James Kerr Email & Phone Number

New York, Ny, Us

KERR Associates provides strategic advice, operations management and administrative services business solutions to health systems, payors and providers including hospital networks, physician group practices, independent practice associations, solo physician practices, pharmaceutical companies, insurers, managed care organizations and healthcare benefits firms.

Baltimore, Md, Us

CEO of the Consortium for Medicare Health Plans Operations (CMHPO) responsible for leading over 400 field staff in all 10 regional offices nationwide providing day to day account management (oversight, surveillance and first level compliance) to over 600 contracts delivering Medicare Advantage, Prescription Drug, Marketplace Qualified Health Plan and Stand Alone Dental Plan services to over 30 million beneficiaries throughout the country as well as performing outreach and resolving beneficiary casework, In collaboration with CMS Central Office/Center Directors, establish overall policy and strategic direction for the Agency’s programs and operations and guide national implementation of CMS goals and objectives for Medicare Parts C & D and the ACA Marketplace.

Baltimore, Md, Us

Temporary detail as Acting Deputy Director of the CMS Center responsible for managing the Medicare Advantage and Prescription Drug programs during ramp up activities for the 2007 open enrollment and end of year processing. This occurred at a time when Part C and D contracts increased by 18% from 695 to 847.

Baltimore, Md, Us

CEO responsible for CMS Region II Medicare and federal share of Medicaid and State Child Health Insurance Programs totaling $35 billion for 10 Million beneficiaries in New York, New Jersey, Puerto Rico and the U.S. Virgin Islands.

Twenty month assignment as Acting Deputy Center Director and Director of Operations for of the CMS Center responsible for major aspects of the Affordable Care Act, including implementing private health insurance marketplace exchanges in the states and at the federal level with a budget of $4.7 billion dollars. CCIIO’s focus includes: ensuring compliance with new insurance market rules, such as the Patient’s Bill of Rights; helping states review unreasonable rate increases and overseeing Medical Loss Ratio rules; providing oversight for the State-Based Marketplaces and Consumer Operated and Oriented Plan Program (CO-OP); standing up and operating the Federally-Facilitated Marketplaces (including State Partnership Marketplaces) and premium stabilization programs as well as administering the Consumer Assistance Program (CAP), Pre-Existing Insurance Plan (PCIP) and Early Retiree Reinsurance Program (ERRP).

KERR Associates provides management and administrative services business solutions to hospital networks, physician group practices, independent practice associations, solo physician practices, pharmaceutical companies, insurers, managed care organizations and healthcare benefits firms. Clients include: eHMO/eInsurancePlatform, Maimonides Medical Center; ULLICO/Devon Health Systems; Women’s Primary Care; Centocor, Inc. and ALLEGIANCE Health Services, L.L.C.. ¨Reorganized Allegiance Health Services, L.L.C. as Interim CEO ¨Analyzed pricing and negotiated fee reductions with network physicians.¨Established physician credentialing verification procedures.¨Developed managed care training programs for providers.¨Negotiated contracts between hospitals, physician networks and insurers.¨Lectured on “Interactions with Managed Care Organizations” at numerous physician and practice manager workshops across the country sponsored by Centocor.

Us

Chief Executive of Government Health Plans, a Medicare and Medicaid HMO with revenues of more than $150 million and a network of over 11,000 private practice physicians, hospitals and other health care providers. Responsible for management of Member Services, Medical Management, Network Services, Claims, Finance, Quality Improvement and Sales and Marketing including profit and loss responsibility for all Government Health Plans’ products. Member of Board of Directors of United HealthCare Insurance Company of New York.

Directed the day to day operation of this $100 million Individual Practice Association model health maintenance organization, with more than 85,000 commercial, Medicare and Medicaid members and a network of over 3,000 private practice physicians, hospitals and other health care professionals; including direct management of Customer Relations, Claims, Enrollment and Management Information Systems and management oversight of Finance, Marketing, Provider Relations, Utilization Review and Case Management. Shared profit and loss responsibility with the Chief Executive Officer.

CEO of the nation’s largest pre-hospital care system with 2,700 employees and an annual operating budget of over $87 million, which serves an average daily population of 10 million citizens and visitors. Managed all aspects of the service, including: responses to over 850,000 emergencies and multiple casualty incidents annually; the operation of 500 daily ambulance tours, including voluntary hospital ambulances operated under contract and a mutual aid program with the volunteer ambulance corps; the design and maintenance of a state-of-the-art “911” communication and dispatch network; and participation with NYPD, FDNY, Port Authority and other response agencies in the design and implementation of disaster preparedness exercises.

M.B.A., Health/Health Care Administration/Management

M.B.A., Healthcare Administration

Master Of Science, Management

Master Of Science - Ms, Business Administration And Management, General

Bachelor Of Science, Mechanical Engineering