CLIENT:
Health Systems - CFO, Managed Care Negotiator, Revenue Cycle Director
DRIVER:
Managed Care was driving hospitals to negotiate and track reimbursement agreements with dozens of payers.
CHALLENGE:
Hospitals did not have a sophisticated way to model contracts for pending contract negotiations or track if an existing managed care contract was profitable - and the payers were paying what they should be paying based on the agreed terms.
SOLUTION:
As the development Product Manager, I led a cross functional matrixed team that integrated and rolled out the Contract Management system that accurately tracked expected vs. actual payer reimbursements and built a foundation for insight to simulate future contract negotiations.
RESULT:
Customer: Captured Return on Investment within 9 months of installation.
Company: Successful sales of contract management product ultimately delivered over $150M to the company.