Expert Details
Healthcare Vendor Management
ID: 732353
New Jersey, USA
Expert has an extensive knowledge base and experience with vendor contracts inclusive of ensuring vendors meet all CMS and SDOH regulatory requirements, SLA’s, and performance guarantees set forth in the agreement.
Expert has over 10 years of direct experience with the adoption of new health plans for pharmacy, dental and vision vendors by liaising with IT, Government Relations, Provider Network, Clinical, Legal and Compliance departments.
He also has extensive experience implementing various new Medicaid/Medicare health plans (Healthcare Exchange, FIDA and HARP) for Fidelis Care that included the creation of new and revised vendor contracts that adhere to all federal & state regulatory compliance standards.
Education
| Year | Degree | Subject | Institution |
|---|---|---|---|
| Year: 1995 | Degree: M.S. Operations Management | Subject: Operations Management | Institution: New Jersey Institute of Technology |
| Year: 1992 | Degree: B.S. Business Administration | Subject: Business Management | Institution: Ramapo College of New Jersey |
Work History
| Years | Employer | Title | Department |
|---|---|---|---|
| Years: 2013 to 2015 | Employer: Fidelis Care of New York | Title: Director, Vendor Oversight | Department: Contract Management / Vendor Oversight |
Responsibilities:Expert managed the development of productive working relationships with Fidelis' major vendors currently providing dental, vision, pharmacy and transportation services exceeding $1.3 billion in annual costs. He also facilitated the adoption of new health plans for pharmacy, dental and vision vendors by liaising with IT, Government Relations, Provider Network, Clinical, Legal and Compliance departments. Expert also assured compliance with all contractual and regulatory requirements and to meet the goals of the company. He also maintained vendor contracts for the company. |
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| Years | Employer | Title | Department |
| Years: 2010 to 2013 | Employer: CenterLight Healthcare | Title: Vendor Manager | Department: Contract Management |
Responsibilities:He managed and maintained all healthcare vendors within the organization. Expert also facilitated the company's RFI (Request for Information) process. He also analyzed the vendors used by the firm and maintained the vendor contracts for the firm. |
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| Years | Employer | Title | Department |
| Years: 2007 to 2010 | Employer: Horizon BCBSNJ | Title: Account Executive | Department: National Accounts |
Responsibilities:Expert managed and coordinated account service activities where typical group size included 1,000-5,000 eligible or enrolled subscribers.He proactively developed effective business relationships with brokers, consultants, and key decision makers in order to meet or exceed new and renewal sales targets. |
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| Years | Employer | Title | Department |
| Years: 1999 to 2007 | Employer: Omnicare, Inc. | Title: Director, Pharmacy Process Improvement Consultant | Department: Pharmacy Operations |
Responsibilities:Expert handled the implementation of all process improvements under Omnicare’s Best Practice guidelines. As Director of Operations, he effected a turnaround of Pompton Nursing Home Suppliers (Bach's Pharmacy) within first year, reduced inventory days-on-hand by 19 days and reduced payroll costs by 43%, saving $1.3MM. |
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Career Accomplishments
| Licenses / Certifications |
|---|
| Six Sigma - Healthcare (Villanova University) |
| Awards / Recognition |
|---|
| Chiefs Award for Outstanding Achievement |
Fields of Expertise
pharmacy benefit management, health care management, Medicaid, Medicare, vendor control, healthcare vendor oversight, HEDIS, regulatory compliance, healthcare regulatory compliance, vendor quality auditing, scope / RFP, performance measurement, health care quality assurance, health care cost control, health care, vendor auditing, vendor selection, health care plan, pharmacy operations, health care industry, analytical data quality assurance