Customer Service Sales
Resume:
Healthcare Professional (South Florida)
Date: ***2-12-12, 3:51PM **************@***.***
Mark R Julian, MHA
Sunrise, FL 33323
Human Resources Department
Dear Hiring Manager:
I hold a Master Degree in Healthcare Administration, Bachelor of Science in Business Management, and currently pursuing a Project Management Professional Certification at FAU to further expand upon my professional career. I am working independently and self-employed at the moment. However, I am looking to retain a permanent position within the healthcare organization market.
I am eager to discuss any employment opportunities for which I am qualified and to share my current and former healthcare experience to enhance your company's brand and reputation.
Sincerely,
Mark Julian
Cell: 954-***-****
Email: ***********@***.***
Resume to follow:
MARK R. JULIAN, MHA
4390 NW 115th Avenue, Fort Lauderdale, FL 33323
Home: 954-***-**** - ***********@***.***
HEALTHCARE EXECUTIVE PROFESSIONAL
Flexible, self-motivated, resourceful, business savvy, well organized and detail oriented, 19 years' experience in healthcare.
SKILL HIGHLIGHTS
Leadership/Management Professional/Enthusiastic Dedicated/Hardworking/Loyal
Positive/Motivated Planning/Organizing Flexibility/Adaptability
Analytical/Problem Solving Teamwork/Willingness to Learn Superior Written/Verbal/Visual Communications
CORE ACCOMPLISHMENTS
Business Development:
Successfully implemented a business plan for a risk partnership contract out from under a $1.2 million dollar deficit into a profitable organization.
Established and managed business partner relationships on a daily basis to promote value and brand recognition with over 200 major practices, 2 mandatory vision networks, 4 major hospital employed physician contracts, and managed service organizations network contracts for Humana.
Retained over $29 million dollars annually for United Healthcare commercial employer group segment and was ranked one of the top 10 employees in the country on a monthly basis.
Legal Document Review
Negotiated and finalized corporate contracts including product agreements, service agreements, nondisclosure agreements, vendor agreements and employer group insurance policies.
Customer Service
Collaborated with contract loading, claims, and marketing to ensure the delivery of efficient, high-quality service for customers.
Consistently recognized for providing superior customer service and relationship building with top clients.
Project Development and Project Management
Collaborated with finance and IT in the development of a desktop application to extract data from a DOS mainframe system.
Assisted and lead teams for United's Medicare Open Access project with marketing, operations, and IT development, along with deliverables and communications including presentations and training.
PROFESSIONAL EXPERIENCE
Independent Healthcare Consultant, Currently Self Employed
Providing business, finance, and operational solutions for physician and ancillary providers, such as, Medicare Risk Management, Medicare and healthcare organization billing, and physician practice set up.
Electronic Health Records (EHR) implementation, Human Resource Management, Medical Risk Assessment (MRA). Create trend analyses and business summaries for future planning and market strategies.
Regulatory compliance, adherence to standards, regulations, and other Federal and State healthcare mandates.
Provider Contractor,
January 2007 to December 2011
Provider Contracting HUMANA, Inc
As a hospital, physician, and ancillary services contract representative, the primary responsibilities are managing the network, interacting with the provider community, and negotiating contracts.
Facilitated the local sales and corporate efforts and initiatives to penetrate new markets and develop new business opportunities.
Facilitated provider education to increase familiarity and satisfaction with Humana's systems and strategies with Medicare, Medicaid and Commercial segments.
Strategic Account Manager,
January 1998 to July 2006
United Healthcare, Inc
Presented sales and renewal information for both new and existing business.
Ability to lead and direct support staff to educate, monitor and coach.
Skills maintained; superior presentation skills, problem solving, claims, analytical, prioritizing, and strong written and oral communication skills.
Demonstrated leadership skills by taking ownership of projects, client issues and identifying the root cause and resolution.
Assisted in achieving market and company growth objectives.
Maintained retention by exceptional service and relationship building with the brokers, consultants, and with the clients.
Renewed existing business and added ancillary products to increase the profitability in the Commercial segment.
Supported the sales team, sales department and company sales targets.
Provided group benefits presentations and enrollment meetings.
Supported assigned high profile accounts, including elite service to agency and broker businesses.
Grievance Advisor
January 1998 to January 1999
United Healthcare, Inc
Management, Quality Assurance and the Claims Processing Center.
Resolved appeal and grievance issues for Medicare members regarding denial of services, claim disputes, and complaints.
Skills maintained; time management, maintaining Excel database, and adhering to all HCFA (CMS) Medicare guidelines.
Coordinated formal responses based on research from Customer Service, Enrollment, Provider Services, Medical.
Compliance Advisor
January 1997 to January 1998
United Healthcare, Inc
Researched and prepared formal responses to HCFA (CMS) inquires. Including all HCFA compliance issues.
Educated and distribute to all appropriate departments all HCFA (CMS) approved collateral.
Directed work group meetings within each department responsible for the 1999 Medicare Direct Open Access launch.
Pharmacy Representative
January 1994 to January 1996
Caremark/CVS Pharmaceutical Services
Responsible for sales and service of national accounts as a pharmacy benefits administrator.
Performed product and service presentations for prospective and current client base (largest account Prudential).
Interacted with Pharmacy IT and Pharmacy staff.
EDUCATION
Florida Atlantic University, PMP Certification, Attending 2012-2013
Professional Management Program (PMP) Certification
Ohio University, Master, Graduated 2012
Health Administration
University of Phoenix, Bachelors, Graduated 2009
Business Management
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