C. Daniel Koon Email & Phone Number

Irving, Tx

Network Strategy & Operations focused healthcare consulting. Engagements:- CMS compliant network development for a California Medi-Cal plan developing Medicare D-SNP plan for 2026- Network Payor network development - Telehealth start-up - California- Network development - Adequacy, Reimbursement for a Medicare Advantage start-up plan - Chicago, IL - Kingdom of Saudi Arabia: Participating Provider contract development for Saudi citizens seeking health care in the United States- Medicaid Dental network development - Texas Medicaid health plan - Illinois health plan: Hospital and Physician recruiting for state wide Medicaid network expansion and part of a 7 member team to develop RFP response to state of IL for Medicaid expansion.- Alabama (Medicaid start up): network development with concentration on hospital and physician contracting.- Illinois health plan: Medicaid and ACA network development

Indianapolis, Indiana Area

Senior consultant with HTMS. Focus on health plan operations, provider network management and development and project management. Various clients across the US with engagements ranging from project management, operations to network management strategy and creation. Experienced in all health plan products including Commercial, Medicare, Medicaid and ACA.

Irving, Tx

Represent client hospitals and providers in contractual language and reimbursement negotiations with all major payors.Develop managed care strategies for clients.Perform Clinical Integration readiness analysis for client organizationsDevelopment team member for The Godbey Report, an analysis tool to allow hospital various reimbursement measurements against national averages by major payors.Joint responsibility for new client growth

Joplin, Missouri Area

CEO of HealthFirstResponsible for PHO contracting for St; 13 independent hospitals and 400 independent providers in the SW Missouri, SE Kansas and NE Oklahoma areaIncreased facility payments from managed care over 10% in 18 monthsIncreased physician reimbursement from managed care contractsResponsible for PHO Sales, Marketing, Account Management for carrier and directly contracted groups.Grew managed care membership by 10% in 18 monthsStrategic planning for PHO and implementationRe-established physician involvement and trust in PHOResponsible for Government Affairs/Government Relations for HealthFirst and St; Missouri House of Representatives passed Any Willing Provider legislation - Failed in Senate

Oakland, Ca

Provider Contracting Identified contracting methodology to save Kaiser Permanente $40m annuallyResponsible for all national health care delivery contracts for the Kaiser Permanente Point of Service, Preferred Provider Organization and Out of Area productsResponsible for Visiting Member Out of Network secondary physician & facility contracts covering all Kaiser Regions Provider Network Management and Provider Relations for Kaiser Permanente Insurance Co. - 1500 direct contracts in Hawaii network Assisted KPIC in the selection and project managed the transition of the POS & PPO TPA functions to a new vendor.

Houston, Texas Area

Assisted in 25% growth of new physicians for a Houston Primary Care Physician Network. Managed a diagnostic imaging company in the development of capitated HMO and individual contracts.Review of Sutter Health Plan's project plan for Data Center relocation

Dallas/Fort Worth Area

Managed the State and Federal regulatory approval and integration of the 350,000-member Harris Methodist Health Plan with full P&L responsibility into PacifiCare Texas with a budget of $13.3 million, on schedule and favorable to budget by $1.5 million. Spokesperson for monthly PacifiCare of Texas Town Hall meetings for 200,000 Secure Horizons Medicare members.Converted 2700 direct physician contracts to capitated group contracts & eliminated 3000 direct contracts and completed 8 Capitated physician group contractsProvider Network Management and Provider Relations for PacifiCare - North Texas. Responsible for the Medical Management and Quality Improvement. All Medical Directors and medical staff reported to this

Summit, Nj

Responsible for establishing a startup Medicare HMO in New Jersey with full P&L responsibility. Developed final budgets and a 3-year business plan and worked with state regulators and the Securities and Exchange Commission to obtain the necessary regulatory approvals for this new venture.

Tamuning, Guam

Management, with full P&L responsibility, of all HMO group model functional areas including the operation of 5 Clinics for medical/dental delivery with a clinical and support staff of 275 and HMO administration staff of 75.

Responsible for all HMO functions for Commercial, Medicaid, and Medicare products.

Coral Gables, Fl

Represent client hospitals and providers in contractual language and reimbursement negotiations with all major payors.Develop managed care strategies for clients.Perform Clinical Integration readiness analysis for client organizationsDevelopment team member for The Godbey Report, an analysis tool to allow hospital various reimbursement measurements against national averages by major payors.Joint responsibility for new client growth

Indianapolis, Indiana Area

Assisted clients with strategy in Health Care Operations and Technology.

Dng, Computer Technology

Computer Science

Dimploma, History

Activities and Societies: Cross Country & History ClubHistory buff, Cross Country