Edward Sotherden Email & Phone Number

Philadelphia, Pa, Us

Philadelphia, Pa, Us

Spearhead the Strategic Growth Plan as related to key provider, supplier, and vendor partners.Developed Provider Network Expansion Plan incorporating bilateral fair and transparent reimbursement which led to two new proposals submitted within my first month.Creating new Provider Contracting and LOA Process Roadmap to enhance turnaround time, member and customer experience, and Provider acceptance rates.

* Earned promotion to COO to help restructure organization and add teams as it grew from a small single site business into a national, multi-site, multiple business-line medium sized enterprise.* Unify Patient Safety and Accreditations across all sites securing 2/3rds of revenue in payor contracts requiring TJC or URAC.* Create departments for Compliance, Audit Response (immediately adding hundreds of thousands to EBITDA via near zero takebacks), Quality, and Internal Billing Review (leading to error rate dropping to <1%).* Manage Department Heads for Pharmacy, Nursing, Operations, Human Resources, Revenue Cycle Management, IT, Contracting & Credentialing, and Analytics.

* Grew hematology >500% in under 2 years creating strong EBITDA contributions.* Created joint venture AvasaRX and managed Sales and Operations with P&L responsibility to yield profitability in 2nd quarter. Led transaction to buyout partners, acquire and integrate this business unit.* Sell services to large complex organizations by messaging value of propositions across diverse stakeholder group. Created strategy for selling into self-insured, reinsurance, and cost-containment vendors creating a win-win-win model for patient, payer and pharmacy.

Greater Philadelphia Area

* Co-founded healthcare cost containment company that raised ROI 7-fold in under 24 months. Collaborated with brokers, consultants, and vendors serving self-insured groups.* Bootstrapped company from scratch as entrepreneurial force behind creating entity with diverse potential client base spanning beyond pharmacy world of BioTek, resulting in stronger understanding of wider group of businesses and industries.* Lowered spends for MCOs, reinsurance companies, stop-loss carriers, and self-funded employer groups by targeting high dollar claims. Coordinated with partners that decided to focus on other assets in 2022 and dissolved company in 2023.

Arrowhead Lakes, Poconos, Pa

* Leveraged internet marketing skills to purchase and renovate property to make it cash-flow positive by second rental reason.* Successfully exited project through sale of property at >20% profit during underperforming local market, just as VRBO/AirBnB were becoming overcrowded space.

Mid-Atlantic

* Gained valuable experience in biopharma life sciences space. Improved sales of niche products Alphanate and AlphaNine SD to Hemophilia Treatment Centers, academic hospitals, health systems, infusion providers, and specialty pharmacy providers.* Used background and knowledge of various customer bases to contribute to key conversations and committees in market access and channel management. When first SubQ (vs infused) alternative hit market, successfully grew old product in face of new competition.* Grew business in mid-Atlantic. Added 9 new accounts in 2015 to 150 key account targets nationally. Served as Marketing Advisory Board Member (2015-2016) and helped evaluate channel and implement limited HUB Services model with LASH Group.

East Coast

2012 to 2014: Regional Director Managed Care2013 to 2014: Interim National Dir. Sales, Bleeding Disorders (concurrent role)2009 to 2012: Senior Bleeding Disorders Specialist* Allied with stakeholders, formed teams, studied customer types to sell and best position company in market. As business development specialist, organically grew $3M region into $12M region in under 2 years. Promoted to lead sales team.* Managed up to >$130M annually by earning promotions into Managed Markets to protect and grow market access.* Increased Managed Care YoY revenue by 48% and operating margins by 58% in 2013. Served as Interim Sales Director for bleeding disorders and merged field team for $82M business unit into CVS/Caremark post-acquisition without attrition.

Regional Care Coordinator / Regional Manager* Accelerated new hematology revenue to achieve brand awareness for early stage start-up company. * Launched De Novo growth to open new mid-Atlantic (2005) and Northeastern (2006) territories that were consistently #1 or #2 nationally to yield >$3M revenue in 1st year and >$15M revenue in 3rd year with >25% EBITDA contributions.* Created and sustained relationships with referral sources to add 6 states, increased patient organizations by 8, and managed trade relations to acquire 7 biopharma manufacturers.

Greater Philadelphia Area

Management/Marketing/Bar Supervisor, Various RestaurantsLearned the value of hard work and customer service as I worked my way up from bussing tables to being a General Manager that delivered an increase in profits of >20% during the off-season due to implementing controlled purchasing and better specials.

Syracuse, Ny

Upstate Administrative Services TPA (acquired by MVP Health Care)Part-time and seasonal job during high school and college. Demonstrates extremely high level of professionalism from very early age being entrusted with PHI when HIPAA’s privacy protections were newly enacted. Trained peers and went from high turnover every season to retaining part-time and seasonal employees for >3 year tenures.

Ba, Communication

Activities and Societies: Leadership Training Program (three-year participant) President's Academic Scholarship (four year recipient).

Graduate Business Certificate, Healthcare Management, 4.0

Advanced Graduate Certificate in Healthcare Management with focuses on value and outcomes based healthcare delivery and reimbursement.