More Related Content Similar to Kurt Boldt Resume 2015 ARS (20) Kurt Boldt Resume 2015 ARS1. Kurtiss E. Boldt, Ph.D.
919-740-4667
kurtboldt@gmail.com
1
Managed Behavioral Healthcare Organization Contract and Network Manager
Healthcare Network Management FacilityContractLanguage/Rate Negotiations
Cost-of-Care Budgetary Projections Cost Containment
Organizational Credentialing Staff Development/Training
Ph.D., CounselorEducation,NorthCarolinaState University
PROFESSIONAL EXPERIENCE
Area Contract Manager; MagellanHealthcare;2007 to present
Contract Negotiations:
Resolutionof Complex andHigh-ProfileFacilityContractandRate Negotiations
Keyhospital contractand rate negotiationsfor NYhealthplan customerensuring99.9%
memberaccess inNewYork Citygreatermetroarea
NY Ambulatoryfollow-up/bridge appointment recruitmentto meet90th
percentile 7day HEDIS
scores
VirginiaDepartmentof Medical Assistance(DMAS) Medicaidfacilityrecruitmentwith95% of
targetedfacilitiesfullycredentialedandcontracted
FloridaMagellanCompleteCare facilitynetworkbuild-outwith98% of targetedfacilities
contractedby transitiondate
MA FallonTotal Care (IntegratedCare Organization) dual demonstrationjointventure facility
and organizational contracting
Network Management:
500+ hospital andorganizational providercontractmaintenance overmulti-milliondollar/multi-
state East Coast marketfor bothcommercial (healthplan) and publicsector
(Medicaid/Medicare)
Organizational credentialingdepartment supportwith99.3% facilityrecredentialingcompliance
Preferred partnerprovidernetworkdevelopment inkeygeographicmarkets andrecruitment
strategiesfornetworkbuild-out
Networkneedandgapareas analysistoensure memberaccess
Team Lead/Participation:
Directinterface withclinical departmentteam forCare ManagementCentersin10 state market
Interdisciplinaryrecruitment teamaddressingnetworkproductexpansion
State mandated APGMedicaidreimbursement andregulatory compliance
Regional credentialingcommittee facilitycase presentationlead
Policyandhandbookreviewcommitteemember
Communication/Provider Relations:
Providerrelationsleadforhealthplan customerperformance plan
Providereducationalandinformational forumpresentations
Networkleadforquarterlyquality initiative providercommittee
Networkcomplaintresolutionsingle pointof contact
2. Kurtiss E. Boldt, Ph.D.
919-740-4667
kurtboldt@gmail.com
2
Finance:
Cost-of-care budgetaryprojections (3-5%) metontime andunderbudget formulti-milliondollar
healthplancontracts in NY ($5.5 million) andVT($2.7 million) FY2014
NY SSIoverpaymentrecovery-$1.2 millioninfacilityclaim retractionwithoutcontractimpact
Monitorcustomerperformance penalties resultingin $100,000 savings FY2014
Networksupportfornewbusiness (RFP)development
Behavioral Health Network Manager; MagellanHealthServices;2000 to 2007
Outpatientprovidercredentialingand contract/rate negotiations
Non-standardFee schedule development
Credentialingcompliance providersite visitand recordreview
Networkdevelopmentandmaintenance via networkgapanalysisandproviderrecruitment
Providerrelationsforumpresentations,complaintresolution,andmultipleproductmarketing
Clinical Care Manager; MagellanHealthServices;1999 to 2000
Mental healthproviderreferral andauthorizationforHMOproductsin NorthCarolina
Team leadforintensivecare management (ICM) of high-riskandhighutilizationmembers
Clinical supervisionof call centerintake coordinators
Database maintenance,membercomplaintresolution,andclinical teamreporting
Private Practice Outpatient Counselor; Raleigh,NC;1997 to 2007
Private practice adult/adolescentindividualandgroupcounseling
Assessmentandtreatmentof depression/anxiety
Marital /relationship issues
Crisisintervention
_______________EDUCATION AND LICENSURE________________________________
Ph.D. inCounselorEducation,NorthCarolinaState University(2000)
Masters of Science inEducation/CommunityCounseling,YoungstownState University (1993)
Bachelor of Science inPsychology, YoungstownState University(1986)
LicensedProfessional Counselor;NCBoardof LicensedProfessional Counselors(#2625)