Expert Details
Provider Relations, Operations, Provider Network Development, Provider Contracting
ID: 728191
Pennsylvania, USA
Having worked in network operations and provider relations for the past 15 years he has developed an extensive experience in performance improvements. This, combined with his vast IT knowledge has proven to be very valuable in being able to take complex problems and bring them down to a manageable size in order to formulate a plan of action.
He wrote the business plan for network development for a TPA in LakelandHe developed the network in 4 states for a national radiology planHe helped implement digital dashboards in various healthcare related facilities
Education
| Year | Degree | Subject | Institution |
|---|---|---|---|
| Year: 1988 | Degree: MBA | Subject: Strategic Management | Institution: Erasmus University/Rotterdam School of Management |
| Year: 1986 | Degree: BA | Subject: Criminology | Institution: Florida State University |
Work History
| Years | Employer | Title | Department |
|---|---|---|---|
| Years: 2009 to 2011 | Employer: PARIM | Title: Interim-Manager | Department: |
Responsibilities:He developed Network Business plan for a Third Party Administrator in Lakeland, FL.He served as Interim Operations Manager for Chakra Info Solutions, a physician software and billing company headquartered in Chennai, India, overseeing day and evening shift (total of 125 FTE’s). |
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| Years | Employer | Title | Department |
| Years: 2006 to 2009 | Employer: AvMed Health Plans | Title: Regional Manager | Department: Network Contracting and Service |
Responsibilities:He oversaw network development, contracting and maintenance for 10 counties in Central Florida, managed, trained and coached 8 FTE's in two locations (Orlando and Tampa), responsible for P&L and departmental budgets and since March 2007 Acting Director for Central Florida Network Department. |
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| Years | Employer | Title | Department |
| Years: 2003 to 2005 | Employer: HRS Associates | Title: Trainer/Coach | Department: Training |
Responsibilities:He coached executives of various companies in international business skills. |
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| Years | Employer | Title | Department |
| Years: 2001 to 2002 | Employer: Keenan & Associates | Title: Sr. Consultant | Department: |
Responsibilities:Consultant to specialty radiology network. |
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| Years | Employer | Title | Department |
| Years: 1996 to 2001 | Employer: Multiplan | Title: Vice President | Department: Southern Region |
Responsibilities:He oversaw daily operations of the hospital, physician and ancillary network for 15 states and Puerto Rico and the Virgin Islands and Directly managed four Regional Directors and 22 FTE’s. |
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| Years | Employer | Title | Department |
| Years: 2011 to 2013 | Employer: Florida Blue | Title: Senior Manager | Department: Network Devekopment |
Responsibilities:Available upon request. |
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| Years | Employer | Title | Department |
| Years: 2013 to Present | Employer: Undisclosed | Title: Director | Department: International Contracting |
Responsibilities:Available upon request. |
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Career Accomplishments
| Associations / Societies |
|---|
| MENSA Toastmasters International |
| Licenses / Certifications |
|---|
| MHP - Managed Healthcare Professional |
Fields of Expertise
contract negotiation, contracting, health care, health care industry, health insurance, HMO, HMO insurance, HMO procedure, HMO referral, insurance contract, organization, preferred provider organization, HMO second opinion, business organization, HMO reinsurance, network design, insurance, World Wide Web programming, international contract negotiation, World Wide Web software, group, health care system