Experience

PopHealthCare

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Vice President Operations

  • Jan 2018 - Present

  Responsible for the overall strategy, growth and performance of the assigned markets including, operational, financial and account management, budgeting, forecasting, reporting and profitability. • Manage performance of key program components including member engagement, provider recruitment / deployment, quality, utilization, and cost management. • Track, monitor and drive program effectiveness compared to customer goals and contractual commitments. • Coordinate business development efforts and relationship management activities with health plan customers. Show less



REMINDTRAC

• Houston, Texas, United States

• CEO / Investor

  • Jan 2015 - Jan 2018

  Responsible for strategy and infrastructure development of an integrated care management platform designed to track key aspects of care management, medication adherence, initial and follow-up screening and/or assessments. • Managed financial performance for the organization to achieve operational efficiencies and position company effectively for investor reporting and funding rounds. • Negotiated third party payer contracts with major market clients including healthcare delivery systems and third-party payers. • Responsible for developing, enhancing, and reviewing all strategic initiatives and marketing plans. • Coordinated with developers and IT vendors to ensure platform and functionality were sufficient to meet and respond to existing and potential client needs and requirements. Show less



St. Luke's Health System

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

• Vice President, Medical Management Group

  • Jan 2012 - Jan 2013

  Responsible for growing and establishing the infrastructure for this multi-specialty medical group. • Led implementation of revenue cycle enhancements, including upgrades to electronic patient billing components, outsourcing of selected segments of accounts receivable, and contracting of vendors to perform specialized services. • Developed policy and procedures to optimize revenue cycle operations and ensure compliance with applicable standards, State and Federal regulations and accreditation agencies. • Negotiated third party payer contracts with major market payers. • Led EPIC EMR/EPM system conversion for employed physicians. • Served on EPIC Executive Steering Committee. • Led physician recruitment activities, including sourcing and negotiating. • Developed physician compensation modeling tools. • Led leadership governance structure development. Show less



THE METHODIST PHYSICIAN ORGANIZATION

• United States
• Hospitals and Health Care

• Vice President, Revenue Cycle Operations and Managed Care

  • Jan 2009 - Jan 2012

  Responsible for developing and implementing the strategic operational direction for clinic revenue cycle operations and third-party payer relationship development for this 325 multi-specialty physician organization, a subsidiary of The Methodist Hospital System. • Developed a highly collaborative relationship with the organization and TMPO physician members predicated on a culture of transparent and open communication. • Developed metrics for efficiency and financial performance that enabled the organization to achieve operational excellence and position TMPO effectively in negotiation with payers. • Negotiated third-party payer contracts with major market payers increasing reimbursement and contract performance. • Responsible for enhancing, developing, reviewing and reporting all matters pertaining to revenue cycle management. • Coordination with IT to ensure systems were sufficient to meet and respond to regulatory requirements and optimal AR management. • Led operational unit ensuring all billing and collections practices were in compliance with legal, contractual and regulatory requirements. • Analyzed impact of regulatory change on internal processes and indentified enterprise-wide impact of changes. • Directly responsible for analyzing, developing, and negotiating professional global organ transplant contract strategies for TMPO and affiliated providers. • Directly responsible for the development and administration of the professional network to support global transplant contracts. Show less



Baylor College of Medicine

• United States
• Higher Education
• 700 & Above Employee

• Executive Director, Business Development

  • Jan 2004 - Jan 2009

  Served as Executive Director of Business Development, providing oversight of the managed care portfolio, credentialing, provider enrollment, and revenue cycle function for this academic multi-specialty physician delivery system. • Led implementation of revenue cycle enhancements, including upgrades to electronic patient billing components, outsourcing of selected segments of accounts receivable, and contracting of vendors to perform specialized services. • Led revenue cycle component of EPIC patient management system conversion. Served as co-chair of Executive Steering Committee and member of Joint Steering committee for EPIC system conversion. • Developed policy and procedures to optimize revenue cycle operations and ensure compliance with applicable standards, State and Federal regulations and accreditation agencies. • Participated in physician retention and compensation program implementation across all clinical departments. • Successfully renegotiated agreement with underpayment software vendor increasing scope of agreement and reducing cost. Participated in the implementation of product across all clinical departments resulting in over $2 million in recoveries. • Responsible for oversight of process improvement initiative for clinic diagnostic services resulting in a 25% increase in time-of-service payments. • Restructured third party payer activity including: o Development and implementation of commercial third-party payer negotiation and reimbursement strategy. o Development of quarterly payer forum attended by health plan executives, medical directors and case management personnel featuring service lines offered by clinical departments. o Expansion of scope of payer agreements as clinical department’s service lines increased. • Implemented a managed Medicare and Medicaid strategy resulting in agreements at rates in excess of Medicaid and Medicare allowable. Show less



Texas Children's Hospital

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

• Director, Contracting and Network Development

  • Jan 1995 - Jan 2000

  Served as Director of Contracting and Network Development for Texas Children’s Integrated Delivery System, providing managed care contracting and network development functions for Texas Children’s Hospital, Texas Children’s Pediatric Associates, and Texas Children’s Home Health; as well as for the organization’s HMO, Texas Children’s Health Plan. • Successfully negotiated and implemented over 150 managed care contracts for the Texas Children’s Hospital, Texas Children’s Heath Plan, Texas Children’s Pediatric Associates, Inc. and Texas Children’s Home Health Services, representing 55% to 70% of organizational revenues. • Responsible for negotiating with State agencies for Texas Healthy Kids Corporation (THKC), Texas Star Medicaid program and Children’s Health Insurance Program (CHIP) contracts. • Collaborated with system executives in the successful application for the first pediatric (HMO) license granted by the Texas Department of Insurance. • Instrumental in researching market trends; financial analysis of various forms of hospital, physician and ancillary reimbursements; and tracking contract performance for the development of effective strategies. • Directly responsible for analyzing, developing and presenting global pricing strategies for Texas Children’s Hospital transplant services to medical staff and hospital executives. • Developed and implemented effective workflows, policies, and procedures for the implementation of managed care contracts for system entities. • Collaborated with system executives in building infrastructure to support pediatric Health Maintenance Organization (HMO). • Successfully completed multiple audits and readiness reviews conducted by State agencies and managed care organizations. • Collaborated with system executives in acquisition and merger ventures. Show less



Cigna Healthcare

• Hospitals and Health Care
• 700 & Above Employee

• Physician Recruiter

  • Jan 1993 - Jan 1995

  Increased healthcare service area by recruiting physicians to address emerging market needs. Developed an effective provider newsletter addressing current managed care information. Participated in employer group meetings to target needs, address concerns and provide network specific information. Increased healthcare service area by recruiting physicians to address emerging market needs. Developed an effective provider newsletter addressing current managed care information. Participated in employer group meetings to target needs, address concerns and provide network specific information.



Charter Hospital

• Sugar Land, Texas, United States

• Marketing Coordinator

  • Jan 1992 - Jan 1993

  Marketed inpatient psychiatric services for Charter Hospital. Developed hospital orientation materials for referring and staff physicians. Served as hospital spokesperson for community events. Marketed inpatient psychiatric services for Charter Hospital. Developed hospital orientation materials for referring and staff physicians. Served as hospital spokesperson for community events.