Description
Senior Healthcare Executive with strong Practice Management Leadership, Engagement Management, Strategy and Operations, Business Development, Provider/Payor Revenue Cycle Management (RCM) and Clinical Transformation (CT)/Optimization Consulting and Services offerings, Healthcare IT, PMO and Project Management, Healthcare Consulting, and Strategic Alliance management background within the Healthcare Provider and Payor industry involving following specialty areas: * Senior Management/Healthcare Industry * Full End to End RCM Healthcare Strategy, Operations, Transformation and Optimization Consulting * Full understanding of Accountable Care Organizations (ACO)-Clinical and RCM * Cerner Clinical and RCM modules * Cerner Patient Accounting (CPA) * Payer Healthcare Exchange BPO Services and Consulting * California Manager Care and MediCal reimbursement, Including SB 90 (QAF) and related capitations reimbursement plans * FQHC reimbursement management * Full RCM and CT Practice Budgetary and P & L Responsibility * Clinical Documentation Improvement Consulting and Optimization Improvement/Optimization Practice Management * Durable Medical Equipment Revenue Cycle and Billing Operations * Government Sponsored Healthcare Programs * Full Understanding of ACOs and new aspects of ACA * Value Based Reimbursement/Purchasing (CMS), and Bundled Payments Consulting and optimization * Managed Care/Payor Commercial Lines * Meaningful Use/ACO Metrics and Analytics * FY10-14 ICD-9/ICD-10 Conversion Management Deployment/Hospitals/Payers * Hospital Charge Master, CDM, Medical Coding related to Reimbursement * HIPAA Regulatory and EDI Compliance * Medicare Advantage/Medicare Managed Care Operations * RCM analytics and metrics tool sets application and product development