Medical Management

Morgan Templar, MHA, CPMSM

Bishop Street; Unit **7

abpdn5@r.postjobfree.com

Framingham, Massachusetts 01702

540-***-**** cell

Strategic

Operations, Quality, Compliance & Accreditation

Accomplished healthcare

administrator with strong operations and strategic leadership skills with

broad-based experience in managed care, hospital system operations, and

integrated delivery systems. Recognized as a leader with excellent strategic

vision, collaborative teambuilding skills, and the vision to actualize

strategic goals. Proven effectiveness partnering with physicians to align

with mission and business objectives of leadership and the Board. Excellent

communication and interpersonal skills serve as the foundation to effectively

collaborate, negotiate, and maintain positive relationships. Passionate

about creating superior quality and safety, satisfaction, and financial

outcomes. Expert knowledge of NCQA, CMS and Joint Commission accreditation

standards. Compliance consultant for contracting, managed care regulations,

bylaws, and program policy and procedure.

PROFESSIONAL

EXPERIENCE

Dell

Services at Harvard Pilgrim Health Care August 2012 - Present;

Wellesley,

Massachusetts

Dell Services Healthcare Consulting

organization is focused on helping care providers through these

transformational changes in healthcare delivery, most of which are enabled by

IT. Working hand-in-hand with industry organizations, such as the Healthcare

Information Management and Systems Society (HIMSS) and the Office of the

National Coordinator for Health Information Technology (ONCHIT), we are deeply

involved in shaping the future of the healthcare IT industry.

Sr. Advisor, Program/Project

ManagementAugust

2012 - Present

Harvard Pilgrim Health

Care (HPHC) is ranked by NCQA as the #1 health plan in America for the past 9

straight years. The innovative IT infrastructure is a significant contributor

to this ranking, which is achieved through a strategic cooperative with Dell

Services.

Agile

Scrum methodology of project management;

Leading

the configuration team implementing the new provider network management system;

Third-party vendor management and collaboration;

Collaborating

with IT leadership and business SME s ensuring seamless transition across all

business areas and functions from Provider enrollment to Claims adjudication,

marketing and medical informatics, etc.

Valley

Health System December 2009 August

2012; Winchester,

Virginia

Health system of six hospitals with 610-bed

capacity and 110 LTC beds; 5,500 employees and about 860 Medical and Allied

Health Staff; One Level 2 Trauma Center and Level 3 NICU; Annual admissions in

2010 were about 31,000, with 112,000 ED visits and 875,000 outpatient visits;

Net operating revenue about $800M, Net operating expenses about $760M.

Corporate DirectorDecember 2009

Present

Accountable to the

Valley Health System Board of Trustees; Reporting to the Chief Quality and

Medical Officer of the VH System; Directed operations, created processes, enacted

agreements, managed culture, driver of change, investigated and corrected

inefficient business practices, influenced physician alignment, and represented

Valley Health in community and professional cooperatives.

Expert NCQA, Joint

Commission, and CMS Compliance oversight;

Physician Alignment,

Negotiation, Medical Staff Governance;

Project Development

and Implementation: Strategic Development and Implementation of regional

credentialing for a Joint Commission accredited multi-hospital system and

creation of regional central credentialing service, Student on-boarding, Policy

& Procedure development and standardization;

Functional integration

of compliance projects; Information System Administration, Database Management,

Technical Liaison between vendors and staff, RFP management;

Third-Party Payer

Delegation; Direct Insurance Enrollment activities and relationships with

third-party payers;

Lean Sigma

Methodology; Capital and Operations Budgeting.

American

Red Cross: Top of Virginia & Shenandoah/Page Chapters Winchester,

Virginia

Providing Disaster Services, Preparedness and

Health & Safety Courses, and Service to the Armed Forces to Clarke,

Frederick, Warren, Shenandoah and Page Counties and the independent City of

Winchester.

Chairman of the Board

of Directors December 2010 August

2012

Elected to the board

in July 2010 and voted in as Chair in December 2010. Merged chapter boards in

January 2012, merging chapters currently in process.

Leadership and

oversight of the operations and affairs of the Board for six county chapter;

Merged two chapters and boards and was again elected Chair; Governance

according to chapter bylaws;

Successfully led

national search and recruited Executive Director;

Effective management

of Public Relations issues and Representation of the chapter for fund-raising,

community and civic events;

Media appearances, mission

promotion, and community relations.

Coventry

Health Care March 2006 December

2009; Harrisburg,

Pennsylvania

Diversified managed care company offering a

full range of products including group and individual health insurance,

Medicare and Medicaid programs, and specialty services, operating 22 health

plans covering more than 5 million members in all 50 states; Operating Revenue

$12M, Medical loss ratio of 82.1%.

Business Analyst

Consultant Harrisburg,

Pennsylvania

Corporate Credentials

Verification Center (CVC)October

2007 December 2009

Process Engineering; Systems

Analysis; Workflow Development; Change Management; Oracle Database mining and

maintenance; Project Management following PMI methodologies; System

Integration, Data Migration for major acquisitions

Expert NCQA, URAC,

CMS and State regulation interpretation and compliance; HEDIS reporting data

collection and mapping

Strategic Analysis

and Implementation of IT enhancement projects: WebCrawler, document

outsourcing; FileNet, Imaging and paperless credentialing

Managed high-performance

personnel: Projects team, Data Integrity team, and Outsourcing team; Policy and

Procedure committee Leadership;

Strategic Design

& Implementation of National CHC Credentialing Caucus forum of 100+ managed

care leaders Think Tank for nationally interoperable strategies, policy, objectives,

and compliance

Operations ManagerSalt

Lake City, Utah

Corporate Credentials

Verification Center (CVC) March 2006 October

2007

Performance

Improvement; Auditing; Strategic driven metrics

Entrepreneurial

start-up project: Opened third U.S. office in Salt Lake City. Initial facility

set-up. Recruited, hired & trained 25 staff in 60 days

Personnel

orientation, training and ongoing education

Leadership of CVC Policy

and Procedure committee, Implemented full-rewrite to meet NCQA, URAC and CMS compliance

guidelines

Intermountain

Healthcare (IHC) April 2001 March

2006; Salt Lake City, Utah

Internationally recognized,

nonprofit health system of 22 hospitals, an employed Medical Group with more

than 185 physician clinics, and an affiliated health insurance company

providing integrated care delivery with over 33,000 employees serving patients

and plan members in Utah and Idaho; Over 135,000 inpatient admissions, 463,000

ED visits, more than 108,000 outpatient surgeries; Net income of $4,573.5M with

$193M in Charity care.

Project CoordinatorSalt Lake City, Utah

Medical AffairsNovember 2005 March

2006

Project

Management following PMI methodologies;

Data

Base Management: Responsible for system integrity and data management; Reporting;

Policy

& procedure; Training Coordinator: employee orientation & training

Medical Credentialing

SpecialistSalt

Lake City, Utah

Medical AffairsSeptember

2004 November 2005

Credentialing

Committee coordination and support; Physician Relations

Recredentialing

of over 2500 providers for Intermountain Medical Group

Senior Executive

SecretarySalt

Lake City, Utah

Urban Central Region

Administration (IHC UCR)July 2002 August 2004

Lead Project

Manager: IHC Urban Central Region/SLCC Nursing Program. Budget: $1.5 Million.

Two-year project including development, implementation and management turned

an idea with budget approval into a fully accredited RN degree program

including contract negotiation, program design, recruitment of key staff,

budget planning and oversight, Public Relations, student selection and student

liaison. Successful project expanded to launch of Ultrasound Technologist

training program and Neonatal Nurse Practitioner training program.

Financial

Dashboards enhanced and presented monthly for region Executive Leadership and

Board of Directors;

Capital Budget

process coordination and ranking

Other Positions: 1990

- 2001; Salt Lake City, Utah area

Director Process Improvement and Human Resources, Internet Events

International (IEI): Internet Top-Level-Domain Registry

Regional Director Sales North American Region, Virtual Media

International, Inc. (VMII): Internet based trade-shows

President, Mohr Consultants: Small business accounting,

bookkeeping, and tax preparation

EDUCATION

& CERTIFICATION

Masters

HealthcareAdministration

2012

Ohio University Athens, OH

Bachelor

of Science Public Relations2007

University of Utah Salt Lake City, UT

CPMSM

Certified Professional in Medical Services Management

National Association Medical Staff Services

Washington, DC

Other Certifications:

Targeted

Selection certified

interviewer

HAZWOPER (HAZMAT)

certified Incident Commander

LEAN Value Stream

Analysis trained consultant

SELECTED

PRESENTATIONS AND AWARDS

Featured

Speaker:

o

The Paperless

Office, Pennsylvania

Association Medical Staff Services Annual Conference, April 2011

o

Managing

vendor, CVO, and large organization relationships, West Virginia Association Medical

Staff Services Annual Conference, October 2011

o

The Mission of

the Red Cross, Rotary

Club of Winchester, March 2011

o

Strategic

Planning, Utah

Association Medical Staff Services Annual Conference, August 2006

o

Professional

Workshops Coventry Health Care, SLC CVC, 2006 2007, Presented Monthly

workshops on Communication, Teambuilding, Organization, Attitude, and

Leadership;

Promotional Appearances

Public, Broadcast, Multi-media and Social Media, The Mission and Vision of

the Red Cross

Awards:

o

Executive of the

Year: Virtual Media International, Inc. 2000

o

Chairman s

Circle: Internet Events International 2001

o

Shining Star:

Intermountain Healthcare 2004

o

Golden Key

International Honour Society

o

The Honor Society

of Phi Kappa Phi

PROFESSIONAL & SERVICE ORGANIZATIONS

American

College of Healthcare Executives (ACHE)

Rotary

Club of Wellesley/Rotary International

Izaak

Walton League

National

Association of Medical Staff Services (NAMSS)

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