Sheila St. Pierre

Experience

Communication plan development for a leading media company.
Worked with company’s IT Program Governance (ITPG) team to develop and rollout a communication plan informing the IT organization of the recent development and implementation of standard IT project management processes and artifacts, new multi-sourcing initiatives, and professional development updates. Developed a variety of communication materials including informational brochures and newsletter, as well as SharePoint updates and notifications. Worked with the team to develop a brand and templates to be used on a go-forward basis.

Provider contracting and claims payment accuracy.
Worked with the executive leadership team at a Medicaid HMO company to provide a thorough review of its hospital claims and contracting practices to determine the relevance of payment accuracy issues. Worked with the contracting team to implement processes and documentation to improve the accuracy of claims payments. Managed the end-to-end recovery process.

Consumer directed health.
Assisted with the development and implementation of process improvement initiatives for CDH products for a large health plan. Improvements included the creation of enrollment audit guidelines for its Direct Billing Entities, streamlined retroactivity review process and guidelines, improved error reporting processes, and other SOP and workflow documents for the internal CDH team.

Provider strategic planning.
Performed numerous market assessments, which included analysis on patient demographics, patient origin, market size, and market share, physician supply and demand, competitor profiling, and payer mix for large healthcare systems and physician groups.