SlideShare a Scribd company logo
Harry L. Duer
Professional Summary
CELL 615-424-2273
ghd2221@gmail.com
LinkedIn Profile
Dear Sir or Madam.
Attached you will find the credentials of a 20 plus year veteran of managed care contracting / network
development in the healthcare field. Admittedly, the format of this document is unique somewhat like
my experience. In showing my work history I had to break it into consulting/ independent project
work as well as my full-time work, thus please note between 2009 and 2010 when the market for IC
work fell out, I did a stint at United and that is listed after my consulting work due to space limitations
of not wanting to list the consulting work twice. In addition, because of the number of projects I have
worked in the past I have noted that there is a risk of viewers of the document not seeing what I have
done due to my lengthy project work therefore I have attempted to alleviate that issue by introducing
the tables shown to highlight the projects while reducing wording. As always, any constructive
feedback on the format is welcome.
In the past 20 years I have developed networks for health plans across the nation in most every
product on the market. My strength is in building relationships with providers and building networks
out of nothing, but I have also worked on the provider side as well in business development. If after
looking over my experience you have any questions, please let me know and I will be happy to supply
any information needed. You can also find references on my LinkedIn profile listed above if you wish.
Sincerely
Harry L. Duer
Harry L. Duer
Professional Summary
CELL 615-424-2273
ghd2221@gmail.com
LinkedIn Profile
A seasoned managed care business development of twenty years with a proven track record of national and
regional development of health plans, medical provider contract negotiation and re-negotiation. Products/ Plans
worked with during this time include Medicare, Medicaid, ACA commercial plans, Workers Compensation and
Commercial. network development.in Hospital and Provider contracting.
Core Strengths
 Network development provider reach out, virtual and in-market.
 Contract language and rate negotiation.
 Contract negotiations with health plans for provider and facility business development.
Select Career Highlights
 Led national PT network development while training internally and externally the use of the network and
changed it from a retrospective discounting operation into prospective.
 Led the certification of Kentucky Workers Compensation MCO.
 Worked on the ACHA audit for network certification.
 Successful network development of a major regional CIN.
 Successfully built hospital ACO.
 Successfully built multiple ACA networks.
 Successfully built I-SNP network.
 Successfully negotiated plan contracts for behavioral health hospital system.
 Successful resolution of multiple legal and network integrity issues in relation to mandated government
regulations in multiple states.
Education
Bachelor of Arts in Management / Human Relations, 1994 Trevecca Nazarene University, Nashville TN.
Career Experience
Ally Align- Provider Contracting Executive – 12-22 to present-Building ISNP and CSNP networks nationwide with
emphasis on PA, OH, MA and CA as well as handling SCA agreements as needed. Filling out service gaps and
establishing relationships with larger health systems and IPA's nationwide. Additionally assisting in building
infrastructure with developing processing, contracting, and marketing material while assisting in training peers
when and where needed.
Bright Health Plan- 10-2018 to 12-22 - National Managed Care Network Development Specialist.
Network Development contracting nationwide in multiple markets building ACA and MA plans working remotely
while supporting nationwide team and traveling in market as business needs dictate. Most of my current
experience.
Duers Consulting - Independent National Managed Care Business Development Consultant 2/08- to 10/18.- Ran
own consulting business in network development/ and healthcare provider business development nationwide.
Worked on no less than 24 larger contracting projects.
Medicaid Network-
Ark
(2) MA Network- OH Self-Funded
Network- National
Transportation
contracting-I-SNP-
KY
Home-Health
Network- Midwest
MA-I-SNP Network-
KY
MA Network- FL (2) CIN and MA
Network NC
Bundled Network
Chicago Illinois
(2) Dual eligible
Network- TX
MA Amendments
for ACO - OH
Accountable Care
Organization- GA.
Health Benefit
Exchange – NY.
Medicaid Network-
KY
Dual eligible
Network AR.
Medicaid Network-
FL
Wk. Comp Network-
SE US.
(2) Medicaid
network- OH and TX
Dual Eligible
Network- SE US
Commercial
Network – GA 5
Additional Services - Market Reports and Research
Reported on market conditions for investment group intelligence. Developed credentialing services network,
paper on Healthcare Exchanges in GA, talking points for contractors for Healthcare Exchanges, contracting
implementation plan for SC and IN. Staffing for Medicaid expansion and VA Medical Recruitment- (Vet-Pro) KY,
Medicare staffing- MI.
Duers Consulting- Independent Provider Business Development and Contracting Projects
Behavioral Health
Hospital System- Acute
and Residential-SCA’s.
Review and Due Diligence
of National SNF contracts
for large SNF provider.
SNF Contracting-Texas and
MO.
IOP Treatment Center-
Drug Addiction
contracting- National.
Laboratory contracting –
National.
Wound Care provider-
National
Home Infusion - GA Non-sterile
compounding
pharmacy- National
Durable Medical O and P
Network- National
Network Account
Manager-IPS
Orthopedic Grp-AK Home Health- MO
Home Infusion-TX Amb. Surgery Center- KY Neurology Grp- FL Urgent Care- TN and
OK
United HealthCare- Network Account Manager 5/09 to 2/10
 Handled provider relations for over 3000 providers in Middle TN area.
 Assisted providers in analyzing claims, credentialing, and data issues.
 Analyze and solve data issues to ensure network integrity.
 Negotiate and re-negotiate Medicare, Medicaid, and Commercial contracts.
 Educate providers on United Healthcare policies and procedures.
ConcentraCoventry HealthCare- Contract Manager- 12/2000 to 02/2008
 Handle issues affecting network integration into Coventry’s network.
 Responsible for network development of TN, GA, and KY commercial market.
 Responsible for management of PTNet national network, marketing, provider/client relations, internal and
external training and building referral streams through call center.
 Assisted payers with analytical and legal issues concerning MPN (California), HCN (Texas), MCO (Kentucky),
Florida, PTNET and other network development issues.
 Worked with delegated credentialing team to correct network issues.
 Contracted 7000 plus providers hundreds of medical facilities and 35 hospitals.
 Handled Focus network national contracting duties.
 Managed recertification of Concentra’s Kentucky MCO.
 Built multiple MPN networks in CA following CA-Senate bill 899.
 Built over 25% of HCN network (TX) for Concentra per House Bill 7.
 Trained Beech Street personnel for network integration with Concentra.
 Worked on National Projects for wrap networks.
Hobbies/ Interest
Amateur collector of historical relics and antiques
References available upon request.

More Related Content

Similar to HarryDuer- 21423.doc

JRStroot Resume 2016 jrs
JRStroot Resume 2016  jrsJRStroot Resume 2016  jrs
JRStroot Resume 2016 jrs
Jackie Stroot
 
Theresa J Todd resume' SEP 10 2014
Theresa J Todd resume' SEP 10 2014Theresa J Todd resume' SEP 10 2014
Theresa J Todd resume' SEP 10 2014
THERESA TODD
 
2468 process innovation & enterprise architecture -(foundation for operation...
2468  process innovation & enterprise architecture -(foundation for operation...2468  process innovation & enterprise architecture -(foundation for operation...
2468 process innovation & enterprise architecture -(foundation for operation...
Ravi Sarkar
 
Health insurance-pmo
Health insurance-pmoHealth insurance-pmo
Health insurance-pmo
Hal Amens
 
Health Net 2007 #5 Summer Quarterly
Health Net 2007 #5 Summer QuarterlyHealth Net 2007 #5 Summer Quarterly
Health Net 2007 #5 Summer Quarterly
LHL Communications
 
Katherine kline
Katherine klineKatherine kline
Katherine kline
Katherine Kline
 
Career Highlights r
Career Highlights rCareer Highlights r
Career Highlights r
Bob Richie
 
Sahil Srivastva resume Ebix Healthcare
Sahil Srivastva resume Ebix HealthcareSahil Srivastva resume Ebix Healthcare
Sahil Srivastva resume Ebix Healthcare
Ebix Healthcare
 
MSB Resume RCMMDW
MSB Resume RCMMDWMSB Resume RCMMDW
MSB Resume RCMMDW
Mark Bodnar
 
Wendy_Reed updated
Wendy_Reed updatedWendy_Reed updated
Wendy_Reed updated
Wendy Reed
 
lauriefijal[1]
lauriefijal[1]lauriefijal[1]
lauriefijal[1]
Laurie Fijal
 
Building the Healthcare Cloud
Building the Healthcare CloudBuilding the Healthcare Cloud
Building the Healthcare Cloud
Steven Rubis
 
MetaVista Proposal HBE-DA-2011-01 Vol I Final
MetaVista Proposal HBE-DA-2011-01 Vol I FinalMetaVista Proposal HBE-DA-2011-01 Vol I Final
MetaVista Proposal HBE-DA-2011-01 Vol I Final
Alexander Doré
 
Paul_Updated_Vinod_R_Resume
Paul_Updated_Vinod_R_ResumePaul_Updated_Vinod_R_Resume
Paul_Updated_Vinod_R_Resume
Paul Vinod
 
How to Leverage Increased Data Granularity in the ICD-10 Code Set
How to Leverage Increased Data Granularity in the ICD-10 Code SetHow to Leverage Increased Data Granularity in the ICD-10 Code Set
How to Leverage Increased Data Granularity in the ICD-10 Code Set
Perficient, Inc.
 
Sidesky Profile
Sidesky ProfileSidesky Profile
Sidesky Profile
Kathleen Sidesky
 
Professional Resume #2
Professional Resume #2Professional Resume #2
Professional Resume #2
Lorri Blouin CPC-A
 
Jmp Consulting Grp Presentation Aug 2011
Jmp Consulting Grp Presentation Aug 2011Jmp Consulting Grp Presentation Aug 2011
Jmp Consulting Grp Presentation Aug 2011
jmpinkney
 
JMP Consulting
JMP ConsultingJMP Consulting
JMP Consulting
jmpinkney
 
Wicker, Paul MULTIPURPOSE RESUME
Wicker, Paul MULTIPURPOSE RESUMEWicker, Paul MULTIPURPOSE RESUME
Wicker, Paul MULTIPURPOSE RESUME
Paul Wicker
 

Similar to HarryDuer- 21423.doc (20)

JRStroot Resume 2016 jrs
JRStroot Resume 2016  jrsJRStroot Resume 2016  jrs
JRStroot Resume 2016 jrs
 
Theresa J Todd resume' SEP 10 2014
Theresa J Todd resume' SEP 10 2014Theresa J Todd resume' SEP 10 2014
Theresa J Todd resume' SEP 10 2014
 
2468 process innovation & enterprise architecture -(foundation for operation...
2468  process innovation & enterprise architecture -(foundation for operation...2468  process innovation & enterprise architecture -(foundation for operation...
2468 process innovation & enterprise architecture -(foundation for operation...
 
Health insurance-pmo
Health insurance-pmoHealth insurance-pmo
Health insurance-pmo
 
Health Net 2007 #5 Summer Quarterly
Health Net 2007 #5 Summer QuarterlyHealth Net 2007 #5 Summer Quarterly
Health Net 2007 #5 Summer Quarterly
 
Katherine kline
Katherine klineKatherine kline
Katherine kline
 
Career Highlights r
Career Highlights rCareer Highlights r
Career Highlights r
 
Sahil Srivastva resume Ebix Healthcare
Sahil Srivastva resume Ebix HealthcareSahil Srivastva resume Ebix Healthcare
Sahil Srivastva resume Ebix Healthcare
 
MSB Resume RCMMDW
MSB Resume RCMMDWMSB Resume RCMMDW
MSB Resume RCMMDW
 
Wendy_Reed updated
Wendy_Reed updatedWendy_Reed updated
Wendy_Reed updated
 
lauriefijal[1]
lauriefijal[1]lauriefijal[1]
lauriefijal[1]
 
Building the Healthcare Cloud
Building the Healthcare CloudBuilding the Healthcare Cloud
Building the Healthcare Cloud
 
MetaVista Proposal HBE-DA-2011-01 Vol I Final
MetaVista Proposal HBE-DA-2011-01 Vol I FinalMetaVista Proposal HBE-DA-2011-01 Vol I Final
MetaVista Proposal HBE-DA-2011-01 Vol I Final
 
Paul_Updated_Vinod_R_Resume
Paul_Updated_Vinod_R_ResumePaul_Updated_Vinod_R_Resume
Paul_Updated_Vinod_R_Resume
 
How to Leverage Increased Data Granularity in the ICD-10 Code Set
How to Leverage Increased Data Granularity in the ICD-10 Code SetHow to Leverage Increased Data Granularity in the ICD-10 Code Set
How to Leverage Increased Data Granularity in the ICD-10 Code Set
 
Sidesky Profile
Sidesky ProfileSidesky Profile
Sidesky Profile
 
Professional Resume #2
Professional Resume #2Professional Resume #2
Professional Resume #2
 
Jmp Consulting Grp Presentation Aug 2011
Jmp Consulting Grp Presentation Aug 2011Jmp Consulting Grp Presentation Aug 2011
Jmp Consulting Grp Presentation Aug 2011
 
JMP Consulting
JMP ConsultingJMP Consulting
JMP Consulting
 
Wicker, Paul MULTIPURPOSE RESUME
Wicker, Paul MULTIPURPOSE RESUMEWicker, Paul MULTIPURPOSE RESUME
Wicker, Paul MULTIPURPOSE RESUME
 

Recently uploaded

PrudentRx: A Resource for Patient Education and Engagement
PrudentRx: A Resource for Patient Education and EngagementPrudentRx: A Resource for Patient Education and Engagement
PrudentRx: A Resource for Patient Education and Engagement
PrudentRx Program
 
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdfchatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
marynayjun112024
 
Bath patient Fundamental of Nursing.pptx
Bath patient Fundamental of Nursing.pptxBath patient Fundamental of Nursing.pptx
Bath patient Fundamental of Nursing.pptx
MianProductions
 
Bringing AI into a Mid-Sized Company: A structured Approach
Bringing AI into a Mid-Sized Company: A structured ApproachBringing AI into a Mid-Sized Company: A structured Approach
Bringing AI into a Mid-Sized Company: A structured Approach
Brian Frerichs
 
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
Dr Rachana Gujar
 
Hypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in itHypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in it
Vishal kr Thakur
 
R3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
R3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
R3 Stem Cell
 
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COMHUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
priyabhojwani1200
 
The Power of Superfoods and Exercise.pdf
The Power of Superfoods and Exercise.pdfThe Power of Superfoods and Exercise.pdf
The Power of Superfoods and Exercise.pdf
Dr Rachana Gujar
 
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
gjsma0ep
 
Luxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage CenterLuxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage Center
Chandrima Spa Ajman
 
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdfInnovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
eurohealthleaders
 
Sheard's criterion and Percival criterion.pptx
Sheard's criterion and Percival criterion.pptxSheard's criterion and Percival criterion.pptx
Sheard's criterion and Percival criterion.pptx
National academy of medical science,Bir hospital
 
Top massage center in ajman chandrima Spa
Top massage center in ajman chandrima  SpaTop massage center in ajman chandrima  Spa
Top massage center in ajman chandrima Spa
Chandrima Spa Ajman
 
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa AjmanFriendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Malayali Kerala Spa Ajman
 
Pediatric Emergency Care for Children | Apollo Hospital
Pediatric Emergency Care for Children | Apollo HospitalPediatric Emergency Care for Children | Apollo Hospital
Pediatric Emergency Care for Children | Apollo Hospital
Apollo 24/7 Adult & Paediatric Emergency Services
 
Get Covid Testing at Fit to Fly PCR Test
Get Covid Testing at Fit to Fly PCR TestGet Covid Testing at Fit to Fly PCR Test
Get Covid Testing at Fit to Fly PCR Test
NX Healthcare
 
MYASTHENIA GRAVIS POWER POINT PRESENTATION
MYASTHENIA GRAVIS POWER POINT PRESENTATIONMYASTHENIA GRAVIS POWER POINT PRESENTATION
MYASTHENIA GRAVIS POWER POINT PRESENTATION
blessyjannu21
 
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSONNEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
SHAMIN EABENSON
 
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdfChampions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
eurohealthleaders
 

Recently uploaded (20)

PrudentRx: A Resource for Patient Education and Engagement
PrudentRx: A Resource for Patient Education and EngagementPrudentRx: A Resource for Patient Education and Engagement
PrudentRx: A Resource for Patient Education and Engagement
 
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdfchatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
 
Bath patient Fundamental of Nursing.pptx
Bath patient Fundamental of Nursing.pptxBath patient Fundamental of Nursing.pptx
Bath patient Fundamental of Nursing.pptx
 
Bringing AI into a Mid-Sized Company: A structured Approach
Bringing AI into a Mid-Sized Company: A structured ApproachBringing AI into a Mid-Sized Company: A structured Approach
Bringing AI into a Mid-Sized Company: A structured Approach
 
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdf
 
Hypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in itHypotension and role of physiotherapy in it
Hypotension and role of physiotherapy in it
 
R3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
R3 Stem Cell Therapy: A New Hope for Women with Ovarian Failure
 
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COMHUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
HUMAN BRAIN.pptx.PRIYA BHOJWANI@GAMIL.COM
 
The Power of Superfoods and Exercise.pdf
The Power of Superfoods and Exercise.pdfThe Power of Superfoods and Exercise.pdf
The Power of Superfoods and Exercise.pdf
 
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
 
Luxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage CenterLuxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage Center
 
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdfInnovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
 
Sheard's criterion and Percival criterion.pptx
Sheard's criterion and Percival criterion.pptxSheard's criterion and Percival criterion.pptx
Sheard's criterion and Percival criterion.pptx
 
Top massage center in ajman chandrima Spa
Top massage center in ajman chandrima  SpaTop massage center in ajman chandrima  Spa
Top massage center in ajman chandrima Spa
 
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa AjmanFriendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
 
Pediatric Emergency Care for Children | Apollo Hospital
Pediatric Emergency Care for Children | Apollo HospitalPediatric Emergency Care for Children | Apollo Hospital
Pediatric Emergency Care for Children | Apollo Hospital
 
Get Covid Testing at Fit to Fly PCR Test
Get Covid Testing at Fit to Fly PCR TestGet Covid Testing at Fit to Fly PCR Test
Get Covid Testing at Fit to Fly PCR Test
 
MYASTHENIA GRAVIS POWER POINT PRESENTATION
MYASTHENIA GRAVIS POWER POINT PRESENTATIONMYASTHENIA GRAVIS POWER POINT PRESENTATION
MYASTHENIA GRAVIS POWER POINT PRESENTATION
 
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSONNEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
 
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdfChampions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
 

HarryDuer- 21423.doc

  • 1. Harry L. Duer Professional Summary CELL 615-424-2273 ghd2221@gmail.com LinkedIn Profile Dear Sir or Madam. Attached you will find the credentials of a 20 plus year veteran of managed care contracting / network development in the healthcare field. Admittedly, the format of this document is unique somewhat like my experience. In showing my work history I had to break it into consulting/ independent project work as well as my full-time work, thus please note between 2009 and 2010 when the market for IC work fell out, I did a stint at United and that is listed after my consulting work due to space limitations of not wanting to list the consulting work twice. In addition, because of the number of projects I have worked in the past I have noted that there is a risk of viewers of the document not seeing what I have done due to my lengthy project work therefore I have attempted to alleviate that issue by introducing the tables shown to highlight the projects while reducing wording. As always, any constructive feedback on the format is welcome. In the past 20 years I have developed networks for health plans across the nation in most every product on the market. My strength is in building relationships with providers and building networks out of nothing, but I have also worked on the provider side as well in business development. If after looking over my experience you have any questions, please let me know and I will be happy to supply any information needed. You can also find references on my LinkedIn profile listed above if you wish. Sincerely Harry L. Duer
  • 2. Harry L. Duer Professional Summary CELL 615-424-2273 ghd2221@gmail.com LinkedIn Profile A seasoned managed care business development of twenty years with a proven track record of national and regional development of health plans, medical provider contract negotiation and re-negotiation. Products/ Plans worked with during this time include Medicare, Medicaid, ACA commercial plans, Workers Compensation and Commercial. network development.in Hospital and Provider contracting. Core Strengths  Network development provider reach out, virtual and in-market.  Contract language and rate negotiation.  Contract negotiations with health plans for provider and facility business development. Select Career Highlights  Led national PT network development while training internally and externally the use of the network and changed it from a retrospective discounting operation into prospective.  Led the certification of Kentucky Workers Compensation MCO.  Worked on the ACHA audit for network certification.  Successful network development of a major regional CIN.  Successfully built hospital ACO.  Successfully built multiple ACA networks.  Successfully built I-SNP network.  Successfully negotiated plan contracts for behavioral health hospital system.  Successful resolution of multiple legal and network integrity issues in relation to mandated government regulations in multiple states. Education Bachelor of Arts in Management / Human Relations, 1994 Trevecca Nazarene University, Nashville TN. Career Experience Ally Align- Provider Contracting Executive – 12-22 to present-Building ISNP and CSNP networks nationwide with emphasis on PA, OH, MA and CA as well as handling SCA agreements as needed. Filling out service gaps and establishing relationships with larger health systems and IPA's nationwide. Additionally assisting in building infrastructure with developing processing, contracting, and marketing material while assisting in training peers when and where needed. Bright Health Plan- 10-2018 to 12-22 - National Managed Care Network Development Specialist. Network Development contracting nationwide in multiple markets building ACA and MA plans working remotely while supporting nationwide team and traveling in market as business needs dictate. Most of my current experience. Duers Consulting - Independent National Managed Care Business Development Consultant 2/08- to 10/18.- Ran own consulting business in network development/ and healthcare provider business development nationwide. Worked on no less than 24 larger contracting projects. Medicaid Network- Ark (2) MA Network- OH Self-Funded Network- National Transportation contracting-I-SNP- KY Home-Health Network- Midwest MA-I-SNP Network- KY MA Network- FL (2) CIN and MA Network NC Bundled Network Chicago Illinois (2) Dual eligible Network- TX
  • 3. MA Amendments for ACO - OH Accountable Care Organization- GA. Health Benefit Exchange – NY. Medicaid Network- KY Dual eligible Network AR. Medicaid Network- FL Wk. Comp Network- SE US. (2) Medicaid network- OH and TX Dual Eligible Network- SE US Commercial Network – GA 5 Additional Services - Market Reports and Research Reported on market conditions for investment group intelligence. Developed credentialing services network, paper on Healthcare Exchanges in GA, talking points for contractors for Healthcare Exchanges, contracting implementation plan for SC and IN. Staffing for Medicaid expansion and VA Medical Recruitment- (Vet-Pro) KY, Medicare staffing- MI. Duers Consulting- Independent Provider Business Development and Contracting Projects Behavioral Health Hospital System- Acute and Residential-SCA’s. Review and Due Diligence of National SNF contracts for large SNF provider. SNF Contracting-Texas and MO. IOP Treatment Center- Drug Addiction contracting- National. Laboratory contracting – National. Wound Care provider- National Home Infusion - GA Non-sterile compounding pharmacy- National Durable Medical O and P Network- National Network Account Manager-IPS Orthopedic Grp-AK Home Health- MO Home Infusion-TX Amb. Surgery Center- KY Neurology Grp- FL Urgent Care- TN and OK United HealthCare- Network Account Manager 5/09 to 2/10  Handled provider relations for over 3000 providers in Middle TN area.  Assisted providers in analyzing claims, credentialing, and data issues.  Analyze and solve data issues to ensure network integrity.  Negotiate and re-negotiate Medicare, Medicaid, and Commercial contracts.  Educate providers on United Healthcare policies and procedures. ConcentraCoventry HealthCare- Contract Manager- 12/2000 to 02/2008  Handle issues affecting network integration into Coventry’s network.  Responsible for network development of TN, GA, and KY commercial market.  Responsible for management of PTNet national network, marketing, provider/client relations, internal and external training and building referral streams through call center.  Assisted payers with analytical and legal issues concerning MPN (California), HCN (Texas), MCO (Kentucky), Florida, PTNET and other network development issues.  Worked with delegated credentialing team to correct network issues.  Contracted 7000 plus providers hundreds of medical facilities and 35 hospitals.  Handled Focus network national contracting duties.  Managed recertification of Concentra’s Kentucky MCO.  Built multiple MPN networks in CA following CA-Senate bill 899.  Built over 25% of HCN network (TX) for Concentra per House Bill 7.  Trained Beech Street personnel for network integration with Concentra.  Worked on National Projects for wrap networks. Hobbies/ Interest Amateur collector of historical relics and antiques References available upon request.