Executive Director Office Staff
Resume:
Benjamin Singleteary
Indianapolis, Indiana 46240
859-***-**** E-mail: *********@*****.***
Professional Objective
The opportunity to continue utilizing my 20 years of professional experience in Health Plan Administration, in a challenging mid-to upper-level management position with an established industry leader, offering opportunities for growth and advancement.
Summary of Qualifications
More than 30 years of Administrative Management experience in varied health care environments, with emphasis on Health Plan Administration and Managed Care.
Exceptionally dedicated administrator with a strong personal commitment to quality of service.
Organized and flexible; skilled with delegating authority and managing multiple projects simultaneously.
Good communication skills; adept at establishing and maintaining productive relationships with clients, staff, and management.
Experienced with facets of budgeting and fiscal analysis.
Professional Experience
Director Provider Services & Credentialing, 12/11 – present
Baptist Health Plan
651 Perimeter Dr, Suite 300, Lexington, KY 40517
Responsible for Provider Services, Credentialing and Data Management including, supervising a staff of 24.
Re-organized the Provider Services department to ensure optimal process work-flow.
Implemented a Data Management department to maintain and promote the highest level of data integrity.
Streamlined the Credentialing process and played a key role in NCQA accreditation.
Negotiated, operationalized and implemented Baptist Health Plan’s first Medicare Advantage Plan.
Re-contracted and repaired relationships with several large providers with whom Baptist Health Plan was either not contracted or had varying levels of operational issues.
Lead negotiator on specialty network arrangements such as behavioral health, home health, and transplant services.
Led extensive contract negotiations that resulted in reducing health plan medical claims and network lease expenses.
Interpret and communicate contract terms to necessary stakeholders.
Frequent evaluation of market trends regarding reimbursement, health plan competition and penetration, utilization and consolidation.
Identification of network development needs and execution of service area expansion as defined by corporate service area strategy.
Monitor and assure compliance with State and Federal laws and contractual obligations/terms as related to provider contracts and arrangements (e.g. use of other networks).
Regular analysis of provider service issues and identification of opportunities for improvements in contracting, payment levels and provider servicing.
Establish and maintain policies and procedures for Provider Services.
Support Baptist Health Plan Marketing Department with sales, enrollment and renewal activities.
Oversee credentialing and re-credentialing functions and adhere to established processes and timeframes.
Maintain credentialing procedures that comply with State, Federal, Baptist Health Plan and NCQA standards.
Ensure all Applications and Site Reviews are tracked.
Executive Director, 06/2005 – 03/2011
Columbus Regional Hospital / Multi County Health Network (MCHN)
2600 Sandcrest Drive, Columbus, IN 47203
Developed, nurtured and maintained relationships with the network’s hospital and physician members, local employers, and payers.
Developed, annually, the operating budget of MCHN and worked with the Board of Directors to adequately fund the work plan for the upcoming year.
Reported monthly financials with explanations of all major variances from budget.
Created policies and procedures to ensure compliance with applicable State of Indiana regulations.
Recruited, discharged and managed staff members of MCHN, including identifying staffing needs and patterns as the organization grew.
Developed, implemented and managed appropriate managed care contracting strategies for MCHN hospitals and physicians.
Created contracting goals and assured the achievement of targets by working with network providers, consultants, local marketing resources and others as necessary.
Conducted an annual Planning Retreat for the Board of Directors.
Developed and maintained member relations programs for individuals covered through local PHO contracts. This included managing and maintaining appeals and grievances and providing for an effective means of member communication with the local network.
Assured that the local networks appropriately credentialed physicians.
Executive Director, 2000 - 2004
St. Joseph Hospital & Health Center/Heartland Regional Health Network
1907 W. Sycamore, Kokomo, IN 46902
Created contracting goals and assured the achievement of targets by working with health plans, internal departments, consultants, and others as necessary.
Developed, implemented and managed appropriate managed care contracting strategies.
Developed, maintained and promoted collaborative working relationships with hospital and physician office staff members to support administration of full risk contracts, as required.
Developed, annually, the operating budget of HRHN, worked with the Board of Directors to adequately fund the work plan for the upcoming year.
Developed and maintained member relations programs for individuals covered through local PHO contracts. This included managing and maintaining appeals and grievances and providing for an effective means of member communication with the local network.
Assured compliant credentialing practices.
Education
Indiana University, Graduate School of Business
Certificate of Business Studies
May 1993
Indiana University, School of Public Health
B.S. Degree in Public Health (with a concentration in Health Administration)
May 1993
Indiana University, School of Business
A.S. Degree in Business Administration
August 1975
References and Additional Work History Available Upon Request
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