Health Physician

Carlos Ramirez

Phone: 305-***-****, Email: ********@*****.***

https://www.linkedin.com/in/cram-mph-hsa/

Vice President Operations/ Executive Leader - Healthcare Administration

Dedicated, competent, and results-oriented Healthcare Administration professional bringing along 20+ years of experience in fostering greatly improved working relationships and ensuring consistent quality of patient care. Adroit in maintaining a highly visible presence, interacting constantly with key stakeholders to inform and advise them of strategies, current healthcare trends, legislation, and activities. Deft at developing and implementing successful strategies that ensure delivery of high quality, cost-effective healthcare. Skillful in balancing cost and quality issues and partnering with the medical staff to address productivity and quality improvements. Success delivering robust strategies to optimize ROI with adeptness in holding full P&L accountability and success managing multiple concurrent projects. Strong business acumen, refined knowledge of healthcare funding, and experience in competitive marketplaces with the ability to make complex and difficult decisions. Communicate and inspire colleagues and staff through vision, goals and strategy for client teams and guide them to produce creative and effective outcomes.

SKILL AREAS: Healthcare Administration & Management ● Strategic Planning & Execution ● Start-Up, Turnarounds & Expansions ● Continuous Process Improvement ● Physician & Clinical Recruitment ● Contract Development & Negotiation ● Budget Development & Administration ● P&L Management ● Financial Forecasting & Analysis ● Program & Project Management ● Consensus Building ● Communication ● Team Leadership ● Cross-functional, Multidivisional and Matrixed corporate leadership experience

PROFESSIONAL EXPERIENCE

Certus Healthcare Management Consultants; Miami, FL (2013 – Present)

Vice President

Certus Healthcare is a metric-driven Healthcare management consultant company that services Physician Practices, MSO’s, Hospitalist groups, ACO’s and Medical centers with a high degree of quality for those we serve.

Leverage Lean Six Sigma methodologies for business operations to deliver substantial gains in ROI and process improvements.

Communicate with HMO, MSO’s, ACO’s, Physician’s groups, and Hospital clients to assess and address their distinct corporate goals.

Hold full P&L accountability across multiple concurrent projects; perform revenue cycle management and implementation of new Electronic Health Record (EHR) systems.

Devise, recommend, and initiate customized strategies/projects that consistently meet or exceed expectations.

Manage the full recruitment life cycle as well as write and implement comprehensive policies & procedures per industry and local / state / federal government & regulations.

Negotiate critical contracts with multiple financial arrangements including FFS, full risk, capitation, case rate, valued base & continuously increasing EBITDA for assigned clients.

Manage client’s Patient-Centered Medical Home setting with NCQA for compliance, as well as setting up and managing MIPS payments, HEDIS with clinical team and Star ratings based on HMO contracts requirements.

Assist clients with their HCCs, MRA scores for individual profit maximization in their practices or groups.

Insurance, Contracts, legal matter governance experience.

Responsible for staff on-boarding, Human Resources, day to day support and oversight, and management of remote teams.

Responsible for facility(ies) management of programs, IT, Revenue Cycle management, and database management.

Lead efforts building de novo clinics integrate acquired clinics in the market space, close existing operations, consolidations, and purchases of PCP offices.

Highlights:

Drove annual billing revenue by 50% for Advinity LLC., a Hospitalist company in Florida/Texas. Created the in-house Revenue Cycle Department.

Delivered a 50% improvement on billing processes and led to increasing monthly revenue by 35% on behalf of MMR Healthcare.

Applied and qualified for MMR to become a Diabetes Teaching Site with the National Institute of Health accreditation. First certified site in Palm Beach County.

Cano Health; Miami, FL (Jan’18 – Oct’18)

Vice President – Project Management: Compliance & Control

Cano Health, LLC, operates 46 primary care centers, pharmacies, and dental clinics that specialize in care for older adults. As part of its care coordination, the enterprise provided sophisticated, high-touch population health management programs including patient-centric programs such as home visits, telehealth, the transition of care, and high risk, complex case management.

Created & modified Standard Operating Procedures (SOPs) and department Key Performance Indicators (KPIs).

Managed and supported a diverse portfolio of projects optimizing quality and compliance efforts spanning across 46 separate medical centers cross-functionally and laterally.

Identified resource requirements for projects by partnering with stakeholders to understand the scope of effort, deliverables, and project milestones & dependencies.

Served as Chairperson on the Policies and Procedures Committee and active member of the Mergers & Acquisitions (M&A) committee.

Engaged in knowledge transfer to coach and develop top-notch teams and improvement as well as promoted ideation and collaboration across the board.

Headed newly opened Cano University, an enterprise-wide initiative for employees teaching weekly sessions with multiple management related topics in project management and wrote monthly curricula.

Held accountable for enterprise-level engagement objectives and served as a project-based lead staff.

Ensured deliverables were within the scope of engagements working with the allocated resources and timeliness.

Identified, developed, and communicated comprehensive and scalable project management processes addressing strategic initiatives.

Monitored initiatives and related project/program implementation and reported progress to the CEO/COO and managing financial company advisors.

Worked on and responsible for working on a range of critical projects and issues in support of the advancement of Cano’s Health strategic priorities, tackling operational challenges, and fostering innovation.

Highlights

Achieved an 85% in 90 days completion rate on the complex, enterprise-wide process improvement project within an aggressive 3-month period with 186+ sub-processes utilized for the investment company enterprise deck.

Florida Acute Care Specialists/ Team Health Inpatient Medicine, Sunrise, FL (1999 – 2013)

Senior Vice President of Operations & Product Development, Vice President, Executive Vice President

FLACS and Team Health provides a variety of hospital medicine and post-acute care opportunities in South Florida and nationally.

Held financial and operational accountability for 30 hospitals generating $30M+ annual revenue as well as developed and led a performance-driven team of 20 direct reports in Mid-Atlantic, Northeast, and Southeast region and Puerto Rico for Hospital Inpatient Management Department and in conjunction with TeamHealth Emergency Medicine Department as Executive Vice President.

Defined and executed strategies to optimize ROI and maintain compliance while spearheading the implementation of the company’s product line and various geographic expansions.

Maintained positive relationships and partnerships with C-suite internal & external stakeholders and employed multisite operations leadership across multiple hospitals. Member of UR/QA and Medical Staff Committees.

Reviewed, strategized, and analyzed Hospital, SNF’s and LTACs KPIs; identified and acted upon areas for improvements; oversaw and managed multiple sites’ physicians’ markets with 800+ physician groups across the Eastern Seaboard and Puerto Rico. Responsible for the Billing, Care Coordination and Quality Department, and H/R while with Florida Acute Care Specialist (FLACS).

Negotiated client and vendor contracts with Health Plans (HMO’s), Hospitals and Skill Nursing facilities, (SNF’s) Home Health Agencies, Hospice units and ensured Studer group initiatives were implemented throughout regions.

Adhered to Clients for Life (CFL) philosophy while ensuring standards of documentation are maintained in the Client Retention Management (CRM) database. Established and maintained Web-of-Influence (WOI) members per Team Health’s Client for Life (CFL) initiatives.

Highlights

Strategically grew assigned market areas by 10% annually; equivalent to a $3M increase in annual income as well as Puerto Rico from $1.1M to $10M+ in revenues in a one-year time frame.

PROFESSIONAL DEVELOPMENT & CREDENTIALS

Masters, Public Health/Finance

Florida International University

Bachelors, Hospital & Health Services Administration

Florida International University

Training

Lean Six Sigma trained

IT Skills

Visio, Mac Book, Microsoft Word, Excel, and PowerPoint

Professional / Volunteer Memberships/ Affiliations-Active

Miami Rescue Mission

National Forum for Latino Healthcare Executives

Current Mentor in the National Association of Health Services Executives (NAHSE)

Advisory Health Services Department Board Member in UBRE University

Adjunct Professor, Miami Dade Community College, Psychology Department

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