Successfully reported this slideshow.
Chris A. Reed
17023 Puntledge Drive
Westfield, IN 46062
MANAGER / COST CONTAINMENT AND CLAIMS AUDIT DEPARTMENT
Cost Containment Manager of Medical Concierge Service, ensuring the Medical Concierge Service
provides information to patients in need of non-emergency medical procedures that will help them
decide on a facility that provides high quality care in the most cost-effective setting. The procedure
can be in-patient or out-patient, and as simple as an MRI or as complex as a Transplant. We have
comprehensive data indicating that different facilities can perform identical procedures at substantially
different costs and levels of quality. My goal is to make sure that quality of care is the primary
consideration, while at the same time provide meaningful, easy to understand information relative to
the cost of the procedure at competing facilities. I work with a Team that pulls Quality Measurements
from public sources run by government agencies. It is composite measure of four components of
hospital value: quality of service, affordability of services, efficiency of service, and patient satisfaction
with service. My experience has helped lead our Team to help employees save money, Health Plans
save money. Money saved can surpass PPO savings and significant return of investment for the
Prior job, helped build Healthcare Network (Supermed Network) from ground up for Indiana.
Extensive experience negotiating contracts and managing provider compensation / reimbursement.
Proven network management methodologies, best practices, and dedicated customer relations skills,
earning a solid reputation for the highest levels of contract performance, quality vigilance,
consistency, reliability, support, and clarity across all functional lines. Core competencies include:
• Planning / Activity Coordination
• Strategic Planning / Implementation
• Problem Resolution
• Process Improvement
• Customer Service Optimization • Mission / Vision Fulfillment
• Mentor / Coach / Train
• Project Management
• Policy / Procedure Development and Delivery
• Contract Negotiations and Execution
• Cost Containment
International Medical Group - Akeso Care Management, Indianapolis, IN
January 2015 – Present
Medical Concierge/Claims Audit Manager – Manage four Medical Concierge Reps. And two
claim auditors. ACM is an accredited international health care management company
specializing in the complete spectrum of domestic and medical management service. Provide
information to patients in need of non-emergency medical procedures that will help them
decide on a facility that provides high quality care in the most effective setting. Our goal is
cost containment for the member and the employer.
IU Health Plans, Indianapolis, IN September 2014 – December 2014
Chris Reed Page 2
Senior Consultant – Network Management Provider Relations, Network Management
expansion efforts, Network Management Training, Network Management Policies and
Procedures development. Managing Hospital and Ancillary Contracting.
Medical Mutual, Cleveland, OH 1997 - 2014
Medical Mutual has been a trusted health insurer for 80 years as the oldest and largest health
insurance company headquartered in the state of Ohio.
Provider Contracting Manager, Network Management 2012 - 2014
Facilitated the management of Medical Mutual’s Indiana provider network. Recommended the
strategic direction for managed care networks. Oversaw Medical Mutual’s relationships and contract
negotiations with physicians and hospital providers throughout the state of Indiana.
• Managed the Company’s provider recruiting and contract efforts to help build and maintain a
comprehensive and cost-effective provider network for the Company and its customers in Indiana.
• Oversaw six employees, four Provider Contracting Representatives and two Provider
• Facilitated all network management activities. Provided direction and recruiting and contracting
efforts to network management team.
• Implemented all policies related to network development, including prioritizing counties for
recruitment, regular data reporting on network composition, and communication to sales and
customer relations of network recruiting plans and network improvements.
• Acted as a focal point and interacted with various areas that impacted providers, including
Provider Information Management, Provider Reimbursement, Provider Communications,
Operations, Network Performance, Care Management and Legal to ensure proper integration and
support of key objectives across all functional lines as well as external entities.
• Trained and developed contracting and coordinator team to optimize team and individual
Provider Contracting Representative, Fayette, MO 2009 - 2012
Recruited and negotiated contracts with medical providers (physician, hospital and ancillary) to build
Proprietary Healthcare Network in the state of Indiana from the ground up. Provided education and
training to medical offices and their staff.
• Oversaw 24 counties in Southwest part of Indiana and 4 counties in Southeast Indiana.
• Managed large provider hospital organization groups in Southwest Indiana.
• Managed, promoted, guided and monitored, as well as serviced and educated providers,
Institutions and Network Communities to establish a business relationship.
• Participated in building team of an Indiana Proprietary Network from the ground up.
Provider Contracting Representative, Toledo, OH 2007 - 2009
Developed, managed and provided services to Institution and Network Communities in order to
establish business relationship. Managed counties in Northwest Ohio and built Indiana for Proprietary
• Oversaw 11 counties in Northwest, Ohio, plus two Physician Hospital Organization groups.
• Built up Indiana Network.
• Oversaw 7 counties in first phase of Indiana, while continuing to keep territory in Ohio up to date.
Provider Contracting Coordinator, Toledo, OH 2005 - 2007
Assisted Contractors and Management by maintaining familiarity with each account and their
designated representatives; understood provider contracts, and field calls / concerns that occurred. In
addition, prioritized and researched problems affecting providers and maintained up-to-date contract
and contract management files and documentation.
• Reported to 4 Provider Contracting Representatives.
Chris Reed Page 3
• Assisted in various duties, including maintenance of providers, credentialing, and rate
• Built professional and hospital provider workbooks.
• Provided ongoing assistance to representatives.
Claims / Customer Service, Toledo, OH 1997 - 2005
Worked in a high-volume, fast paced operations department that required a specific quota to meet
proper daily processing of medical claims.
• Spoke with members and providers, primarily servicing Ohio Retirement Service members.
• Verified benefits, researched claims, and adjusted claims when necessary.
PROFESSIONAL RECOGNITIONS / ASSOCIATIONS
• Shining Star Award presented by Kevin Lauterjung, Vice President, and Manager Valerie DiMasso
for overseeing Ohio territory while taking on 7 additional counties in Indiana to recruit and build
Phase I of Indiana Proprietary network.
• Member of Executive Women in Health Care.
Bachelor of Arts (BA) in Business Management (partial completion)
Arizona Western College, Yuma, AZ
Excel, PowerPoint, Access, Word, Kronos, Microsoft Outlook, HRAdvantage, Cisco VPN