Greg Mccarthy Email & Phone Number

Denver Health Medical Plan (DHMP) was created in 1997 and is an entity of Denver Health. DHMP provides health insurance services to over 130,000 people. DHMP supports Medicare Advantage, Medicaid, CHP+, Large Group, and Individual Exchange products.

Denver, Co, Us

In addition to being CEO of Denver Health Medical Plan, responsible for overseeing Managed Care at Denver Health. Key activities include managing relationships with physicians, referral and authorization processing and supporting financial aspects of Denver Health expansion activities.

Lewiston, Maine, Us

Affordable Care Act Consumer Oriented and Operated Plan (CO-OP) Health Plan with 80,000 members in two states including individual and group business both on and off Exchange. Responsible for overseeing Network Contracting, Credentialing, Data Provider Integrity, Member Service and Enrollment & Eligibility. Maintain vendor relationships to drive quality and efficiency including wrap / travel network, Third Party Administrator, Payment Processing, and others.

Portland, Maine, Us

Profit and loss (P&L) responsibility for 42,000 plus member Uniformed Services Famility Health Plan (USFHP), a part of TRICARE. Responsible for overseeing Sales, Enrollment, Member Services, Provider Inquiry, Claims Processing, Claims Recovery, Subrogation and COB, and Managed Care Software Applications and claims configuration using Trizetto QNXT and Optum's Claims Editing System iCES. Achieved target Medical Loss Ratio (MLR), very high member satisfaction, strong HEDIS and CAHPS results, and strong employee morale and culture.Prior positions at Martin's Point include Interim VP Medicare Advantage Plan, VP of Health Plan Operations, VP of IT and Director of IT.Led significant projects for Provider group including Electronic health record, practice management, Laboratory interface, Maine Healthinfonet Regional Health Information Organization implementations.Member of organization Benefits committee overseeing employee healthcare and 401k and 457b plans, Great Place to Work Team, and Position Approval Committee. HIMSS Fellow (FHIMSS) and ADP 1 security clearance.

Portland, Maine, Us

Leader in healthcare Management Consulting practice with clients including hospital, physician practice, behavioral, long term care, home care, and managed care. Acquired clients, planned, and managed system selection, disaster recovery, IT strategy, project management, and HIPAA engagements. Began career as Senior Consultant serving multiple industries and advanced through Manager and to Senior Manager.

Armonk, New York, Ny, Us

Provided on-site support for high visibility computer network issues for Blue Cross Blue Shield, Allstate, Sears, Metra Transportation, Helene Curtis, etc. Certified Novell Engineer (CNE).Began IBM career in Customer Service. Managed computer service calls and coordinated repair assignments for South Chicago and Northern Indiana service Team.

Mba, Business

Ba, Public Management