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Managed Care Business Development

Location:
La Grange, Kentucky, United States
Posted:
November 27, 2018

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Resume:

Harry L. Duer

Executive Profile

CELL 615-***-****

ac7s8r@r.postjobfree.com or ac7s8r@r.postjobfree.com

Over the last 18 years I’ve worked as an independent consultant or full-time employee doing business development for healthcare networks and providers. These experiences led to a deep understanding of multiple markets nationwide. The methodologies used to develop these markets are generally a 50/50 mix of telephonic contact and in-market provider meetings. In doing this I also become well versed in contract language negotiations as well. I have worked with all specialties of providers, ancillaries, facilities and hospitals and multiple payers nationwide introducing new products and services. I am also experienced in various reimbursement methodologies such as Value Based contracting and Capitation. I have also drilled past the payer level to service employer and TPA needs on the provider side when needed. The following list more detailed information about my experiences and qualifications in a way to hopefully break the mass of information down to a more readable format If you do not feel comfortable with all the links then please visit www.duersconsulting.com where you can see most of the same info. Harry Duer LinkedIn Address

Linkedin References

Map of Contracting Experience - Please note most states while having one star should have more, however only one star was used due to space requirements.

Products Developed

• Medicare

• Medicaid

• Duals

• Workers Compensation

• Commercial

• Commercial Exchanges

• SNPs

• ISNP

Payment Methodologies

• Percent of Medicare

• Medicaid

• Incentive

• Capitation

• Case Rates

• Groupers

• Per Diem

• Bundled

• Value Based

Managed Care Network Development Project List - Network Development Detailed Project List 6 Medicare networks

4 Dual networks

5 Medicaid networks

2 Health Exchanges

1 Clinical Integrated Network

1 Accountable Care Organizations

3 Commercial networks

1 Workers Compensation network

I Behavioral Health network

3 Additional contracting projects

Provider Market Research for Investors/ Consulting Firms Reported on the following market conditions-Behavioral Health, Physical Therapy, Urology, Homecare/Hospice, Women’s Health, Nursing, Toxicology, Vein Industry, and Florida market. Managed Care Provider Contracting List - Detailed Provider Contracting List 1 BH Hospital system

5 SNF’s

1 IOP Treatment Center

1 Laboratory provider

3 Home Infusion providers

1 Durable Medical O and P network

1 Home Health provider

1 Ambulatory Surgery Center

1 Neurology Group

1 Urgent Care Center

1 Orthopedic Grp

1 Wound Care Provider Group

1 Pain Management Network

Employment Detailed Employment List

Bright Health Plan- 10-2018 to Present- National Managed Care Network Development Specialist. National Managed Care Business Development Consultant 2/08- to 10-2018 United HealthCare- Network Account Manager 5/09 to 2/10 Concentra\Coventry HealthCare- Contract Manager- 12/2000 to 02/2008 Additional Smaller Projects

Developed credentialing services network, paper on Healthcare Exchanges in GA, talking points for contractors on Healthcare Exchanges, contracting implementation plan for SC and IN. Staffing for Medicaid expansion and VA Medical Recruitment- (Vet-Pro) KY, Medicare staffing recruitment- MI Review and Due Diligence of National SNF contracts for large SNF provider Education

Trevecca Nazarene University – BA Management and Human Relations 1994. Intangibles

Inventive in marketing

Strong work ethic

Ability to build something out of nothing in the managed care world Great team player but strong in handling all things as solo contributor as well Ability to see and work the big picture

Notable Career Events

References available upon request



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