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Home Health Medical

Location:
Kansas City, Missouri, United States
Salary:
125,000
Posted:
May 22, 2018

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Resume:

James R Sergeant, MBA

***** ** **** ******

Kansas City, MO 64152

Mobile 775-***-****

ac5kag@r.postjobfree.com

Summary

More than twenty years in a Senior Administrative Role with National and local hospitals, Ambulatory Surgery Centers and Multiple Physician Practices.

Extensive Managed Care contract Negotiations and Network development

Strong financial performance.

Strong leadership, strategic planning, communication, regulatory survey planning and presentation skills.

Accomplished negotiator and lobbyist in both the U.S. and State legislatures of Kansas, Nevada, and Oregon.

Professional Experience

St Joseph Center for Outpatient Surgery LLC/ Nueterra Capital November 2015 to October 2017

St Joseph, MO

Administrator/CEO

Joint Venture ASC between 13 surgeons, and Nueterra management company. SJCOS has 2 operating rooms and 4 procedure rooms.

The facility currently performing 2 total joints per month. Personally negotiated managed care contracts for a network of pre and post care with Home Health, Physical Therapy, Rehabilitation hospital to provide a comprehensive care program.

28 credentialed medical staff who performed over 7,000 procedures per year.

East Portland Surgery Center LLC February 2013 to Jul 2015

Portland, OR

Administrator/CEO

First ASC in the USPI Portland area to successfully perform an outpatient Total Knee surgery. Developed a pre and post care network with Home Health agencies, Rehab Hospitals and Physical therapy to provide a comprehensive program.

Participated in an early ACO model with Legacy Health System called Health Share of Oregon’s CCO for Medicaid participants.

Joint Venture ASC between 12 surgeons, Legacy Hospital System and United Surgical Partners International. EPSC has 4 operating rooms and 2 special procedure rooms.

35 credentialed medical staff members who perform an average of 4,000 procedures per year.

I developed one of the first bundled total joint, back surgery, and hand surgery contracts with large self-insured employers from the state of Alaska during my tenure at East Portland/ USPI. This product required that I negotiate fee schedule rates based on the portion of the bundled payment allowed for Anesthesiology group, Neurosurgeons, Orthopedic Surgeons, the ASC, and Orthopedic Hand Surgeon. Plus contracting with physical therapy company and home health agencies.

Sierra Surgery Hospital and Imaging Center June 2009 to Jan 2013

Carson City, Nevada

CEO

Sierra Surgery Hospital was sold to the 70% owner Carson Tahoe Regional Healthcare in January 2013 all SSH senior officers contracts were not renewed.

Negotiated Managed care agreement with Hospitalist group to cover non-surgical co-morbidities.

JACHO certified multi-specialty surgical hospital that began operation in 2005. SSH/NV is a 70/30 joint venture between Carson Tahoe Regional Healthcare, a not-for-profit hospital, and CASCI, a 55-member physician-owned management organization.

Six operating rooms, along with an Imaging Center that utilizes state-of-the-art equipment to provide digital MRI, CT, Ultrasound and Fluoroscopy services. Special emphasis is placed on breast imaging at The Breast Imaging Center, which is designated as a “center of excellence,” by the American College of Radiology.

SSH/NV has 95 credentialed medical staff members who perform an average of 6,000 procedures per year.

Salina Surgical Hospital June, 2003 to June, 2009

Salina, KS

CEO

Negotiated managed care contract with internal medicine group to cover non-surgical care also contracted radiology and lab agreements with Salina Regional for service not provided by SSH.

Salina Surgical Hospital (SSH/KS) is Joint Venture multi-specialty surgical hospital open since 1999. 50/50 joint venture between Salina Regional Health Center, a 359-bed regional medical center and Physician and Investors a physician-owned entity. Four operating rooms and two specialty procedure rooms used for G.I. procedures. Opened with eight inpatient rooms and was expanded in 2005 to a total of sixteen inpatient rooms.

The medical staff of 50 providers. Performs on average over 8,000 procedures per year.

In June 2003, joined Salina Surgical Hospital (SSH/KS) as an employee of Health Inventures, Inc., the management company retained by SSH to provide management and administrative service. I was employed by Health Inventures but reported to the Boards of Salina Surgical Hospital and Salina Surgery Properties.

HCA/Continental Division/Wichita Market 1996-2003

Wichita, KS

Vice President of Managed Care & Business Development/ State of KS Legislative Liaison

Negotiated managed care contracts for 30 national and local insurers.

Developed strategic new business opportunities, in a hyper-competitive market, for Wesley Medical Center, a 760-bed tertiary hospital, Surgi-Care of Wichita, Wesley Occupational Health Services and Wesley Family Medicine (25-physician PHO).

Developed a capitated product with Raytheon Aircraft, Coventry Healthcare, and HCA to cover Raytheon’s 2000 plus employees. Developed provider network in Kansas areas such as Salina, Hays, and Dodge City to cover the outlying Raytheon employees.

Worked with United Healthcare to develop a provider network beyond the hospital system such large multi-specialty groups like Wichita clinic.

I performed network development in conjunction with an HCA owned PPO network called Health Partner of Kansas (HPK). I assisted HPK in developing several PHO models by contracting with Wesley Medical Center and its 25 physicians 4 clinic system, Hays Medical Center its two physician clinics, Salina Regional Healthcare and it one physician clinic, and Western Plains Regional Hospital in Dodge City and its two independent clinics. This process required over a year to complete with multiple face to face rate negotiations and language revisions.

Riverside Health System 1992-1996

Wichita, KS

Director of Clinic Operations

Directed a 10 clinic, 24-physician health care system with a budget of $10 million.

Managed a team of 10 office managers and over 100 employees.

Established a centralized billing service to reduce overhead.

Successfully negotiated insurance contracts with all major insurers in the Wichita marketplace.

Consulted on CLIA laws, Stark I and II and OSHA compliance.

EDUCATION AND TRAINING

M.B.A. Healthcare Administration, Wichita State University, Wichita, KS, 2000

B.S., Wichita State University, Healthcare Administration and Finance, Wichita, KS, 1989 graduated magna cum laude

Professional Memberships

Past Board Member of Oregon Ambulatory Center Association

Past Member, Nevada Hospital Association (NHA)

Past Member, NHA Policy, and Advocacy Committee

Past Member, NHA CEO Council Northern Nevada

Past President and current member of the Physician Hospitals of Kansas

Member, Physician Hospitals of America

Member, American College of Healthcare Executives

Social Responsibilities

Member, Northern Nevada Development Advisory Committee (NNDA)

Member, NNDA Healthcare Advisory Council

Member, Carson City Chamber of Commerce

Member of Salina Rotary Club

Board of Directors Member for Salina Community Theatre

Board of Director Member for Salina Downtown Association



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