Jim Maher Email & Phone Number

Responsible for managing HealthPlan Services (HPS), which is a Third Party Administrator (TPA) for enrollment, billing and premium collections, contact center, customer service, print fulfillment, sales and retention, financial management and reconciliation for the Affordable Care Act (ACA) market for large commercial payors. In addition, HPS provides Administrative Services Only (ASO) to commercial payors including benefits administration, claims processing, provider data management… Show more Responsible for managing HealthPlan Services (HPS), which is a Third Party Administrator (TPA) for enrollment, billing and premium collections, contact center, customer service, print fulfillment, sales and retention, financial management and reconciliation for the Affordable Care Act (ACA) market for large commercial payors. In addition, HPS provides Administrative Services Only (ASO) to commercial payors including benefits administration, claims processing, provider data management, enrollment and billing, contact center, customer service, contract management and pricing methodologies, and print fulfillment.Responsible for managing a global team of 2,600+ professionals expanding the Philippines, India, Mexico and the US. Direct reports include Operations, Information Technology, Human Resource, Finance, Legal, Compliance, Government Relations, Sales and Marketing.Managing HPS with annual revenue of $193M improving gross margin by 14% (1,400 basis points) in 2 years, manage premium billing and collections of $22B+ annually in subsidies and premiums supporting @25% of the national ACA membership and just short of 1M ASO members.Jim's strategic vision that encompasses the management of a BPaaS and SaaS end-to-end Managed Services proprietary ACA platform and an ASO platform for commercial health insurers. These platforms seamlessly integrate with health insurers, state and federal exchanges, and CMS ensuring a cohesive and efficient system. Responsible for managing the HPS’ business, client delivery and satisfaction, platform strategy & roadmap by re-aligning business priorities and transforming the leadership team.Streamlined service delivery operations thru organizational change management and implementing foundational processes and technologies to manage day-to-day operations to achieve client outcomes. Show less

Vice President, Health Administration ServicesResponsible for solutions, sales and program management focusing on end-to-end health administration system implementations leveraging an information technology/business process outsourcing approach in an ITaaS and BPaaS cloud computing environment.ITaaS/BPaaS Management Developing health administration solutions by partnering with 3rd party software partners and client executives to address the client’s business strategies that… Show more Vice President, Health Administration ServicesResponsible for solutions, sales and program management focusing on end-to-end health administration system implementations leveraging an information technology/business process outsourcing approach in an ITaaS and BPaaS cloud computing environment.ITaaS/BPaaS Management Developing health administration solutions by partnering with 3rd party software partners and client executives to address the client’s business strategies that maximize automation by leveraging collaborative technologies and Optum assets, drive efficient delivery models such as business process efficiencies and shared services models to accelerate program delivery. Managed a cohesive team consisting of IT, BP, human capital, global sourcing and conducted client sessions to develop sourcing strategies to address the client’s business goals and growth in a competitive cost effective solution utilizing a scalable and flexible ITaaS/BPaaS cloud environment.Designed detailed implementation roadmaps maintaining a seamless approach to the client business needs while focusing on transitioning the client’s current IT and business processes and driving efficiencies thru transformational change. Show less

Managing Director, Health Administration Services PracticeResponsible for sales and delivery focusing on health administration system replacement strategies and application outsourcing. Developing health administration solutions by partnering with 3rd party software partners and client executives to address the client’s business strategies that maximize automation by leveraging collaborative technologies, Accenture assets and efficient delivery models to accelerate program… Show more Managing Director, Health Administration Services PracticeResponsible for sales and delivery focusing on health administration system replacement strategies and application outsourcing. Developing health administration solutions by partnering with 3rd party software partners and client executives to address the client’s business strategies that maximize automation by leveraging collaborative technologies, Accenture assets and efficient delivery models to accelerate program delivery.Developed customized solutions for application development, maintenance and help desk support, which included client resources and leveraging Accenture’s global delivery centers (offshore and near shore). Focused on meeting client business needs by providing an integrated team utilizing a multi-delivery center approach to address time zone, 24x7 support, and client interfacing roles. Show less

Services Partner, (Client Account Services Leader) - Global Business ServicesAssigned to a few large payers client and PBM clients as the Global Business Services Leader defining and driving healthcare solutions. Responsible for all consulting services, solutions, sales activities, financial P&L, client presentations, contract negotiations, engagement start-up activities, managing client executive relationships, monitoring engagement quality, and follow-on sales… Show more Services Partner, (Client Account Services Leader) - Global Business ServicesAssigned to a few large payers client and PBM clients as the Global Business Services Leader defining and driving healthcare solutions. Responsible for all consulting services, solutions, sales activities, financial P&L, client presentations, contract negotiations, engagement start-up activities, managing client executive relationships, monitoring engagement quality, and follow-on sales activities.Business Development Executive – IBM Application Management Services (2001 – 2006)Led sales and solutions leveraging global sourcing models. Managed an integration management team consisting of IBM and the client to implement and manage project phases spanning multiple years. Responsible for business planning, financial cases, sales activities/presentations, managing client executive relationships, and monitoring engagement quality.Executive Consultant - Industrial Sector - IBM Global Services (2000 - 2001)Consulted with large industrial sector clients providing thought leadership for public consortium and private e-marketplaces. Responsible for driving leadership and coordination for a global Construction, Agriculture Equipment (CAE) e-marketplace IT strategic roadmap to meet business objectives.Principal - New Ventures Group - IBM Global Services (2000 - 2001)Evaluated companies and/or lines of business focusing on the New Economy business solution, to introduce IBM hardware, software, and service offerings. Provided leadership, coordination, development and oversight for launching new strategic business initiatives that use new business models (alliances, equity, alternative pricing, etc.) to significantly grow revenue for IBM Global Services’ core lines of business.Principal - Testing Center of Excellence (TCE) - IBM Global Services (1997 - 2000)IBM Global Services - Project Executive - Legacy Application Transformation Practice (1992 - 1997) Show less