Erica Diana

Provider Relations Representative with over 8 years of experience leading client, member and providers relations, network expansion, and retention across Medicaid sector and other lines of business. Expert in managed care, CMS compliance, data analysis, and stakeholder management to accelerate integration timelines, negotiate provider agreements, and stabilize network capacity. Dedicated to operational efficiency, measurable network performance, and building robust provider partnerships while driving innovation in access and care coordination.

Highly experienced Provider Relations Representative with over 8 years in the Medicaid sector and other lines of business, specializing in leading client, member, and provider relations, network expansion, and retention.

Core Expertise:
• Network Strategy & Negotiation: Expert in managed care and CMS compliance. Successfully negotiated provider agreements to expand statewide network capacity and access, supporting strategic growth objectives for Delta Dental.
• Provider Engagement & Retention: Leveraged advanced analytics and CMS reports to develop and implement targeted retention strategies, resulting in marked gains in network stability and performance. Built strong, long-term provider partnerships, delivering ongoing education and support for complex Medicaid programs.
• Operational Efficiency: Led provider onboarding process optimization for new providers, significantly reducing integration time and improving network readiness. Implemented targeted outreach initiatives to boost preventive care participation and support HEDIS compliance.
• Client & Member Support: Provided direct client support, conducting outreach to government health program members, and assisting them with benefits navigation and access to resources (Capital District Physicians Health Plan).

Holds an Associate Degree in Chemical Dependency Counseling from Hudson Valley Community College.