Derek Tefft Email and Phone Number
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Senior executive with successful track record in managed care, healthcare finance, and health plan operations. Superior skills and experiences in all aspects of managed care operations, analysis, and implementation of strategic plans, network operations, contract negotiations, business development, marketing and integration of managed care and provider operations.
Ascendant Health Care Inc./Burns Consulting Associates Inc.
View- Website:
- burnsconsulting.com
- Employees:
- 7
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Co-FounderLynkdx, Llc. Aug 2023 - PresentUnited StatesLynkDX provides mobile dental diagnostics direct to employers, on-site clinics, primary care clinics and other “dental deserts” across the United States.
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Senior Vice President & Director, Network & Managed Care ServicesAscendant Health Care Inc./Burns Consulting Associates Inc. Aug 2015 - PresentMaumee OhioProvide strategic direction for development and implementation of provider networks and other innovative care management programs for self-insured clients across the United States. Develop quality standards and competitive pricing benchmarks for provider contracting targets within defined healthcare markets.Lead team member on all managed care initiatives including: key provider negotiations, senior level client meetings, and new projects or engagements with current or prospective clients.Provide oversight of the financial and operational performance of customized provider networks and health care management programs. Oversee the day to day operations of the managed care division and coordinate the development and implementation of company policy and procedures. Serve in different senior leadership roles for each of the customized provider network products including: Chief Operating Officer, Vice President of Strategic Development, and Vice President of Network Development.
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Senior ConsultantBurns Consulting Associates, Inc. Jan 2008 - Jul 2015Maumee, OhioDeveloped and implemented provider contracting strategies for managed care clients in Ohio, California, and Florida.Assisted in creating a high performance provider network for a 800,000 member coalition in Pennsylvania based on quality measure data published by PHC4.Created claim payment protocols, provider credentialing processes, and contract modeling matrixes for managed care network clients.Assisted in the day to day management of all managed care initiatives for all self-insured clients across the United States.
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ConsultantBurns Consulting Associates, Inc. Nov 2005 - Dec 2007Maumee OhioDesigned strategic market research projects for certain healthcare markets to determine the competition as well as the key stakeholders (i.e. employers and brokers/consultants).Developed audit policies to audit managed care contracts loaded into the medical claim repricing system.Created a risk adjusted rating model to calculate healthcare premiums for a consortium consisting of over 12,000 employee lives.Analyzed, negotiated, and implemented over twenty healthcare vendor contracts for self-insured clients throughout the United States. Vendors included provider networks, third party administrators, disease management programs, and population health management applications.
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Vice President Of OperationsAscendant Healthcare, Inc. Jan 2010 - Jul 2015Maumee, OhioDeveloped and implemented client specific programs including: Employer sponsored managed care networks, risk targeting and gaps in care analysis, Medication Therapy Management (MTM) programs, integrated telehealth programs, community-based population health management programs, on-site or near site care management clinics, and "Concierage Medicine: programs.Oversaw day to day operations of provider networks including provider contracting, credentialing, repricing of medical claims, management of EDI interfaces with claims payers, and problem resolution support for clients.Lead role in all implementation meetings and architect of specific timelines and action items related to implementation of provider networks or other health care management programs.Supported marketing efforts for new business development specific to the needs for the prospective client.
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Director, Managed CareAmerican Health Group, Inc. May 2000 - Oct 2005Maumee OhioNegotiated over 100 hospital contracts that were part of $500 million in annual healthcare spend. Researched and implemented client specific provider networks at the local, regional, and national level for over 45 manufacturing facilities nationwide.Member of the SAS-70 and HIPAA compliance team and developed SAS-70 protocols for claim processing and claim payment operations.
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Account ManagerAmerican Health Group, Inc. Sep 1997 - Apr 2000Maumee, OhioCoordinated and formulated the managed care claims review process for self-insured clients.Organized and researched medical and financial information in order to achieve affordable managed care contracts for clients.Managed a non-network provider negotiations program that represented approximately $25 million in healthcare spend annually.
Derek Tefft Skills
Derek Tefft Education Details
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Business Management -
Science Comprehensive, Education
Frequently Asked Questions about Derek Tefft
What company does Derek Tefft work for?
Derek Tefft works for Ascendant Health Care Inc./burns Consulting Associates Inc.
What is Derek Tefft's role at the current company?
Derek Tefft's current role is Senior Vice President - Ascendant Healthcare, Inc..
What is Derek Tefft's email address?
Derek Tefft's email address is dt****@****ing.com
What is Derek Tefft's direct phone number?
Derek Tefft's direct phone number is +141989*****
What schools did Derek Tefft attend?
Derek Tefft attended Kent State University, Bowling Green State University.
What skills is Derek Tefft known for?
Derek Tefft has skills like Managed Care, Healthcare, Strategic Planning, Health Insurance, Insurance, Employee Benefits, Health Policy, Program Management, Healthcare Management, Process Improvement, Disability Insurance, Brokers.
Who are Derek Tefft's colleagues?
Derek Tefft's colleagues are Mary Gorman, Rhia, Chda, Jo Finch.
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Derek Tefft
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