The document provides a summary of qualifications and experience for Katherine N. Kline, who is seeking a Director-level Managed Care position. She has over 20 years of experience in population health, performance management, and managed care policy. Her experience includes positions at Humana and Coventry Health Care, where she negotiated provider contracts, managed quality initiatives, and analyzed utilization and cost data. She is skilled in areas such as value-based contracting models, quality management, and Medicare and Medicaid programs.

1. KATHERINE N. KLINE
Phone: (804) 815-5075 | Email: knkline06@yahoo.com
Address: 7725 Patriots Way  Gloucester, VA 23061
SUMMARY OF QUALIFICATIONS
Detail-oriented, dedicated, and highly qualified professional with expertise in population health, performance
management and managed care policy and direction. Committed to maintaining a reputation based on
quality, service, and effective leadership. Possess in-depth knowledge of physician, ancillary, hospital and risk
contracting. Seeking a Director-level Managed Care position which will effectively utilize all skills, abilities,
and areas of expertise as follows:
CORE COMPETENCIES
 Path to Value contracting models including model Practice, medical Home and global risk.
 Quality driven healthcare and performance management
 Medicare, Medicaid and Duals Demonstration filings and expansions.
 Physician, ancillary and hospital contracting
 Strategic negotiation and network management
EXPERIENCE
Humana, Inc. Jan. 2013 – Present
Provider Engagement Executive March 2015 - Present
 Responsible for the establishment, maintenance and oversight of Provider risk agreements and
relationships.
 Facilitate and provide detailed analysis, reporting, training, education and support to Provider groups to
promote financial success and membership growth.
 Analyze trend issues, cost savings opportunities, and utilization patterns
 Make recommendations to market leadership on product design, provider contract terms & negotiations,
key performance indicators and engagement metrics.
 Successfully facilitate and implement quality initiatives such as HEDIS, MRA, and STARS.
Provider Administration Manager Jan 2014-March 2015
 Managed, mentored and led team of physician contractors, providing oversight and guidance on contract
initiatives, best practices and strategic planning.
 Facilitated training and development of other associates in the Provider Contracting department.
 Subject matter expert for Medicare and Duals Demonstration expansions and network filing with the
Centers for Medicare and Medicaid (CMS). Acted as market liaison with Humana corporate health
services delivery team to ensure network adequacy for Virginia, Maryland, Delaware and Pennsylvania
markets.
 Managed projects, collected and analyzed data and disseminated to appropriate departments as
necessary.
Large Practice and Ancillary Contracting Executive Jan. 2013 – Jan 2014
 Negotiated, secured and strategically managed provider contracts within Humana’s quality and cost
parameters.
 Ensured that provider retention rates and positive negotiations meet and regularly exceed network
targets.

2. KATHERINE N. KLINE
Phone: (804) 815-5075 | Email: knkline06@yahoo.com
Address: 7725 Patriots Way  Gloucester, VA 23061
Coventry Health Care, Inc. Dec. 2003 – Jan. 2013
Senior Contracting Specialist
 Accountable for securing competitive contracts with Complex Health Systems and Physician Hospital
Organizations (PHOs)
 Negotiated competitive contracts with ancillary providers including Acute Care Rehabilitation Hospitals,
Home Health/Hospice Agencies, Ambulatory Surgery Centers (ASC), Sleep Centers, Dialysis Centers,
Skilled Nursing Centers, Imaging Centers, Physical, Speech, Occupational Therapy Practices, and
Laboratories.
 Strived to identify cost savings opportunities with inpatient and outpatient provider services by
evaluating claim utilization, case mix index, unit cost, trend and financial spend data to determine where
fixed pricing for services would be most cost effective.
 Acted as Virginia Project Manager for recruitment of physician and ancillary providers for National
Corporate Accounts, Leased Network, Auto Medpay, and Workers’ Compensation clients.
 Evaluated and facilitated new business Requests for Proposals (RFPs) from the Sales and Marketing
Department for comparative marketability of networks.
 Mentored employees on items such as claim resolution, physician/ancillary contracting, an
understanding utilization analyses reports
 Served as the Tidewater area Project Manager for the integration of provider network contracts between
Coventry Health Care and the First Health Network following Coventry’s acquisition of First Health.
Re-contracted a provider network of 2,000 physicians and four hospitals.
 Conducted annual delegated credentialing audits for large (100+) physician groups to review compliance
with NCQA requirements.
ADDITIONALEXPERIENCE
United HealthCare of Virginia, Inc. · Contracting Representative Dec. 2000 - Dec. 2003
CIGNA HealthCare · Provider Relations Representative Mar. 1999 - Dec. 2000
United HealthCare of Virginia, Inc. · Provider Relations Representative Nov. 1995 - May 1998
CIGNA HealthCare · Provider Relations Representative Jan. 1995 - Oct. 1995
CIGNA Behavioral Health · Office Manager Jan. 1993 - Jan. 1995
CIGNA Behavioral Health · Patient Services Coordinator Jul. 1992 - Dec. 1993
CIGNA Behavioral Health · Clinical Administrative Assistant Jan. 1989 - Jun. 1992
EDUCATION
Old Dominion University · B.S. in Sports Medicine Aug. 1986
PUBLICATIONS
 Nuttall, K.N. (1987, Mar.). The Myocardial Infarction Patient From Hospital to Home. Journal of Practical
Nursing, 32.
 Rosenthal, T.T, and Nuttall, K. N. (1987, Dec.). Premenstrual Syndrome. Journal of Practical Nursing, 28.