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Vice President of Managed Care Resume
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| Desired Industry: Healthcare |
SpiderID: 84039 |
| Desired Job Location: Pinckney, Michigan |
Date Posted: 5/16/2023 |
| Type of Position: Full-Time Permanent |
Availability Date: One month |
| Desired Wage: 165000 |
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U.S. Work Authorization: Yes |
| Job Level: Executive (President, VP, CEO) |
Willing to Travel: Yes, 25-50% |
| Highest Degree Attained: Masters |
Willing to Relocate: Yes |
Objective:
Innovative and acclaimed senior executive, with wide-ranging experience in sales, healthcare operations, and contract negotiation; complemented with proven record of success in positioning companies toward the highest productivity and service quality.
Hands-on leader, with expertise in developing and implementing strategic plans and programs that maximize revenue, market share, and unit growth.
Concept-to-execution driver, with strong ability to analyze procedures; identify new opportunities; facilitate continuous process improvement; as well as train and motivate teams to ensure attainment of goals.
Articulate communicator, necessary to prospect and build strong and long-term relationships with C-level executives.
Experience:
NATIONAL SEATING AND MOBILITY INC. FRANKLIN, TN
Vice President, Payer Relations October 2017Present
Assume responsibility for developing profitable in-network relationships with all types of payers, including commercial health insurance, Medicare advantage plans, Medicaid managed care organizations (MCOs), workers compensation plans, life insurance plans, third-party administrators, delegated risk medical practices, waiver programs and government payers, Medicare, and Medicaid plans.
Coordinate with the Payer Relation Team for the implementation of all activities related to contracting, credentialing, business and medical licenses, fee schedules, and new payer set-ups, along with training and process improvements for the department.
Collaborate with field operations to maximize strategy implementation in accordance with contract alignments.
Manage key accounts, including Humana, Tricare, Multiplan, United HealthCare, and BCBS plans, covering all regional and state plans in two-thirds of the country.
Provide training to the Payer Relations Team on contracting and negotiations while implementing the departments standard operating procedures (SOPs), credentialing, and licensures.
ANN ARBOR AREA MI
Private Consultant Dietitian June 1990−Present
Educate patients on medical nutrition therapy as part of health-care team in private, hospital, and nursing care facilities
Key Highlight
Demonstrated excellent negotiation skills in securing 78 new agreements and renewing 6 agreements, resulting in improved year-to-date (YTD) return rates.
NUMOTION BRENTWOOD, TN
Vice President, Payer Contracting (East Division) March 2016September 2017
Took charge of payer contract negotiation and new reimbursement agreements to drive profitability and company growth.
Maintained active participation in state and federal legislative activities concerning complex rehabilitation technology (CRT) coverage and reimbursement.
Key Highlights
Successfully acquired over 28 new commercial and MCO profitable agreements for the East Coast market.
Oversaw payer policy improvements addressing prior approvals and service models for complex rehabilitation markets.
AMERICAN RED CROSS BIOMEDICAL SERVICES LANSING, MI (EXTENSIVE US RESTRUCTURING)
Division Senior Sales Director August 2011January 2016
Held accountability for all blood products and service contracting, sales strategy planning, team development, sales production forecasting, and continuing education development for staff and customer in accordance with Food and Drug Administration (FDA) regulations and product safety standards.
Administered key integrated delivery networks (IDN) systems, such as DMC, HFH, McLaren, Beaumont IU, Parkview, Covenant, Community Health Systems, Indiana University and Kentucky One.
Trained and managed new sales associates on step-by-step account management techniques, quarterly business reviews, proper steps of preparing clinician call verses contract/supply management call, customer satisfaction methodologies, potential assessments, along with contacting C-suite, chief financial officer (CFO), and chief operating officer (COO) to reach deeper into accounts.
Key Highlights
Increased budget from $128M to $143M through excellent performance management and task delegation of 6 regional account managers focused on boosting hospital and IDN sales and marketing across 5 states in Midwest.
Served as the driving force behind the attainment of the following key results:
− 15% increase (80% to 95%) in customer satisfaction scores by organizing central division quarterly/monthly webinar series led by medical directors and clinical staff to ensure stronger transfusion and expert perception from customer base.
− Additional $50K savings in annual external education expense by working with the chief medical officer for central division to identify topics for presentation by medical directors and reference laboratory personnel.
− Successful negotiation of a 5-year sole source agreement with Indiana University Health System, achieving $20M as the companys largest single annual IDN; and
− Additional 20% market share for collection division state expansion by cultivating strong relationships with client decision makers, as well as providing service/product portfolios, value additions of education programs, community relationship to support, inventory management system, and cost savings to the entire health system.
STRATIVA/PAR PHARMACEUTICALS WOODCLIFF LAKE, NJ
Regional Account Manager, Managed Markets Contracting January 2008−July 2011
Delivered 85% formula tier placement coverage of products on respective account base within 9 months of launch of new product, Zuplenz / Oravig, by targeting top MCOs in each respective state.
APRIA HEALTHCARE LAKE FOREST, CA
Market Manager, DME& Infusion Sales January 2008−September 2008
Presided over team achievement of 105% of quota by end of 3rd quarter, for the first time in 2 years, by revamping sales targets for each representative on key product lines and services emphasizing respective territories, as well as placing 2 poor performers on performance improvement plans.
NOVARTIS MEDICAL NUTRITION ST. LOUIS PARK, MN
Regional Manager, Field Sales/Contracting October 2001−January 2008
Secured $36M savings through product/supply chain enhancements and elimination of 25 products throughout Novartis purchase and merger of Mead Johnson Nutritional Company by collaborating on SWAT team focused on enhanced incentives plans, SKU management of product portfolio, and determining new sales team with new mergership.
EXTENDICARE HEALTH SERVICES SAULT STE MARIE, MI
Corporate Operations/Consultant Dietitian February 1996−September 2001
Achieved 15% reduction by researching bids and vendors and redesigning enteral nutrition program.
FCI MILAN MILAN, MI
Consulting Dietitian/Food Service Supervisor June 1993−Janurary 1996
Provided Nutrition/Clinical counseling to inmate population and supervised food service departments.
Education:
Master of Business Administration in Marketing/Finance, May 1995
Eastern Michigan University | Ypsilanti, MI
Bachelor of Science in Premed/Dietetics, April 1989
Michigan State University | East Lansing, MI
−Honor Society ▪ Volleyball Team
Skills:
KEY Accounts
Sales Associates
Sales Director
Senior Sales
Account Management
Account Manager
Healthcare
Medicare
Healthcare Operations
Managed Care
Annuities
Budgeting
Compensation
Additional Information:
Lean Six Sigma Healthcare Green Belt, October 2019 | NSM Training
Registered Dietitian (RD), June 1991 | Academy of Nutrition and Dietetics (AND)
PROFESSIONAL AFFILIATIONS
Founder ▪ Director of Sales, Healthcare | Healthcare Sales Leadership
Member | Academy of Nutrition and Dietetics (AND)
Member | National Association Women Professionals (NAWP)
Member | Association of Manage Care Professionals (AMCP)
Payer Relation Board Member | AAHomecare
Industry and Legislative Member | National Coalition for Assistive and Rehab Technology (NCART)
Board Member | HOMES
HONORS AND AWARDS
Operational Division Award ▪ MVP of the Year, 2022 | National Seating & Mobility
Field Support Leader of Year ▪ Pinnacle Award Leadership, 2019 | National Seating & Mobility
Top Contract Award, 2015 | American Red Cross
Acute Care Market Director of Year, 2002 | Novartis Medical Nutrition
Rookie of the Year Award, 2001| Novartis Medical Nutrition
ACTIVITIES
Volunteer | Meals on Wheels
Volunteer | American Red Cross
Board Treasure | Ann Arbor Disc Golf
Member | Adult Volleyball League Greater Ann Arbor
Candidate Contact Information:
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