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ANGELIA HART, LPN 813- 528-0390 | angelia.hart1@gmail.com
linkedin.com/in/AngeliaBHart
Tampa, Florida
INNOVATIVE HEALTHCARE MANAGER
Provider Network Management/Case Management /Medical Staff Management
A Healthcare professional with over 15 years of progressive experience in healthcare management,
physician, hospital and insurance credentialing as well as medical staff management.
Core professional competencies include:
 Project Management
 Communications
 Problem-solving skills
 Case Management
 Public Speaking, Presentations
 Medical Staff Management
 Team Building Leadership
 Computer Literacy
 Cost Effectiveness
 Knowledge of MLR, HEDIS and HCC
PROFESSIONAL EXPERIENCE AND CARRER ACHEIVMENTS
Credentialing Manager JSA Healthcare Tampa FL 12/15 to current
 Concierge management of Credentialing Department including departmental budget and
assures JSA’s credentialing program is compliant with health plan, state and federal
regulations including Medicare, NCQA and other accrediting bodies.
 Develop/Implement Credentialing Policies and Procedures to move JSA toward delegated
credentialing.
 Supervises, trains and evaluates the performances of team members.
 Oversees Hospital Privileging process for employed clinicians.
 Manages quality control of content and completeness of clinician data within the
credentialing arena.
 Facilitates and oversees various interdepartmental meetings including management of
agendas, attendees and minutes.
 Oversight of provider enrollment with AHCA, CMS and Health plans including revalidation and
re-credentialing.
 Restructured team geographically to reinforce relationships with team, providers, health
plans and hospitals.
 Communicates regularly with health plans including quarterly credentialing status reports.
 Produce and distribute reports corporate wide of provider status and plan participation.
In Patient Care Manager JSA Healthcare Tampa FL 9/14 to 12/15
 Evaluation of patients with hospitalist or alone with discussion of care after rounds.
 Discharge planning with member and family regarding discharge needs. Communicate the
needs for the discharge to the attending/primary care physician and hospital staff.
 Provide oversight in patient care evaluation, coordinate the collaboration of the Primary Care
Provider and Consultants, and make suggestions to improve plans to meet patient needs such
as home health care, DME and utilization of specialty care.
 Assist with the monitoring of utilization management and make recommendations regarding
effectiveness of health care resources, trending and intervention.
 Assure compliance with CMS guidelines and covered service guidelines.
 Facilitate and coordinate with hospital resources and those of the PCP and JSA as a Patient
Centered Home.
 Participate in QI projects. Attend Care Management Meetings.
 Train other Care Managers in the JSA model of care

Angelia Hart, LPN page 2
Director, OR Services Intralign – IOS Tampa FL 1/2014 to 7/2014
 Oversight of Scheduling and Credentialing Departments with a total of 16 direct reports in a 24/7
365 days business that places surgical assists from physician level to RN first assists.
 Operating an average of 175 new applications and 100 reappointments at any given time.
 Assure accuracy and completeness of the applications working with Medical Staff Services in 8
states.
 Oversight of monitoring skill sets communicating updates with facilities, tracking expiring items to
keep all assists up to date with CME, required hospital specific education and health testing.
 Work with escalated issues with facilities to mutual satisfaction.
 Development and implementation of credentialing process.
 Direct the flow of initial professional performance evaluations as well as OPPE for credentialing.
 Point person for process improvements in both credentialing and scheduling practices.
 Train both credentialing and scheduling personal on new technologies and flow.
 In Process of designing new software for scheduling that will integrate with credentialing.
 Manage budget and workforce for both credentialing and scheduling.
 Utilize knowledge of Joint Commission Standards to successfully credential over 120 surgical
first assists with varying levels of training, competency and privileges.
Sr. Director, Provider Networks Professional Health Choice Tampa FL 2/2013 to 12/2013
 Contracting PCPs , including education on benefits and reimbursement methodology of
government sponsored plans.
 Development of policies, procedures and educational material for providers and plans.
 Primary contact for providers serving as a liaison between the provider and the health plan
 Conduct site visits and educate providers on CMS/State requirements.
 Conduct face to face meetings with the providers addressing various issues creating action
plans for researching claims issues, patient management processes, on-site reviews and routing
to the appropriate area for resolution.
 Educate providers on issues related to referrals, member care and claims submission; web site
education, EDI solicitation and problem solving.
Contractor Provider Relations Coordinated Care Management Tampa FL 3/12 – 2/13
13046 Race Track Rd. #195 33626 Phone : 813-528-0390
Manager, Health Services Transatlantic Healthcare Tampa FL 1/2010 to 2/2012
 Develop and maintain relationships with hospital and skilled nursing case managers as well as
health plans case management departments to assure that patients receive appropriate level of
care including working with home health and families for discharge planning.
 Tracking information from service funds, cost analysis and other financial information to make
decisions on provider contracts and hospital, home health and DME utilization.
 Oversight and analysis of data and development of performance improvement programs for
case management processes and the consumer assessment of healthcare providers and
systems (CAHPS, HEDIS and STARS). Assisting with credentialing process for contracting new
primary care providers to the company.
Manager, Provider Relations WellCare Health Plans, Inc. Tampa FL 5/2007 to 12/2009
 Managed a 13-member team of provider relations representatives and operations coordinators
for the West Florida region of a national managed care company, directing provider contracting,
negotiations, and service.
 Analyzed PMPM data by specialty to develop action plans that decreased medical cost and
financial risk.
 Strategized membership growth and retention, improving provider count and assuring
satisfaction of internal and external partners by taking responsibility for resolving issues and
problem solving.
 Trained and monitored team in quality assurance and data systems, consistently exceeding
goals.
 Maintained the lowest contract credentialing rate in the company.

Angelia Hart, LPN page 3
Director, Medical Staff Services University Community Hospital Tampa FL 2001 to 2007
 Directed a team of professionals with responsibilities including reviewing credential files and
working closely with leadership on peer review, utilization management, quality, malpractice
insurance, bylaws, and regulations.
 Assured steady communication between leadership, 12 internal divisions, staff, administration,
and board.
 Teamed with patients, staff, and physicians to address quality issues and resolve grievances,
developing and revising privilege criteria to guarantee care standards and using HEDIS and
other measures to evaluate providers.
 Developed and implemented orientation and education programs for physicians and allied
health.
Education and Certifications
BS in Health Services Management, St. Petersburg College, FL. Hours completed 54 with
expected completion date 2018
Licensed LPN in the State of Florida # PN 1355361
Member of Case Management Society of America 2013
LPN Certification, Clayton State University, Morrow, GA, National Dean’s List
CPCS & CPMSM National Certification, Tampa, FL, 2006
Affiliations and Training
Medical Staff Services Seminars, 1997 to present
Six Sigma Management Methodology Green Belt
DDI Management Training
Member, NAMSS, 2000 to present
Member, FAMSS, 2000 to present
Subject Matter Expert for HIPAA Compliance, 2009

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Angelia Hart LPN 2016

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