Hernan Rodriguez
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Hernan Rodriguez Email & Phone Number

VP, Contracted Operations at WellMed Medical Management
Location: Dallas, Texas, United States 8 work roles 4 schools
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Current company
WellMed Medical Management
Role
VP, Contracted Operations
Location
Dallas, Texas, United States
Company size
2305 employees

Who is Hernan Rodriguez? Overview

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Hernan Rodriguez is listed as VP, Contracted Operations at WellMed Medical Management, a with 2305 employees, based in Dallas, Texas, United States. AeroLeads shows a matched LinkedIn profile for Hernan Rodriguez.

Hernan Rodriguez previously worked as Director, Physician Business Management at Wellmed Medical Management and Manager, Physician Business Management at Wellmed Medical Management. Hernan Rodriguez holds Master Of Business Administration - Mba, Health/Health Care Administration/Management from Satish & Yasmin Gupta College Of Business.

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Email format at WellMed Medical Management

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WellMed Medical Management

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Profile bio

About Hernan Rodriguez

I have over 15 years of experience working in the healthcare industry. Currently, I hold the position of VP, of Contracted Operations, managing large medical groups in the Dallas/Ft. Worth Metroplex. A major role in my position includes analyzing and reducing healthcare costs as well as HEDIS and Risk Adjustment education. My career began working with Medicaid products as a member service representative and soon moved on to a Member Advocate. The role truly gave me insight into most aspects of the industry. Every day consisted of interactions with Claims, Utilization Management, Provider Relations, and Case Management just to name a few departments. This is where I truly found my passion for Network Management. I have now worked in Network Management for over 9 years working closely with Physicians, Specialists, and Hospital systems. Most of my work in Network Management has been with concentration in Medicare products. I serve as an advocate for my physicians providing them with any necessary tools and education they need to succeed. I’m very passionate about my work and strive to make every engagement as fruitful as I can.Networking can be the most enjoyable field to work in, especially in healthcare. I’m privileged to work with some of the greatest minds in DFW and look forward to expanding my knowledge in this industry.Specialties:Value-Based Care, Account Management, Manage Care, Medicaid Products, Medicare Products, Team Mentoring, Risk Adjustment, HEDIS/STARS, Project Managing, Sales & Marketing, Business Operations, Market Development, Grievances & Medical Appeals, Contract Negotiation, Customer Service, Compliance, Claim Adjudication, Process and Procedure Improvement, Call Center Operations, Individual and Group Training

Current workplace

Hernan Rodriguez's current company

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WellMed Medical Management
Wellmed Medical Management
VP, Contracted Operations
san antonio, texas, united states
Website
wellmedhealthcare.com
Employees
2305
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8 roles

Hernan Rodriguez work experience

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Sr. Physician Business Manager

Wellmed Medical Management

Dallas/Fort Worth Area

Provider education, including DataRaps Department (Risk performance Adjustment/Coding), Quality(HEDIS), & Case Management (cost and care)Support Market Leaders with daily operational functions.Deliver and interpret monthly financial reports to the primary care providers.

Feb 2018 - Sep 2019

Network Management Representative

Wellcare Health Plans

• Service contracts and negotiates with primary care, specialty physicians and ancillary providers for all product lines.• Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area. Provides service and education to network physicians/providers. • Conducts site visits to service providers, resolve issues, educate staff/providers on policies, collect credentialing information, and reviews HEDIS information.

Jan 2013 - Apr 2016

Member Advocate

Aetna

Worked with Medicaid, CHIP and CHIP Perinate products. Handled Member and Provider Complaints, Medical Appeals and inquiries. Including Behavior Health (BH) and Pharmacy requests. Conducted the role of Health Plan liaison with HHSC, TDI, and TMHP.

Oct 2011 - Oct 2012

Customer Service Representative

Aetna

High Volume Call Center for State Medicaid, CHIP and CHIP Perinate products. Serviced Member and Provider calls for two health plans; Parkland Community Health Plan and Aetna Medicaid in the Dallas/Ft. Worth and San Antonio service areas. Type of calls include but are not limited to eligibility verification, PCP changes, Authorizations look-up, Claims status, and newborn add-ins. Managed call queues and assisted CSRs with questions and concerns. Assisted Member Advocates with Complaints and Appeals. Managed team projects

Feb 2009 - Oct 2011
Team & coworkers

Colleagues at WellMed Medical Management

Other employees you can reach at wellmedhealthcare.com. View company contacts for 2305 employees →

JV Judith Villarreal Judith Villarreal Colleague at Wellmed Medical ManagementSan Antonio, Texas, United States View → MM Marissa Martinez Marissa Martinez Colleague at Wellmed Medical ManagementBoerne, Texas, United States View → MO Mariana Ortiz Mariana Ortiz Colleague at Wellmed Medical ManagementHouston, Texas, United States View → KC Kathryn Chavez Kathryn Chavez Colleague at Wellmed Medical ManagementPearland, Texas, United States View → EG Elizabeth Garza Elizabeth Garza Colleague at Wellmed Medical ManagementSan Antonio, Texas, United States View → EG Emoline Gonzales Emoline Gonzales Colleague at Wellmed Medical ManagementNew Braunfels, Texas, United States View → MA Meko Askew Meko Askew Colleague at Wellmed Medical ManagementSugar Land, Texas, United States View → ZB Zhane Brantley Zhane Brantley Colleague at Wellmed Medical ManagementAustin, Texas Metropolitan Area, United States View → MP Mirelys Perez Pinero Mirelys Perez Pinero Colleague at Wellmed Medical ManagementLakeland, Florida, United States View → CF Carina Finn Carina Finn Colleague at Wellmed Medical ManagementSan Antonio, Texas, United States View →
4 education records

Hernan Rodriguez education

Education record

Texas Center For Massage Therapy

—818.45 Hours —119 Clinic Internship Hours: —5 full body massages; 50 minute massages in a 5.5 hour shift —CPR/First Aid Certified.

FAQ

Frequently asked questions about Hernan Rodriguez

Quick answers generated from the profile data available on this page.

What company does Hernan Rodriguez work for?

Hernan Rodriguez works for WellMed Medical Management.

What is Hernan Rodriguez's role at WellMed Medical Management?

Hernan Rodriguez is listed as VP, Contracted Operations at WellMed Medical Management.

Where is Hernan Rodriguez based?

Hernan Rodriguez is based in Dallas, Texas, United States while working with WellMed Medical Management.

What companies has Hernan Rodriguez worked for?

Hernan Rodriguez has worked for Wellmed Medical Management, Wellcare Health Plans, and Aetna.

Who are Hernan Rodriguez's colleagues at WellMed Medical Management?

Hernan Rodriguez's colleagues at WellMed Medical Management include Judith Villarreal, Marissa Martinez, Mariana Ortiz, Kathryn Chavez, and Elizabeth Garza.

How can I contact Hernan Rodriguez?

You can use AeroLeads to view verified contact signals for Hernan Rodriguez at WellMed Medical Management, including work email, phone, and LinkedIn data when available.

What schools did Hernan Rodriguez attend?

Hernan Rodriguez holds Master Of Business Administration - Mba, Health/Health Care Administration/Management from Satish & Yasmin Gupta College Of Business.

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