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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
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)

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Kurt Boldt Resume 2015 ARS

  • 1. 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)