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Director Contracting Managed Care in Birmingham AL Resume Paul Britt

Director Contracting Managed Care in Birmingham AL Resume Paul Britt

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Published by PaulBritt
Paul Britt is a polished professional with diverse and successful experience in healthcare operations, contract negotiations, provider/payor/ government reimbursement, financial analysis, marketing, management, network development, and problem solving.
Paul Britt is a polished professional with diverse and successful experience in healthcare operations, contract negotiations, provider/payor/ government reimbursement, financial analysis, marketing, management, network development, and problem solving.

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Published by: PaulBritt on Feb 22, 2012
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P
AUL
B
RITT
 
B
IRMINGHAM
,
 
AL
 
·
 
35243(205)
 
422-1805
 
·
 
 
http://www.linkedin.com/in/paulbritt Polished professional with diverse and successful experience in healthcare operations, contract negotiations,provider/payor/ government reimbursement, financial analysis, marketing, management, network development, andproblem solving.
A
REAS OF
E
XPERTISE
 
 Account Management Strategic Planning Contract NegotiationsProvider/Payor Operations Sales/Marketing Market AnalysisProcess Improvement Relationship Building Network Development 
P
ROFESSIONAL
E
XPERIENCE
 
Abbreviated employment tenure from 2006
 – 
2011 was due to a spousal medical disability and a planned permanent moveto Belize; both events are now behind me.
P
RACTICE
P
ARTNERS IN
H
EALTHCARE
(B
IRMINGHAM
,
 
AL)
March 2010
 – 
August 2011
Outpatient surgery center management company
Vice President of Operations
 
 
Managed daily operations for two ambulatory surgical centers specializing in pain management. Formulated strategiesto streamline patient throughput and maximize efficiencies related to staffing, scheduling, payor reimbursement andprocedure case mix.
 
Initiated a time management study that resulted in process improvements which slashed patient wait times from overthree hours to an hour and twenty minutes. Mined revenue cycle data to identify margins on all proceduresperformed. Money losing and break-even procedures were eliminated.
 
Anticipated and adjusted to changing reimbursement policies from Medicare, Medicaid and commercial payors.
U
NITED
H
EALTHCARE
(B
IRMINGHAM
,
 
AL)
January 2009
 – 
March 2010
The largest single health carrier in the US.
Senior Network Account Manager, Gulf States
 
 
Initiated and led negotiations with hospitals and ASCs in Alabama, Mississippi and Louisiana to produce ageographically competitive, stable network to achieve objectives for cost performance and trend management.Negotiated and implemented contracts to ensure compliance with reimbursement goals, language standards, and keyprocess controls.
 
Identified and targeted non-network ASCs with substantial spend amounts, initiating negotiations to achieve theobjective of in-network status. Successfully added 10 ASCs within the first year, directly impacting the financialperformance of the Southeast region.
 
Established and maintained strong business relationships with C-level officers and physician leaders at hospitals andASCs in order to promptly resolve issues within a self-directed environment.
F
AMILY
M
EDICAL
L
EAVE
(S
POUSE
)
August 2006
 – 
January 2009
H
EALTH
S
PRING OF
A
LABAMA
,
 
I
NC
.
 
(B
IRMINGHAM
,
 
AL)
January 2006
 – 
August 2006
 A Medicare Advantage HMO serving 25,000 seniors in 42 Alabama counties.
 
 
P
AUL
B
RITT
·
 
Page 2
Manager, Institutional and Ancillary Contracting
 
 
Directed all functions of the Facility Contracting Department, responsible for contract negotiations for all Alabamahospitals and ancillary providers. Analyzed medical costs to identify re-contracting opportunities.
 
Managed a staff of four and met frequently with hospital leadership to advance positive relationships, focusing onaccurate claims payment, promp
t resolution of provider concerns, and education related to the company’s direction
and strategy.
 
 
Reported directly to the President and worked closely with the CFO and Medical Director to improve the providernetwork. I r
efocused the company’s contractin
g philosophy to align solely with providers that had a proven history of cooperation, resulting in a smaller but vastly more efficient network of quality providers.
 
I
NTEGRATED
M
AGNETIC
I
MAGING
(M
ONTGOMERY
,
 
AL)
 
June 2005
 – 
January 2006
Privately held company that owns and manages two multi-modality diagnostic imaging facilities located in central Alabama.
Chief Operating Officer
 
 
Maximized operational efficiencies to streamline patient through-put, billing and collections, RIS/PACS, payorcontracting, credentialing and marketing strategy. New patient visits increased by 11% under my direction.
 
 
Piloted the purchase and installation of a Toshiba 64-Slice CT scanner, successfully coordinating equipmentprocurement and delivery, room construction, financing, regulatory compliance and the sale and removal of the oldscanner. Referrals increased by an average 11% per month and first-time physician referrals were realized.
 
 
Managed the company’s payor relations to ensure contract compliance and accurate,
timely payments. By eliminatinga wasted step in the payment process, funds were deposited an average of four days sooner.
 
Established new markets via attorney
liens and workers’ compensation, increasing new referrals by 6% from
theprevious year.
 
T
OUCHSTONE
M
EDICAL
I
MAGING
,
 
LLC
 
(B
IRMINGHAM
,
 
AL)
 
September 2003
 – 
May 2005
Private company based in Brentwood, Tennessee, that owns and manages 19 diagnostic imaging facilities in nine states.
National Director of Managed Care
 
 
Directed all aspects of 
the company’s interaction with national, regional and local commercial payors, plus Medicare,Medicaid and other government programs. Continuously sought opportunities to establish or improve the company’s
relationship and financial position with its payor partners, negotiating an average 1.5 new agreements per month.
 
 
Developed and implemented the company’s first
-ever contract management system, involving document scanning,logging and file sharing of 400+ payor agreements to enable access by administrato
rs and Touchstone’s billing
partners. Efficiencies were immediately realized by eliminating the reliance on hardcopy documents.
 
 
Supervised and trained coordinators in four states, providing leadership to manage local payor applications,credentialing and claims payment issues. Routinely traveled to each market to foster teamwork, advance company
goals and further the team’s knowledge of managed care trends.
 
H
EALTH
S
OUTH
C
ORPORATION
(B
IRMINGHAM
,
 
AL)
 
August 1999
 – 
April 2003
One of the nation
’s largest providers of rehabilitative healthcare services.
 
Assistant Vice President, Payor Contracting & National Accounts
 
Oversaw contract management and partnerships with national payors. Performed financial analysis of contracted rates for1,700 facilities, encompassing acute care hospitals, ASCs, imaging facilities, outpatient physical therapy centers andinpatient rehab hospitals. National payor contracts valued at $200M in annual gross revenue were systematically analyzedfor prompt payment compliance, regulatory issues, opportunities to maximize reimbursement rates, and overall value tothe company.
 
 
Initiated and led a company-wide overhaul of an inefficient contract approval process, streamlining it into a workable,centralized system where appro
val turnaround time was slashed by 47%. Trained the company’s 50+ field contracting
directors on contract language and financial analysis to ensure market-driven reimbursement levels.
 
One of only four field-based directors in company history to be promoted to officer level.
 

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