Director

David Fontaine

**** ********* ***** . ************, ** 21136

abmql5@r.postjobfree.com . 443-***-**** h . 443-***-**** c

Director of Managed Care Services / Health Plan Administrator

VISIONARY, TEAM-ORIENTED PROFESSIONAL WITH MORE THAN EIGHT YEARS OF CURRENT

EXPERIENCE STRATEGIZING AND LEADING CONTRACT NEGOTIATIONS FOR ALL ENTITIES

OF MANAGED CARE LINES OF BUSINESS. MOTIVATIONAL, SOLUTIONS-FOCUSED LEADER

WITH PROVEN EXPERTISE IN BUILDING AND DIRECTING CROSS-FUNCTIONAL EXECUTIVE

TEAMS IN DEVELOPING POLICIES AND PROGRAMS FOR HEALTH PLAN ADMINISTRATION

AND MANAGED CARE SERVICES.

HISTORY OF EXCEEDING KEY RESULTS OBJECTIVES AND GENERATING SIGNIFICANT COST

REDUCTIONS WHILE SUBSTANTIALLY IMPROVING CUSTOMER SERVICE SCORES.

CONSISTENT TRACK RECORD OF ESTABLISHING, DIRECTING, AND FACILITATING HIGHLY

PRODUCTIVE AND EFFICIENT TASK FORCES AND COMMITTEES.

AREAS OF EXPERTISE:

NEGOTIATION STRATEGY DEVELOPMENT Multimillion-dollar Budget

Administration

Reimbursement Methodology Financial Modeling and Analysis

Creation Training Program Design and

Performance-based Payment Rates Delivery

Strategic Partnership Building Team Building and Leadership

Professional Experience

ADVENTIST HEALTHCARE (AHC), ROCKVILLE, MD

Director of Managed Care Services (6/2004 to Present)

Negotiated reimbursement contracts with large commercial insurance payers

on behalf of $900 million healthcare organization with over 7,000 staff

members; manage $25 million self-funded employee health plan for 7,200

covered lives.

Create database of all managed care contracts for all AHC entities

including two Acute Care hospitals, Home Health Services, Behavioral Health

hospital and outpatient services, Rehabilitation hospital and out-patient

services, physician practice agreements, urgent care centers, cytology lab,

and radiology center. Devise tracking system for process management of

negotiations. Build exceptional working relationships with Executive teams

of AHC entities, commercial insurance providers, and contracting

professionals. Oversee conflict resolution with insurance companies and

physician groups. Effectively lead research and problem-solving efforts

related to managed care issues. Study and advocate for clinical integration

and coordinate care initiatives through Health Plan pilot projects and with

insurance companies. Facilitate work of Health Plan Steering Committee

(cross-functional Executive team) in developing strategic plans, policies,

and programs for health plan and managed care services. Develop,

administer, and monitor $25 million budget for employee health plan. Design

Pay-For-Performance (P4P) plan for doctors.

- Exceeded CFO Key Results Areas and improved customer service scores

during all eight years.

- Saved $1.2 million in '09/'10 through Patient-Centered Medical Homes

Pilot initiative.

- Successfully reorganized and redesigned entire managed care department

to include corporate policy and workflow planning.

- Created, implemented, and wrote magazine cover story for Patient-

Centered Medical Home pilot.

- Chaired multiple committees as well as Task Force that created AHC

Wellness Program and developed smoke-free campus policies.

Governor's Workforce Investment Board, State of Maryland

Director of Business Policy (10/2001 to 6/2004)

Fully responsible for developing and implementing workforce investment

policy for the State of Maryland.

Led and conducted nationwide research on best practices in workforce

development. Designed and executed statewide research into critical worker

skill shortages. Managed Board subcommittees for Marketing; Workforce

Diversity; Quality Outcome Measurement; and Attracting, Retaining, and

Developing Maryland's Workforce. Coordinated and managed statewide business-

to-business conference on workforce development.

- Created cluster-based approach to Workforce Development; established

and convened first cluster-based (HealthCare) summit of education,

business, and education leaders.

- Designed, wrote, and secured first-of-its-kind, $5 million grant from

U.S. Department of Labor.

- Assisted in creating and facilitating cluster-based steering

committees in HealthCare, Aerospace, Hospitality, Tourism, and

Manufacturing.

Fontaine Associates, Inc., State of Maryland

President / CEO (6/1996 to 10/2001)

Led team of professional associates providing consulting and training

services to Fortune 500 companies.

Directed and coordinated delivery of training programs on topics such as

leadership and team training, facilitator training, problem solving,

organizational readiness assessment, high-performance workplace systems,

interest-based bargaining, gain sharing design and implementation, change

management, and results measurement.

Baltimore Area Labor-Management Committee / Maryland Alliance for Labor-

Management Cooperation, Baltimore, MD

President (9/1989 to 10/2001)

Started up, managed, and coordinated all aspects of operations for two non-

profit organizations dedicated to attracting and retaining jobs through

highly effective labor-management cooperative programs.

Led and facilitated strategic planning with Board of Directors. Wrote

grants and solicited contributions to achieve organizational goals and

objectives. Developed and presented training programs and seminars on

elements of high-performance workplaces including leadership, team

building, supervision, active listening, effective feedback, and conflict

resolution.

- Created and led task forces of business / labor leaders to develop

public policy recommendations on healthcare reform, economic

development, child care, and drug and alcohol abuse in the workplace.

** *** **

Prior experience as Assistant to the President / COPE Director (1985 to

1989) with the Metropolitan Baltimore AFL-CIO Council of Unions and

Incentive System and Payroll Analyst / Business Agent / Education and

Political Director / Assistant Regional Director (1972 to 1985) with the

International Ladies Garment Workers Union.

Education and Credentials

UNIVERSITY OF PHOENIX - PHOENIX, AZ ( BUSINESS MANAGEMENT

Johns Hopkins University - Baltimore, MD ( Business Leadership

Antioch College - Silver Springs, MD ( Labor Studies

Additional Professional Development

ECR Associates: Adult Learning Model, Team Building, Strategic Planning,

Project Management, Gain Sharing, Socio-Technical Redesign; Association for

Quality and Participation: Interest-Based Conflict Resolution, Rewards and

Recognition; ODI: Total Quality Management, Group Dynamics and

Facilitation; Penn State University: Time and Motion Studies; Health

Finance Management Association: Various Seminars; Franklin Covey: Seven

Habits of Highly Effective People

Public Service / Community Organizations

"THE LEADERSHIP," GREATER BALTIMORE COMMITTEE; ADVISOR TO U.S. DEPARTMENT

OF LABOR, OFFICE OF THE AMERICAN WORKPLACE; ADVISOR TO NATIONAL ALLIANCE OF

BUSINESS; FELLOWS MEMBER TO AMERICAN CENTER ON INTERNATIONAL LEADERSHIP

(U.S./U.S.S.R. EMERGING LEADERS SUMMIT, U.S./MEXICO SUMMIT, U.S./EUROPE

SUMMIT); HPWO SEMINAR LEADER FOR INTERNATIONAL INSTITUTE FOR RESEARCH;

VOLUNTEER FOR HABITAT FOR HUMANITY

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