1. Robert Anthony Sonnessa
Mailing - PO Box 484 McCoy, VA 24111
Physical Address – 6170 Centennial Rd, Blacksburg VA 24060
Cellular (703) 853-4862 Office (540) 639-9721 email: ssonnessa@comcast.net
SENIOR-EXECUTIVE
PROVIDER NETWORK DEVELOPMENT AND MANAGEMENT
_________________________________________PROFESSIONAL PROFILE___________________________________________
 Health Care Executive with over 20 years of leadership experience with various Key Managed Care Organizations. Achievement
oriented leader that is results driven, hands on professional that provides strong leadership, motivation and vision to transform
current state and future business growth.
 Demonstrated success and leadership integrating business and market opportunities with revenue-maximizing strategies.
 Multidimensional manager and skilled communicator with the proven ability to establish rapport and build relationships at every
level of an organization in conjunction with strong customer centric views and work ethics.
 Strong Leadership which is applied to planning and executing operational changes to reduce costs, improve plan efficiency,
obtain better outcomes and support Cost of Care initiatives.
__________________________________________AREAS OF EXPERTISE____________________________________________
 Unique blend of program development and integration
 Contract negotiation
 Accountable Care and CAP negotiations
 Provider Network Development
 Contract analysis
 Provider relations & customer service
 Marketing, sales, and operations skills
 Strategic Planning and Leadership
 Medicaid Managed Care
 Customer Satisfaction
 Multi-Site Operations
 Performance Management
 Continuous Improvement of Operations
Processes/Standards
 Cross-Functional Team Leadership
 Training and Leadership Development
 Problem Solving
 Decision Making
 Ability to develop, implement, and manage innovative health programs in various facility settings
 Effective team leader with strong analytical and communications skills
 Focused upon achieving measurable results in a team-based environment
 Effective at problem assessment, resolution and sustainable governance/management for improved performance and results
_______________________________________PROFESSIONAL EXPERIENCE_________________________________________
National Vice President Network Development and Management, Magellan Complete Care, May 2011 – Present
 Lead, Developed and implemented the national strategic direction and operational oversight of all Network activities in support of
Magellan Complete Care.
 Responsible for direction and execution of provider contracting and relations, credentialing, network implementation and
management, and Provider Data administration.
 Responsible for the development of network strategies to meet specific business unit’s growth and profitability objectives while
ensuring effective provider relationships are maintained.
 Developed and implemented PODS (Provider Optimization Delivery Systems) to enhance consistent and positive staff
relationships and Market connectivity with Hospitals, Providers and Ancillaries providers.
 Works cross functionally with key internal business units, Finance, Health Services, Legal, Compliance, Vendor management,
Claims, Medical Directors, Fraud and abuse and customer service to enhance communications and develop strategic iniatives for
Cost of Care projects.
 Recontracted key facilities and vendors to bring in over $7 Million saving in 6 months.
 Worked in conjunction with finance to manage all aspects of Network development, Single Case Agreements in order to optimize
the profitability of the business unit and company.
 Developed statewide and regional provider utilization dashboards including but not limited to financial status, readmits, 7 day
follow up, Hedis indicators and ER utilization
 Developed on going coaching and mentoring to over 30 network staff to optimize performance, improve job satisfaction and
provide opportunities for career development.
 Developed and fully implemented a local and national Vendor oversight program to manage over 45 delegated providers and
vendors.

2.  Assisted and provided guidance as needed in the negotiation of Key and critical Providers working to move from a Fee For
Service environment to more of a financial risk model (P4P, Performance based , bundled payments, shared savings, shared risks
and Full Risk), ensuring we meet the provider and Hospitals where they currently are in this transformation.
 Provides leadership and management to the network team to ensure all goals and business objectives of the department are
achieved and internal and external customer’s expectations are met and exceeded.
Vice President, Network Development, Centene, October 2010 – May 2011
 Lead network team in developing Provider network for Kansas based Sunflower State Health Plan.
 Responsible for all aspects for network delivery, provider data identification provided training to network staff, provided
oversight for provider mailings.
 Developed Strategic Reimbursement Strategies for Fee for Service, Performance Based Contracting, Bundled Payments, Shared
Savings, Shared Risks and Full Capitation agreements. Met the providers where they were and drove them to increase from
Limited to Moderate to full Integration.
 Worked collaboratively with Sr. Leadership, Health Services and Local staff to identify Network Strategy and execute feet on the
street approach to obtain Letters of Intent for submission with RFP response.
 Provider oversight and direction to Vendor contracting team to ensure optimized vendor selection process.
 Created and developed the vision, structure and process for Provider Network Development.
 Lead Network Management and Development in multiple state expansion initiatives across Centene.
 Developed and implemented PCDA (Provider contracting and Data Administration) to ensure tracking of all provider data,
managed Geo Reporting to quantify network progress.
 Maintained -ongoing plan for network development and maintenance, with a focus on growth via Provider relationships
 Developed staff through mentoring and strategic (stretch) assignments during Provider Network Development and other strategic
projects.
Director of State Sponsored Business Contracting, WellPoint, Inc. November 1, 2009 – October 2010
 Lead team in developing Network Optimization and COC Savings Projects for Indiana, West Virginia, South Carolina and
Wisconsin in collaboration with state leadership to optimize provider, member, health and plan goals.
 Responsible for the development and implementation of targeted contracting and network strategies in 10 states and over 75
micro markets.
 Created and developed the vision, structure and process for SSB Network Optimization.
 Represent network management in multiple state expansion initiatives across SSB
 Led projects (CHOP, ER recontracting, ABD reclassification) to provide over $5M in savings
 Led Letter of Agreement standardization process for ALL SSB states which streamlined existing work processes for Medical
Management, Legal, Field Staff, Claims and PCDA.
 Directs multi-functional team in developing, organizing, and standardizing provider utilization, unit cost, and micro-market
analysis.
 Developed and implemented Indiana Real Time Quality incentive program to ensure that state obtains highest return of premium
dollars withheld for quality targets.
 Developed long term plan for network development and maintenance, with a focus on growth
 Leading project team focused on an SSB wide Provider Contracting Training program, which will lead to standardization of
contracting processes, sharing of best practices, and ultimately increases the portability of Network Optimization projects across
SSB and yield larger savings.
 Developing staff through mentoring and strategic (stretch) assignments during Network Optimization process development and
other strategic projects.
Provider Network Management Director, WellPoint, Inc. December 25, 2006 – October 30, 2009
 Responsible for National Provider Network development and led implementation of 4 new states
 Led National State Sponsored Business Ancillary contracting including Anthem and UniCare agreements with multiple national
ancillary vendors.
 Active member of the “Leadership team” addressing all aspects of business operations, staffing, budgeting, membership growth,
medical management and cost of care initiatives.
 Directed collaborative workgroups that included Sr. Management, Legal, Actuary, Compliance, Medical Management, Finance
and Claim operations.
 Worked with the Marketing and Communication department to develop approved marketing material for providers and members,
focused on increasing brand/plan awareness and membership growth.
 Identified leads and presented/sold product to Sr. Management including CEO’s, CFO’s and COO’s and including key members
with Hospitals, Physician groups and Trade Associations to ensure complete understanding of WellPoint’s Medicaid philosophy
and program operations and objectives.
 Cultivated a national footprint through provider, state and association relationships.

3.  Created strong staff relationships through hiring, training and mentoring new contracting and Community Resource Center staff.
 Served as “subject matter expert” and provided input to Business development when responding to Request for Proposals for new
state and programs.
 Managed successful resolution of competing priorities between SSB business segments to ensure timely response to the customer.
 Worked collaboratively with Legal, Compliance and internal SSB departments to develop all contract rate templates for various
provider types and payment methodologies for provider community to include, DRG, Percent off billed charges, State Fee
Schedule variations, Primary Care CAP models and Full Risk agreements.
Manager, Network Development, WellPoint, Inc. /State Sponsored Business July 1, 2005 – December 24, 2006
 Responsible for all aspects of developing, managing and expanding provider networks for SSB in six states.
 Developed Hospitals, PHO’s, Ancillary, Physician, FQHC’s and RHC’s networks in order to achieve state wide Medicaid
expansion and to reach and often surpass membership and provider network projections.
 Performed network analysis and provider adequacy reports (Geo reports) to determine network needs and gaps and prioritized
accordingly.
 Directly managed recruiting staff of 40 to ensure appropriate provider panel and provider network requirements were achieved.
 Worked with local providers, facilities and community based organizations to educate staff and Medicaid members on the
benefits of Managed Medicaid.
 Responsible for establishing and strengthening provider relationships through face to face visits and resolution of any distributes.
 Worked closely with Actuary and Finance to manage provider network pricing and remain within financial objectives.
 Developed, presented, interacted, marketed and sold WellPoint as a company and the Medicaid program and objectives to CEO’s,
CFO’s, COO’s of large PHO’s, organizations and trade associations to ensure their complete understanding of the strengths of
WellPoint and the benefits of contracting with SSB for the Medicaid lines of business.
 Worked closely with marketing, compliance and state DHHS offices to develop company wide Medicaid marketing material for
providers and members.
 Responsible for review and analysis of Due Diligence projects involving company purchases of other Medicaid companies.
Sr. Contract Manager, UNICARE/State Sponsored Business July 1, 2004 – June 30, 2005
 Directed all contract negotiations for hospitals, PHO’s, ancillaries and physician agreements in order to develop and expand the
West Virginia Medicaid Program.
 Successfully executed contracts with 55 in state Hospitals, 22 out of state Hospitals, 5 PHO’s, 130 Ancillary providers and over
3000 Physicians that render services to the current WV Medicaid recipients.
 Directed over 75 support staff members during the period of January 1, 2003 through November 1, 2003 during program
implementation and start up.
 Responsible for the direction of the education training sessions for Hospital, Ancillary and Physician offices staff members.
 Assisted with membership enrollment by expanding the Medicaid program and network into 57 counties.
 Responsible for various network analysis reports which include, high utilized provider reports, ER utilization reports,
immunization reports, specialist utilization reports, etc.
 Collaborated with Legal, Customer Call Center, Pre-Auth department, Claims and Compliance departments and staff to ensure
program efficiencies.
_____________________________________EDUCATION___________________________________________
Master of Science, Virginia Polytechnic Institute and State University
 Exercise Physiology/Adult Fitness, emphasis in Cardiac Rehabilitation
 Community Health Education
Bachelor of Science, Radford University
 Therapeutic Recreation Administration, Pre-Med
 Minor in Business Administration