BRIAN F. MUSEKIWA

***** ***** ******* ****** *** D

Germantown MD 20876

Phone: 240-***-****

E-mail: abmeln@r.postjobfree.com

EDUCATION

Master in Public Administration (MPH) - June, 2006

Southeastern University, Washington, DC

Healthcare Management Specialty: GPA - 3.5

SUMMARY

An energetic and innovative professional offering "exceptional

Sales/Marketing, Business Development and Leadership abilities"

including: Presenting, Negotiating, Closing Planning, Organizing,

Implementing, Competitive Analysis Crisis/Problem Management Account

Penetration/Development Creative/Resourceful, Customer

Relations/Service Recruiting/Training/Coaching Promotion/Advertising.

. Knowledge of CPT, HCPCS, ICD-9, ASA, NDC coding, Statistical

Package for the Social Sciences (SPSS), NCQA, JCAHO, OSHA, Word,

Excel & Access.

Professional Accomplishments:

Managed Care Transitions

. Originated, implemented, and monitored practice protocols and work

flow for success under capitated contracts, reducing patient office

visits by 25% while improving patient satisfaction.

. Developed and implemented disease specific patient education

programs which decreased complication rates by as much as 30% and

generated cost savings of over $4 million per year.

. Designed managed care, capitation, integrated delivery systems

education programs for health care providers. Conducted workshops

for over 2,000 conference participants both domestically and

internationally.

Provider Network and Business Development:

. Collaborated with primary care and specialty physicians to

streamline referral mechanisms, decreasing patient waiting time by

25% and improving patient satisfaction.

. Participation in provider network development / capitation

contracting for Medicare Risk / Medicaid managed care products in

90,000 members HMO.

. Developed referral protocols which increased appropriateness of

primary care referrals to specialists by as much as 30%.

. Spearheaded revenue growth from $7 million to $20 million in 2

years for start-up.

. Negotiated 3-year contracts totaling $70 million with 4 key

clients.

. Launched start-up and propelled annual sales from $20 million to

$250 million; developed national network of 23 specialty medical

product/critical care distributors.

. Drove revenue from $18 million to $40 million in 3 years.

. Strategic Planning / Marketing

. Identified niche markets in specific patient populations. Designed

marketing strategies which increased patient population base by as

much as 30%.

. Directed cross-functional consulting teams in generating proposals

/ producing reports from multiple geographic locations, reducing

document delivery time by 50%.

. Created networks of contacts in acute, ambulatory, home health

settings, facilitating streamlined referral processes and

increasing both provider and patient satisfaction.

EXPERIENCE

06/06 to AMERICHOICE, Washington, DC

02/10 Health Plan Consultant

. Americhoice Company is one of the largest publicly- held HMOs

in the United States with 1.7 million members and revenues of

$2.5 billion. The mission of the United Health Group managed

care techniques to regional health care systems, both

domestically and internationally.

. Provided strong leadership including providing required

training, employee mentoring, teamwork, coaching and

feedback, career development and establish performance

standards.

. Implementing sales and marketing strategies for new and

existing business nationwide.

. Implemented a Strategic Plan in October of 2006 to target

specific Health Plans around the country for contract

development and census development activities.

. Led/Developed/Implemented the successful Network Development

of the Americhoice's Medicaid, Alliance and Medicare

Advantage product in Washington DC County. This effort

included contracting and credentialing activities for

Regional Hospital, Primary Care Physicians and Specialists.

. Negotiated/Developed a client contracts with hospital Chief

Executive, Chief Financial, and Chief Nursing Officer's,

healthcare groups, clinics with a large Washington DC based

HMO.

. Prepared/Managed strategic plans to develop a provider

network for a managed Medicare product for physician

providers, hospitals and healthcare systems to educate

providers about managed care plans and to gain their

acceptance.

. Initiated, built and sustained client relationships,

qualified new opportunities, developed in-depth knowledge of

competitive landscape, participated in pricing strategy and

ensured client satisfaction.

. Acquired and maintained data/information on market, industry,

economic, consumer and competitive conditions and trends

pertaining to health insurance/managed care and related

services.

. Provided research, analysis and recommendations on the

external environment as part of the development of strategic

plans for the business unit.

. Develop and implement operational policies, procedures and

standards to ensure that applicable and compliance

requirements are being met in a timely and professional

manner.

. Collaborated with account executives in marketing/sales

effort, creating new consulting opportunities and increasing

revenues.

07/03 to COMPREHENSIVE HEALTH SERVICES - Vienna, VA

02/06 Provider Network Administrator

. CHS is the only major workforce health management firm with a

three-fold service delivery capability Major corporation and

government agencies look to CHS for workforce health and

productivity management solutions that help maintain a

healthier, more stable productive workforce, maximized

employer's health care investment and integrated seamless

with their existing benefits strategies.

. Dealt in problem solving with providers.

. Identifies and monitors provider issues and concerns,

recommends solutions, and works with local and corporate

staff to resolve the issues

. Dealt with provider contracting, negotiating and pricing for

more than 20 non-defense government vendors and private

organizations and negotiates with providers alternative

methods of implementation that supports the intent of already

agreed upon terms or rates.

. Analyzed and interpret contractual, legal, regulatory and

legislative provisions to ensure contracts meet business and

regulatory compliance.

. Manipulated and extract costs, utilization, budgeting, cost

analysis, management of federal healthcare programs

(Medicare, Medicaid including Medicare Part D) using MS

Access, and Excel as needed to achieve desired goals.

Client Services Coordinator (12/2004 - 02/2006)

. Served as a liaison with the provider network community as it

relates to contract maintenance and management, operational,

and implementation issues.

. Generated and verifying claims, submitting claims to

Medicare, following up on claims suspended or denied on Fiss

System.

. Served as a resource for network contacts to provide ongoing

consultation and coaching, with a focus on action plan

development and monitoring, drill down analysis, and bulletin

board training.

. Review Patient Accounts, Determine appropriate billing

distributions, Process statements Collections, Post Payments.

09/02 to COVANCE, INC - Rockville, MD

07/03 Program Specialist

. Covance is one of the world's largest and most comprehensive

drug development services companies, with annual revenues

greater than $1.8 billion,

. Involved in health economic and outcomes research work

including managing projects, directing systematic literature

reviews.

. Directing qualitative interviews with patients, physicians,

and key opinion leaders; and directing qualitative and

quantitative analyses.

. Managed client engagements, directing the collection and

analysis of primary and secondary data and formulating

strategic advice for clients.

. Raised funds 20% above goals by coordinating fundraising

events for local health and wellness programs and greatly

improving community healthcare awareness.

12/98 to CITIGROUP - Dallas, TX

08/02 Credit Officer

. An International financial conglomerate with operations in

consumer, corporate, and investment banking and insurance.

. Underwritten loan requests for new and existing relationships

ranging primarily in loan size up to $5MM for new to bank

customers and $10MM for existing customers, with some larger

transactions on an exception basis.

. Documented recommendations in thorough credit memoranda that

accurately present credit risks and analysis.

. Organized awareness programs to inform community of various

services offered by Citi Group.

. Received Highest Number of Award quarterly.

VOLUNTEER EXPERIENCE

. SOME, Washington, DC volunteered as a vocational rehab

counselor and outreach worker educating the community about

the services of the clinic

. Children's Hospital, Washington, DC volunteered in the

oncology ward assisting patients and parents with various

activities.

Contact this candidate