Manager Medical

Boyd Woolsey

Email: abqg15@r.postjobfree.com

Address: **** ******** *****

City: South Jordan

State: UT

Zip: 84095

Country: USA

Phone: 801-***-****

Skill Level: Management

Salary Range: $120,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Boyd J. Woolsey, MHA

4827 Rosewood Drive * South Jordan, Utah 84095 * 801-***-**** * abqg15@r.postjobfree.com

Skills Summary

A skilled healthcare leader with 23 years guiding physicians, health care professionals, technicians and administrative staff in hospital, clinic, home health and durable medical equipment settings. Extensive skill in contracting and cross-functional project partnering, strategic development with tactical execution resulting in solid solutions.

Professional Experience

University of Utah Health Plans

Director of Provider Relations and Contracting August 2012 to Present

Responsible for oversight of all provider operations and functions including network contracting, provider relations and credentialing activities. Planned, organized, directed and controlled all aspects of assigned team interactions with external customers, human resource and financial management.

* Evaluated provider network and implemented strategic plans to achieve company targets through aggressive primary care, specialty, hospital and ancillary provider contracting and management

* Identified potential new relationships and calibrated network for achievement of profitable growth

* Assisted in the analysis of claims trend and market data to derive positive contract arrangements

* Delivered direct, complete and actionable feedback to support staff to foster continuous learning

Johnson & Johnson

Managed Markets Regional Director, Animas / Life Scan

December 2011 to August 2012

Responsible for managing account teams to promote company products to payers and ensure favorable access, coverage and reimbursement. Developed positive payer relationships with key opinion leaders and executives to establish targeted initiatives in promoting and building consensus.

* Determined contract requirements, terms and conditions to ensure adherence to laws, regulations, and corporate polices resulting in broader coverage and timely reimbursement

* Directed payer opportunities and trends resulting in positive growth and significant attainment of goals

* Developed strategic initiatives and led tactical execution resulting in broader opportunities for growth and influence with health care professionals, payers, pharmacies, and national distributors

* Managed all personnel functions including hiring, performance evaluations, payroll and training

Director, Managed Care, Animas August 2006 to December 2011

Provided market intelligence, education on benefit design and reimbursement trends to solidify brand value to national payers. Led all contract reviews, solicitations, proposals and bids.

* Provided leadership and tactical support to AR resulting in $1MM in gross reduction in cash collections; realized 11% payment improvement in claims from previous year

* Led cross functional teams and provided contractual guidance leading to the highest percent and volume growth increase in the distributor channel of 65%

* Interpreted significant or unique contractual requirements, special provisions, terms and conditions resulting in compliance with appropriate laws, regulations, and policies

* Managed all personnel functions including hiring, performance evaluations, payroll and training

Regional Manager, Managed Care, Animas

September 2004 to August 2006

Provided contractual guidance to business team members. Analyzed new laws, regulations and contract trends for potential impact on territory goals and objectives. Developed and implemented pull-through activities with targeted Payers.

* Formulated strategic ingenuity and led tactical execution with team resulting in double digit growth

* Completed merging Tri West Region contracts into one comprehensive offering resulting in combining 21 States, 2.7 million covered lives and reducing administrative burden

Lt Col, Medical Service Corps

November 1989 to October 2012

Healthcare Administrator, Air Force and Navy Reserves

Provided leadership and oversight for all clinic and hospital administration functions.

* Enhanced administrative affairs of up to 52 physicians- family practice, internal medicine, pediatrics, general surgery, cardiology, gastroenterology, endocrinology, ob/gyn, emergency medicine, occupational medicine, and radiology

* Organized credentialing, compliance/quality improvement; call schedule, hospital privileges, coding, malpractice and professional societies to maintain licenses and professional affiliations

* Oversaw physician staff grievance process and arbitrated issues related to unionized employees to interpret and apply provisions of employment contract conditions

Intermountain Health Care - May 2001 to September 2004 Group Operations Manager, Physician Division, Salt Lake City

Facilitated all operations, budgeting, professional recruitment and capital planning for 7 clinics

* Prepared and implemented $30 million budget for 16 clinics with, 43 providers, 3 pharmacies, 12 direct reports, and 100 in-direct reports. Hired ancillary practitioners, nursing and administrative staff

* Led region billing functions, policies and procedures, government regulations resulting in successfully resolving collectibles and managed care payer contractual issues

* Performed in-depth operation and capital budgeting forecasting for strategic planning resulting in solid physician recruitment, business improvement initiatives, and community relations

* Established and expanded outpatient services and programs resulting in successful addition of cardiology, retail pharmacy, dexascan, and diabetes care services

Business Development Director, Home Care and Hospice, May 1996 to May 2001

Developed and implemented comprehensive contract and negotiation strategy with pharmacy services, and durable medical equipment.

* Developed and implemented the first comprehensive contract and negotiation strategy for pharmaceutical and durable medical equipment resulting in lowering fixed costs by $30,000

* Streamlined contract coordination with AmeriNet, Deltec, Zevex (Moog), Abbott, Ross and McKesson resulting in consistent terms, conditions, and maximum efficiencies in contract administration

HealthTrust Inc.

September 1995 to May 1996

Account Executive, Payer Contracting Salt Lake City,

Refined relationships with payer groups through managed care contract negotiations and development of business development strategies.

* Nurtured productive contracting relationships with HMO`s, PPO`s, and government payers

* Analyzed Utah House and Senate Bills dealing with healthcare resulting in implementation of recommended course of action with lobbyists, committee members, and hospital administrators

Patient Account Services Director,

February 1994 to September 1995

Price, Castleview Hospital

Directed AR with a staff of 23 in admitting, billing, and cash posting for a rural hospital.

* Improved accounts receivable days from 63 to 45 and bad debt from 3.5% to 1.0%

* Reduced $270,000 in budgeted costs and increased recovery profitability by 67%

Education

University of Colorado - Denver, Colorado, Master of Science, Health Administration

University of Phoenix - Murray, Utah, Bachelor of Science, Business Administration

Coursework

Hospital Operations and Leadership Fellowship, Ambulatory and Managed Care Contracting Series, Service-Disney Style, TQI/CQM, Getting Things Done, State and Local Government Contracting, Contracting & Pricing Compliance

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