Robert P.

Executive healthcare economist with 10+ years in revenue cycle & payments

United States of America
EN

EXECUTIVE MANAGEMENT: Dynamic and innovative healthcare economist with the innate ability to transform data into information and incorporate that information into demand management and risk mitigatio...see more

  • Professional Services
  • Financial Services Banking & Insurance
  • Healthcare Wellness & Fitness
  • C-Level & Leadership
  • ...

400

/hr
  • Pre-vetted expert
  • Confirmed hourly rate
  • Available on short notice

Experience

Executive Vice President, Payor Relations & Revenue Cycle Enhancement

Kairological Consulting Group
6 months
Current position
Mar 2022 - Present
Provides revenue enhancement and process transformation consultation services for healthcare providers. Interacts with healthcare providers to improve operational efficiency and maximi...see more

Director, Corporate Payment Integrity

Highmark New York
12 years
Sep 2010 - Mar 2022
Recruited to maximize the operational efficiency and magnitude of the Company’s savings and recoveries by integrating the resources of Fraud, Waste, and Abuse (FWA), Medical Economics, ...see more

Vice President Clinical Effectiveness

UNITEDHEALTH GROUP, OVATIONS
2 years
Jan 2009 - Sep 2010
Recruited to develop metrics and reporting formats and to lead the evaluation of operational and financial effectiveness of Ovations’ clinical programs. Interacted with clinical progra...see more

Director, Business Intelligence

HEALTH NET
5 years
Jan 2004 - Jan 2009
Lead the development and implementation of business strategies to increase operational efficiency, customer satisfaction, and profit margins for Fortune 200 Company. Accountable for ri...see more

Director, Medical Informatics

HEALTH NET
4 years
Jan 2000 - Jan 2004
Directed the formulation, validation and implementation of provider pricing models, population health and preventive health strategies and evaluation models, claims processing audits, H...see more

Director, Managed Care Support Services

HEALTH NET
5 years
Jan 1995 - Jan 2000
Directed the healthcare research and development of reimbursement rates and contracting strategies, utilization and quality indicators, provider profiling methods, analytical methods fo...see more

Healthcare Economist

AETNA HEALTH PLANS
2 years
Jan 1993 - Jan 1995
Directed the management and development of the California network of 201 hospitals, 13,172 physicians, and 925 ancillary providers. Directed healthcare research, forecasting and financ...see more

Administrator, Network Management

AETNA HEALTH PLANS
2 years
Apr 1991 - Jan 1993
Directed the development and management of provider network for 430,000 covered lives. Administered at-risk and fee-for-service contracts for network of 64 hospitals, 5,837 physicians,...see more

Financial Economist

ECONOMIC RESEARCH SERVICE
2 years
Jul 1989 - Mar 1991
• Developed forecasting models for factors affecting interest rates, inflation, and input processes • Drafted journal articles, Congressional staff reports, research proposals, an...see more

Industries, roles and expertise

Industry experience

  • Professional Services
  • Financial Services Banking & Insurance
  • Healthcare Wellness & Fitness

Role experience

  • C-Level & Leadership
  • Finance