Communicate with clients to identify needs and goals, develop plans, provide guidance, and ensure successful project completion. Provide expertise in health care marketing, public health, and medical device reimbursement/policy as well as managed care contracting and network development. Develop marketing collateral based on comprehensive research and analysis. Delineate strategic solutions to benefit clients.
• Implementing LEAN Healthcare for Danville Regional Medical Center as a 5S execution with LifePoint Hospitals, Inc.
• Actively negotiating and contracting network development with United Healthcare while establishing the TRICARE pre build out. Ranked consistently in top 10% of consultants in securing contracts.
• Develops the provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and data analytics. Evaluates and negotiates contracts in compliance with reimbursement structure standards, and other key process controls. Establishes and maintains strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensures the network composition appropriately.
• Managed Care initiatives with Windsor Health Plan (Medicare) TriServ Alliance (TRICARE)
• Supported and designed effective decision making for various medical device companies, including BioMimetics, EMS, Heartscape, The Reimbursement Group and BioDTech, through creation of strategic plans, dossier, reimbursement and policy documentation.

ST. FRANCIS MEDICAL TECHNOLOGY, Alameda, California • *****
Start-up medical device company, acquired by Kyphon in 2007, with sales growth to over $30M in the US within two years of FDA approval

Senior Reimbursement Representative
Oversaw efforts to secure positive medical policy and coding for a first generation minimally invasive spinal surgical technology, X STOP IPD, FDA approved for Lumbar Spinal Stenosis. Presented product to contact points included: Medical Directors (CMO), Champion Physicians, CEO; managed technical queries regarding product research, development, and study findings. Played key role in market analysis and product launch efforts in key locations. Led operations throughout eastern US.
• Secured favorable medical policy, contractual negotiations and coding guidance, including policy for 40 million commercial covered lives within 9 months representing approximately 15 health plans.
• Top reimbursement contractor achieve annual quota after 6 months service and finished at 200+% of goal including Medicaid, Medicare with over 80 national commercial payers.
• The value of these efforts extrapolated to current would represent the following sales impact: 2006: $25MM in product sales (SFMT), 2007: $35MM (under Kyphon) 2008: $100+MM (under Medtronic)
• Integral component of Policy Development Committee at St. Francis
• Identified trends in coverage area and leveraged relationships to resolve issues and expand*****cate and trained provider accounts regarding reimbursement coverage and coding.
SMITH & NEPHEW, INC., Memphis, Tennessee • *****
$3B leader in Orthopedic reconstruction.

Regional Account Manager
Led policy development for Exogen by administering 60 clients across 8 states. Conducted training regarding FDA approval/coding practices. Fostered insurance company contacts and orchestrated presentations to promote offerings and secure favorable policy acceptance. Mitigated product and policy issues through exemplary client relations and creative solution engineering. Delivered comprehensive presentations for Supartz and Exogen to representatives and prospects regarding product guidelines and policy. Sales contact points included; Medical Directors (CMO), VP of Provider Networks, Participating Physicians, Office Managers and Billing Clerks.

• Ranking in the top 25% meeting and exceeding MBO 100%
• Garnered policy with Medicaid to cover 2 million lives, while expanding guidelines for various commercial plans, regionally and locally.
• Facilitated contractual negotiations and policy improvements with major insurance companies, such as OH Medical, Medical Mutual, and Humana.


CARDIONET, INC., Conshohocken, Pennsylvania • *****
Nation-wide mobile cardiac outpatient telemetry provider, downsized due to loss of VC

Regional Director, Payor Relations
Engineered and deployed reimbursement strategy to capture medical device payment across mid-west and southern US. Garnered accounts equaling more than 3 million lives covered within 6 months.


MEDSOLUTIONS, INC., Franklin, Tennessee • *****
Radiology utilization management network operating across US.

Director of Network Development
Negotiated contracts with major radiology outfits and promoted network to health care and insurance industry leaders via presentations, private meetings, and trade show presentations. Utilized extensive research to define favorable rates and improve profit margins; implemented tiered pricing infrastructure that incorporated subscriber volume into final rate. Oversaw network credential activities. Sales contact points included the Chief Medical Director (CMO), VP of Managed Care, Director of Provider Network and key department heads. My role was less territorial and more national support and development

• The deals worth: – AZ $12 million – TX $ 15 million - GA $8 million - DE $10 million
• The average size of the sales was $10 million directly related to my activities. Instrumental in closing the CIGNA GA risk contract in the amount of $8 million annually.
• Led start-up operations for Preferred Provider Network comprised of 1,500 facilities within 1 year.
• During my tenure, MSI grew from $20 million in revenue to over $100 million in revenue directly related to the development and sales activities associated with radiology network development.
• Developed national network and on a market specific basis – AZ, TX, GA, DE.

Master of Public Health in Health Care Organization and Policy
Bachelor of Science in Nuclear Medicine Technology
University of Alabama at Birmingham