Heather
Burke
President
Healthcare Provider Connections, LLC
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- Ms. Burke has more than 15 years experience in
managed care and currently oversees her company’s support
services and business infrastructure including human resources,
benefits, information services, network development and marketing.
- She founded Healthcare Provider Connections, LLC in
2006 and has developed networks across the country for several
Medicaid, Medicare Advantage, and Commercial Health and Dental Plans.
- In the past three years she has contracted thousands
of providers for her health plan clients using state of the art, web
based software. Using Salesforce.com, Burke provides her clients with
real time reporting on provider recruitment and network status. The
RBRVS software allows her team to create customized fee schedules in
any GSA for all services. By utilizing these tools, HCPC has reduced
their development time by 40%.
- Prior to 2006, Ms. Burke worked in Network
Development and Provider Relations for Amerigroup Illinois.
Responsibilities included physician services, claim adjustments, 2nd
and 3rd payment appeal review and determination, credentialing site
visits and orientations, strategic planning, and new product line
development.
- Upon joining Amerigroup, Burke was responsible for
the design and implementation of its multi county network development
and strategy approach. In this role Heather negotiated contracts with
large hospital systems, IPA’s, PHO’s, and multi
specialty physician groups across the Midwest.
- Before her employment at Amerigroup, Heather worked
at American Imaging Management for several years where she lead a 30
member Utilization Management team, worked closely with Compliance, and
scored a 100% on a NCQA audit.
- Ms. Burke holds a Bachelor’s degree in
Business in Healthcare Management from AIU where she graduated Magna
Cum Laude with a 3.8 GPA. She is the founder of Managed Care Provider
Contracting on LinkedIn.com, and a member of Executive Women of Managed
Care.
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