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Yyyyyy x. yyyyyy
3501 SW 139 Ave. | Miramar, XXXXXX xxxxxx xxx-xxx-xxxx | abc@xyz.com
Physician Executive
Patient-centered, expert-level Board Certified Physician Executive with a career history rooted in the delivery of seamless clinical patient management circa 1987. Adept at enhancing healthcare delivery methods using proven business practices and by leveraging integrated health acumen. Skilled in developing and leading profitable BCPI program operations. Also serve as a tech-savvy Integrated Medical Management Software Developer. Well-versed in supervising multidisciplinary teams in achieving organizational objectives and attaining high levels of growth. Seeking a President or CMO role with an innovative, care-focused healthcare organization that is poised for both growth and success.
Highlights
Core skills include leadership, strategic planning, finance, medical management, managed care contracting, marketing, sales, collaborative teamwork and Spanish xxxxxxuency
Launched a successful BPCI program at TeamHealth that generated profit each quarter; steadily surpassed all financial and growth targets
Earned the highest clinician engagement scores in the entire TeamHealth organization across all service lines nationally; upheld a 95.6% clinician retention rate
Expanded the reach of medical management to include large global clients at PPHA
Introduced a new cardiology reimbursement methodology and network at BCBS; garnered $7.4M in annual savings
Launched a new Utilization Management Program in Central Xxxxxx that yielded 38% in Medicare product savings and 27% in BCBS commercial line of business
Spearheaded the Orlando Turnaround Project at BCBS
o Slashed Medicare product losses from $1.8M to $250K per month over the course of six months
o Vastly improved the commercial HMO product by $4.70 PMPM, generating a fiscal transformation for the entire South Geographic Business Unit
Integrated care and network functions at BCBS, which bolstered staff efficiency by 15%
Led American Medical to a 55% membership increase during the first six months spent in the role
Improved American Medical s net output by 40% per full-time staff member compared to corporate staffing ratios, also led productivity measures that incurred $560K in cost savings
Unswervingly maintained American Medical s length-of-stay at 3.6 days for PPO and 3.3 days for HMO/Point of Service
Expanded the Plaines network to almost all Xxxxxxoridian counties; increased ROI to $29.39 per dollar paid in access fees
Expanded the Xxxxxx Physicians primary care group from 12 to 70 Physicians and an operating staff of 300 in a multi-county area with $43M in yearly revenue
Professional Experience
TeamHealth Hospitalist Division/ XXXXXXACS, President/Chief Medical Officer (2002-2017)
Led the largest dedicated full-time hospitalist group in South Xxxxxx of 20 major health plans and 400 Clinicians at 46 hospitals, 109 Skilled Nursing Facilities and right LTACHS in Palm Beach, Xxxxxx, and Dade counties
Contracted with a series of Managed Care organizations including MSOs, ACOs and IPAs
Liaised with hospital CEOs to boost hospitalist efficacy and emergency room throughput, along with co-management of specialty referrals and medical-surgical
Generated a 23% increase in hospitalist participation and expanded the group into new market segments
Held meetings each month with Medical Directors, Chief Medical Officers and CEOs to achieve goals, lead strategic planning efforts and encourage innovative acute care practices
PPHA, LLC, President/Chief Executive Officer (1998-2010)
Founded and led a multinational firm that served hospitals, health plans, self-funded employers and the public sector using fully-integrated medical management programs
Expanded the organization to serve large populations in the areas of Medicaid, Medicare, Reform and Commercial across an array of disease management program offerings
Designed and developed proprietary software to support Utilization, Case and Disease Management programs that were fully accredited and integrated
Crafted custom wellness and preventive health efforts used extensively by large, self-funded employers
Yyyyyy x. yyyyyy
Continued
Blue Cross Blue Shield of Xxxxxx, Regional Director, Network Management and Development (1999-2002)
Oversaw operations for state and regional network management of the largest managed care organization in Xxxxxx
During tenure, generated over $5B in annual revenue and offered coverage to approximately 2.6M members
Individually negotiated regional and state contracts in excess of $1.4B; also headed a statewide negotiation team that contracted 46 HCA hospitals across the state
Tenaciously negotiated a two-year contract with Baptist Health Systems in Miami during a hostile termination; excelled in establishing an effective working relationship between both involved parties
Brokered a contract for a simultaneous market-wide termination with Xxxxxx Hospital and Orlando Regional Medical Center; included 20 facilities in total throughout Central Xxxxxx
Created and launched a statewide physician profiling process used to enhance physician performance and foster a number of sound, mutually beneficial health plan relationships
Represented South Xxxxxx during the blueprinting and streamlined reorganization of three Blue Cross Blue Shield regions into two entities
Earlier Roles
President/Chief Executive Officer, American Medical HealthCare, 1997-1998
Chief Medical Officer, American Medical HealthCare, 1995-1997
Executive Director, Plaines Health Network, 1996-1998
Medical Director, Xxxxxx Physicians Medical Group,1994-1995
Associate Medical Director, Humana Health Plan, 1994-1995
Founder/Senior Partner, Orlando Family Medicine Associates, 1987-1995
Faculty Appointments
Asst. Clinical Professor, Dept. of Family Medicine, Nova Southeastern College of Osteopathic Medicine, 2000-2002
Asst. Clinical Professor, Dept. of Family Medicine, University of South Xxxxxx, 1988-1999
Education & Credentials
Master of Business Administration, University of Central Xxxxxx
Chief Resident, Family Practice, Western Reserve Care System-Northside Medical Center
Residency, Family Practice, Western Reserve Care System-Northside Medical Center
Medical Doctor, Universidad Central Del Este
Fellow, American Board of Family Practice
Diplomate, American Board of Family Practice
Diplomate, American Board of Quality Assurance and Utilization Review Physicians
Licensure, Board Certified Physician Executive, State of Xxxxxx
Memberships & Affiliations
Boca Raton Regional Medical Center | Hialeah Hospital | American Academy of Family Physicians
Xxxxxx Academy of Family Physicians | Phi Kappa Phi, National Scholastic Society
Beta Gamma Sigma, Business Honor Society
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