C. Patrick Ryan Email & Phone Number

Tampa, Florida

* Provide expertise & recommendations for all aspects of federal Medicare Programs & Medicaid Operations for State Programs across the US* Research & Develop innovative technical and financial strategies to ensure competitive proposal preparation and assist in negotiations for successful contract bids & proposal submission.* Direct contract implementation.

Tampa, Florida

Member of County Health Plan Advisory Board and Management Subcommittee

Patient & Family Support Volunteer and Transitions Companion

Direct the implementation of the Person & Family Engagement(PFE) aspect of the KePRO Medicare Beneficiary and Family-Centered Care QIO Contract in 32 States Nationwide. Responsibilities include recruiting Staff and monitoring Budget and Deliverables associated with the PFE Project.

Tampa, Florida/Baton Rouge, Louisiana

Directs, administers and coordinates the activities of the organization in support of the goals and objectives established by the Chief Executive Officer and the Board of Directors.Provides the leadership, management and vision necessary to ensure that the company has the proper operational controls, administrative and reporting procedures and people and.

Tampa, Florida

• Responsible for overseeing day-to-day Florida Operations providing Prior Authorization Services in a variety of settings involving 150 FTEs and two offices (Tampa and Miami).
• Responsible for Budget Management, Personnel Management (including recruitment & hiring staff) and Performance Management of Contract Deliverables.
• Working with Executive Director, serve as liaison with State Agency and external contacts, e.g. hospitals, home health agencies, etc.
• Report significant operational issues to Chief Operating Officer and Senior Executive Team and recommend solutions.
• Act as principal liaison between Operating Departments and centralized Information Systems Department.
• Responsible for oversight of ongoing Internal Quality Control Program to minimize exposure and risk to contract.

Responsible for assisting with implementation of major Utilization Management contract for the State of Florida Medicaid Program

Provides support for the preparation of technical proposal and negotiations with Medicaid Agencies involving Compliance, Fraud, Waste & Abuse contract activities

WellCare is a leading provider of government-sponsored health plans such as Medicare, Medicaid, State Children's Health Insurance Programs and others.Director of Network Compliance (2008 - Present)Implemented Network Department's Compliance and Process Improvement Activities including: Network Contract Integrity Initiative, Medicare & Medicaid Internal.

Established overall strategic direction for health care utilization management / quality improvement organization in State of Georgia.Directed more than 120 staff in the operation of two contracts (Medicare & Medicaid) valued at more than $12 million/year.Established and maintained liaisons with CMS, State Medicaid Agencies and Statewide health.

Directed all operational / financial aspects of a statewide Medicaid Hospital Prior Authorization Contract using internet technology, significantly decreasing administrative burden on healthcare providers. Responsibilities included Contract liaison/compliance with Medicaid Agency (AHCA)Annual review volume exceeding 300,000. 95% completed in less than four.

Responsible for solicitation, evaluation and awarding of grant requests prepared to support community-based programs designed to improve/measure health status in Georgia.

Developed long-term strategic plan for statewide Peer Review Organization.Pursued opportunities to direct, facilitate and partner with health care organizations in the evolving health care market. Efforts include Georgia Medicaid MMIS procurement, Veteran's Administration External Review program and HCFA's Program Safeguard Contractor proposal.

Responsible for all operating components relating to four major contracts for State and Federal government entities with annual revenues exceeding $9 million, supported by a staff of 125 and more than 400 physician consultants.Full administrative and P&L responsibilities encompassing program management, policy development, systems and software.

Responsible for directing a staff of 100 in the oversight of three principal operating contracts including: Medicare Peer Review Contract, State of Georgia Long Term Care Review Contract, and State of Georgia Hospital Precertification Contract.Secured long-term care contract renewal through competitive procurement.

Responsible for correcting operational performance deficiencies in Medicare Quality Improvement contract and securing three-year contract renewal.

Developed business plan and directed start-up operations for a new for-profit Health Care Utilization Management company. Providing case review, worker compensation, credentialing, case management, and related services (Subsidiary Corporation of GMCF).

Bachelor Of Arts, Political Science

Master Of Public Administration, Government Health Programs