Popular in Course
verified elite notetaker
Popular in none
This 2 page Document was uploaded by an elite notetaker on Tuesday December 22, 2015. The Document belongs to a course at a university taught by a professor in Fall. Since its upload, it has received 18 views.
Reviews for VP-Director-Operations-Healthcare-in-Washington-DC-Resume-Lee-Chapman
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 12/22/15
LEE CHAPMAN Eldersburg, MD 21784 443-271-6444 email@example.com VP / D IRECTOR – H EALTH S ERVICES O PERATIONS Claims / Client Relations / Financial Analysis / Benefit Plans / Managed Care / Budgets / Contracts Program Management / Project Management / Provider Networks / Workers Compensation / Training Skilled healthcare industry consultant with tremendous knowledge of front and back office applications. Improved productivity, expense reduction and process improvements in growth companies. Equipped to contribute equally to healthcare firms or consulting firms. Extensive public health experience. Developed and implemented operational plans, oversaw multiple programs and budgets, negotiated contracts with all types of health care providers. Building, leading, and motivating result-oriented teams Establishing strategic alliances to achieve objectives Handling multiple priorities with excellent organizational and managerial skills Building and maintaining strong relationships with internal and external stakeholders Interfacing with government, regulatory and public bodies MHSA, Healthcare Finance, The George Washington University BS, Public Administration, James Madison University CAREER H ISTORY& SELECTED A CCOMPLISHMENTS JBS international, Inc., Operations Manager, 2010-Present. Participates in management of $3.5 million child domestic violence prevention project providing budgeting and contract management services. Prepares all project budgets and monthly invoice summaries for client, and provides recommendations for improvements to project operations. Senior Business Analyst, 2009-Present. Provides corporate support of business development and financial management activities including budgeting, manpower and resource planning, financial analysis, and reporting. Review business development and proposal opportunities and assist business development staff in implementation of recommended enhancements. Collaborates to prepare management plans and reports. Develops business/cost proposals in support of RFPs. Fiscal & Contracts Manager, 2009-Present. Forge project infrastructure and systems for contract and budget management for Clinical Technical Assistance project. Designs and implements approval systems for consultant and vendor agreements. Collaborates with staff to implement planning systems of annual budgets in 10 program areas and redesigns program area budgets as necessary. Manage $14M budget. Reduced erroneous expense reimbursements 10%, saving $130K annually. Project consultants were being reimbursed for ineligible expenses. Trained project employees on Federal travel regulations and eligible expenses. Assumed signing authority for all project consultant expense vouchers. Deputy Project Director, 2008-2010. Participated in management of substance abuse prevention project providing budgeting, contract services, and staff management. Prepared and approved all internal and external budget-and expenditure related requests and reports. Provided guidance on methodologies for analysis of state prevention systems' infrastructures, and recommendations for technical assistance to states for infrastructure enhancements and Federal Substance Abuse Prevention and Treatment Block Grant prevention fiscal compliance. Managed $3.8M budget. Senior Contracts Administrator, 2007-2008. Managed corporate client contracts with annual value in excess of $20M. Prepared and reviewed cost proposals for contract solicitations. Drafted and implemented subcontract and consultant agreements. Monitored contract performance and compliance and assisted project directors and managers in preparation and analysis of project budgets. Project Director, 2005-2007. Provided program and logistical support to Title IV-E Foster Care Eligibility Review Project, managing reviews of state child welfare agencies with an annual budget of $1.3 million. Drafted and directed plans for the recruitment of 200 consultant peer reviewers supporting Federal review teams performing onsite reviews. Authored training curricula and headed trainings for consultant peer reviewers. Developed and implemented best-ever client training program. JBS client had never used non-federal staff to conduct child welfare agency eligibility reviews. Developed training curricula and materials, case studies, exercises, and evaluation tools. Trained non-government employees to conduct onsite reviews when selected. Chief Operating Officer, Golden & Cohen, LLC, 2004-2005. Managed client service operations, including enrollment and termination processing, client billing issues and customer claims resolution. Supported sales and marketing. Oversaw underwriting function. Significantly reduced clients’ balanced billing claims. Golden & Cohen clients’ medical claims were being improperly processed and paid by insurance carriers. Researched client medical plan provisions. Analyzed feedback from clients and insurers. Negotiated with insurers reductions or $0 payments to balanced bills. Vice President Business Operations, Rehab at Work Corp., 2002-2003. Managed operations of corporate office and nine free-standing clinics, including customer service staff, human resources administration, and billing/collections. Vice President of Operations, StatCare, LLC, 2000-2002. Directed operations through office administration, recruitment and contracting of PPO providers across wide-ranging disciplines, and client billing. Vice President of Operations, Statutory Benefits Management Corp., 1997-2000. Oversaw development of guidelines and procedures for managing 3 business units. Headed a medical claims department with staff of 17 processing annual payments in excess of $70M. Managed 20-seat, 24/7 first report of injury call center. Optimized workflow of a nurse case management division and championed the development of a statewide PPO network. Rescued client’s first Workers’ Comp PPO. $7M statewide Workers' Compensation PPO network for Statutory Benefits client was eight months behind schedule. Leveraged relationships with client staff to assist in recruitment efforts. Reined in key provider groups with multiple practices. Developed network in six months. Reduced 15,000 claims backlog 83% in 90 days. Statutory Benefits client had long delays in processing and paying claims. Assessed client's Provider Payment Group operations. Developed new policies and procedures. Set standards to measure accountability. Remedied client system edit check flaws. Reorganized department. Director of Provider Networks, MaxWorldwide, LLC., 1995-1997. Established and maintained provider networks throughout North America in support of call center activities. Designed and supervised network quality assurance programs, recruited and evaluated network providers, and trained call center staff on use of provider network. Collaborated with in-country PPO for the provision of health care services to out-of-country travelers. Developed first-ever non-healthcare provider network for insurance program. MaxWorldwide client, USAA Insurance, required tradesman provider network to support value added client proposition. Identified target markets based on client member population. Recruited providers with measures to increase provider business. Deputy Project Director, Johnson, Bassin & Shaw, Inc., 1992-1995. Directed and performed systemic management and financial analyses of State substance abuse treatment delivery systems funded by the Federal Substance Abuse Prevention and Treatment Block Grant as part of a 5-year, $2.6M/year Technical Reviews project. Averted On-site Review Crisis. Review team member of 3 person team decided to quit project in the middle of the first week while conducting a 3-week onsite review. Negotiated with team member to finish out review week and document all findings for final report. Quickly identified, contacted and had replacement deployed with no delay in review schedule. Review successfully completed on time with total satisfaction by the client. Associate Director Network Development, American PsychManagement, Inc., 1990-1992. Directed a staff of 21 professionals in the establishment of a national provider network with participants in excess of 15,000 through the recruitment of managed behavioral health care providers. Participated in the design, implementation, and maintenance of the network development management information system. Supervised network accessibility and facility and provider fee discount analyses. Increased IBM provider network participation 240% in six months. American PsychManagement’s client recruitment efforts for benefit program implementation were backsliding. Conducted workflow process analysis. Reorganized department into regional teams. Focused recruitment strategy on client management priorities and concerns. Senior Financial Analyst/Senior Associate, Principal HealthCare/Jurgovan & Blair, Inc., 1988-1990/1985- 1988. Provided financial and actuarial services for an operational and consulting managed care organization including medical cost utilization budgeting and analysis, premium group rating development, pro-forma financial statement development, IBNR projection development, claims analysis, financial feasibility analysis, and due diligence review.
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'