quality team, budget and numerous delegate contracts.

Medical/Chiro Program Manager

South Country Health Alliance
01.2016 - 01.2019
  • Provided oversight, management, and was the subject matter expert for claims processing programs and management of our medical and chiropractic contracts for our Third Party Administrators (TPA’s).

Clinical Facilitator

South Country Health Alliance
01.2013 - 01.2016
  • Developed, operationalized, trained, and monitored health management programs for enrollees.
  • Managed County Care Coordination Contracts to ensure all care coordination regulations and requirements were met.

Care Coordinator

Steele County Public Health Nursing
01.2007 - 01.2013
  • Care Coordination for South Country Health alliance members 65+ living in the community and in the Nursing Home.
  • Care planning
  • Relocation
  • Resource and service set-up
  • Care transition management.

Swing bed admissions

Waseca Medical Center
01.2001 - 01.2007
  • Hospital admission utilization review
  • Discharge planning
  • Setting up community resources and services
  • Caregiver support group co-facilitator.

Admissions

Pleasant Manor Nursing Home
01.1997 - 01.2001
  • Discharge Planning
  • Care conferences
  • MDS assessments
  • Health care directive education and assistance.

Education

Bachelor of Science - Social Work

Mankato State University
Mankato, MN
06.1997

Associate in Arts - Human Services

Austin Community College
Austin, MN
03.1995

Skills

  • Excellent working relationships
  • Critical thinking
  • Effective communication
  • Attention to detail
  • Independent decision making
  • Contract management
  • Data analysis
  • Microsoft Office Suite
  • Excel
  • Claims Analysis
  • Regulatory Knowledge
  • Provider Relations
  • Contract Negotiation
  • Team leadership
  • Problem solving

References

Available upon request

State License

Licensed Social Worker (LSW), MN, 13298

Timeline

Senior Provider Contract Manager

UCare
01.2024 - Current

Provider Contract Manager

UCare
05.2022 - 01.2024

Quality Manager

South Country Health Alliance
01.2020 - 05.2022

Medical/Chiro Program Manager

South Country Health Alliance
01.2016 - 01.2019

Clinical Facilitator

South Country Health Alliance
01.2013 - 01.2016

Care Coordinator

Steele County Public Health Nursing
01.2007 - 01.2013

Swing bed admissions

Waseca Medical Center
01.2001 - 01.2007

Admissions

Pleasant Manor Nursing Home
01.1997 - 01.2001

Bachelor of Science - Social Work

Mankato State University

Associate in Arts - Human Services

Austin Community College
Staci DeBus