Experience

Quality Medical Consultant Group - QMC Cares

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Chief Executive Officer

  • Feb 2016 - Present

  Provides general oversight of all activities, manages the day-to-day operations, and assures a smoothly functioning, efficient organization. Assures program quality and organizational stability through development and implementation of standards and controls, systems and procedures, and regular evaluation. Assures a work environment that recruits, retains and supports quality staff and volunteers. Assures process for selecting, development, motivating, and evaluating… Show more Provides general oversight of all activities, manages the day-to-day operations, and assures a smoothly functioning, efficient organization. Assures program quality and organizational stability through development and implementation of standards and controls, systems and procedures, and regular evaluation. Assures a work environment that recruits, retains and supports quality staff and volunteers. Assures process for selecting, development, motivating, and evaluating staff and volunteers. Recommends staffing and financing to the Board of Directors. In accordance with Board action, recruits personnel, negotiates professional contracts, and sees that appropriate salary structures are developed and maintained. Specifies accountabilities for management personnel (whether paid or volunteer) and evaluates performance regularly. Show less Provides general oversight of all activities, manages the day-to-day operations, and assures a smoothly functioning, efficient organization. Assures program quality and organizational stability through development and implementation of standards and controls, systems and procedures, and regular evaluation. Assures a work environment that recruits, retains and supports quality staff and volunteers. Assures process for selecting, development, motivating, and evaluating… Show more Provides general oversight of all activities, manages the day-to-day operations, and assures a smoothly functioning, efficient organization. Assures program quality and organizational stability through development and implementation of standards and controls, systems and procedures, and regular evaluation. Assures a work environment that recruits, retains and supports quality staff and volunteers. Assures process for selecting, development, motivating, and evaluating staff and volunteers. Recommends staffing and financing to the Board of Directors. In accordance with Board action, recruits personnel, negotiates professional contracts, and sees that appropriate salary structures are developed and maintained. Specifies accountabilities for management personnel (whether paid or volunteer) and evaluates performance regularly. Show less



Magellan Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Sr. Director Network Management for Magellan Complete Care

  • Apr 2013 - Feb 2016

  •Responsible for developing and implementing a network development strategy financially sound and metrics driven, to ensure profiability needs of the organization are met •Ensure unit cost targets are met. Develops negotiation strategies that are within financial projections. Develop and assure long term mutually successful provider relationships •Influences behavior of providers in accordance with business operations goals and objectives •Directs all facility recruitment activities.… Show more •Responsible for developing and implementing a network development strategy financially sound and metrics driven, to ensure profiability needs of the organization are met •Ensure unit cost targets are met. Develops negotiation strategies that are within financial projections. Develop and assure long term mutually successful provider relationships •Influences behavior of providers in accordance with business operations goals and objectives •Directs all facility recruitment activities. Oversees the preparation/tracking of recruitment target lists, fee schedules, and mailings for network development. Assumes lead role in negotiations with key providers at National and Statewide levels •Continually monitors provider network access to identify potential access gaps and provider recruitment opportunities •Work closely with Medical management on all out of network access issues in order to provide robust network of providers to enrollees Show less •Responsible for developing and implementing a network development strategy financially sound and metrics driven, to ensure profiability needs of the organization are met •Ensure unit cost targets are met. Develops negotiation strategies that are within financial projections. Develop and assure long term mutually successful provider relationships •Influences behavior of providers in accordance with business operations goals and objectives •Directs all facility recruitment activities.… Show more •Responsible for developing and implementing a network development strategy financially sound and metrics driven, to ensure profiability needs of the organization are met •Ensure unit cost targets are met. Develops negotiation strategies that are within financial projections. Develop and assure long term mutually successful provider relationships •Influences behavior of providers in accordance with business operations goals and objectives •Directs all facility recruitment activities. Oversees the preparation/tracking of recruitment target lists, fee schedules, and mailings for network development. Assumes lead role in negotiations with key providers at National and Statewide levels •Continually monitors provider network access to identify potential access gaps and provider recruitment opportunities •Work closely with Medical management on all out of network access issues in order to provide robust network of providers to enrollees Show less



Simply Healthcare Plans

• United States
• Insurance
• 200 - 300 Employee

• Network Contracting Director for Clear Health Alliance

  • Aug 2011 - Apr 2013



AmeriHealth Caritas Florida

• Hospitals and Health Care
• 1 - 100 Employee

• Director of Operations

  • Jun 2010 - Aug 2011



AvMed

• United States
• Insurance
• 400 - 500 Employee

• Director of Network Contracting and Service for South FL

  • Aug 1994 - Jun 2010