On October 23rd, 2014, we updated our
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Contract Negotiations Planned, developed, and contracted statewide provider network for a large self funded employer association. Contracted more than 80 acute care hospitals and more than 6,800 physician providers exceeding strategic plan requirements.
Network Development Developed and built network for a major insurance organization in Dallas/Fort Worth and Austin/Central Texas. Dallas network included 41 acute care hospitals and 6,000 physicians. Austin network included 18 hospitals and 3,000 physicians. Completed project on time and under budget.
Operations Management Directed all operations of two regional organizations with 48,000 members. Managed the efforts of 4 department heads with down-line authority for 36 professionals, 24 in Dallas, Texas and 12 in Las Vegas, NV. Provided high-level guidance in the evaluation of regional market operations prompting the restructuring of the customer service, management processes and contracting.
Experience: JMP Consulting Group
Revenue Enhancement Spurred revenue growth across all commercial business lines for an organization with 2 hospital campuses and 348 beds. Led contract negotiations with all payers while driving employer business development and revenue maximization through contract and denial management. Managed a portfolio of 20 managed care contracts generating more than $300M in gross revenue and $90M in net revenue.
P & L Responsibility Chief Operating Officer for North Texas a $42M Regional operation. Established new regional operation and led the integration of a purchased company. Managed regional management team comprised of 6 director level reports. Led a multi-regional team in the operational elements of the Anthem acquisition, completing the project on schedule and under budget. The project team received
JMP Consulting Group
2011 - Developing EPO and PPO networks for major healthcare systems in Texas
Developing EPO and PPO contract documents and processes
2010 – 2011 Negotiation of Medicare and Medicaid contracts for Texas Plans
Consulting Services: JMP Consulting Group
Michelle L. Dietrich Director – Network Development, Principal Financial Group
“ John has contributed to every facet of this project and ultimately been the person most responsible for its success. John created the original network development plans, contracting templates and project tracking tools. Because of his years of experience in network development, strong understanding of the uniqueness of each market and personal relationship with key providers, John was able to help us form our strategic plan and develop rate proposals that were not only competitive in each market, but would also drive the required unit cost and street price improvements. “
P. Thomas Blair President, General Health Services Corporation
“ I wanted to recognize the excellent work you did on the "Alliance Texas Market Audit Report" just completed for Texas Health Resources. The document indicated a thorough understanding of overall business and market planning and of our specific needs related to the project.”