Jason Sharp, Mpa Email & Phone Number

United States

Responsible for bringing a new proprietary reference lab service to Managed Care markets in the East and West regions of the U.S. Responsible for analyzing Managed Care payer policies to determine if payers will pay for CDx services. Influences payer policy changes by leveraging clinical trial outcomes and published studies showing efficacy of CDx’s services as compared to existing protocols. Builds relationships and networks with payers to build awareness of CDx services and position in the market. Negotiates and implements payer network agreements including all terms and conditions and reimbursement terms for services with Managed Care payers.

Albuquerque, New Mexico

Directs, negotiates and implements all Payor and revenue-based contracts for Presbyterian Healthcare Services, including Presbyterian Hospitals, Presbyterian Medical Groups, Albuquerque Ambulance, Presbyterian Pharmacies, Presbyterian Specialy Care Pharmacy, Presbyterian Home Health and Hospice and Presbyterian Healthplex.

Albuquerque, New Mexico

Responsible for developing and implementing provider network strategies for an integrated healthcare system of with over 420,000 active members in Commercial, Medicare and Medicaid plans across the state of New Mexico. Directly responsible for the development of PHP's managed medicaid expansion, Healthcare Exchange and medicare program implementations in 2013. Leads a team of contract managers and is responsible for conducting provider contracting functions including contract agreement negotiations, overseeing all new and exisiting provider contracts and maintaining the consistant improvement and development of the Presbyterian Provider Network.

Albuquerque, New Mexico Area

Albuquerque, New Mexico

Responsible for negotiating complex hospital, medical group and ancillary contracts with a wide variety of managed care organizations and third party payers. Manages contract development and implementation, and coordinates contract maintenance through the resolution of operational, administrative and clinical issues among stakeholders.

Albuquerque, New Mexico

Responsible for negotiation and implementation of new provider contracts and renewed contracts, in a highly competitive and political network, with medical, hospital, durable medical equipment, behavioral and pharmacy providers statewide. Responsible for negotiating and implementing new and renewed agreements with reimbursement methodologies that are highly complex and both fiscally and operationally sound into PHP reimbursement systems. Works closely with Reimbursement team to ensure that negotiated agreements will operate within the PHP standards reimbursement methodology. Responsible for maintaining positive relationships with providers who are both contracted and not contracted with PHP. Interacts directly with Medical Professionals, both internal and external Executives and decision makers. Responsible for being a Subject Matter Expert for internal Provider Services department staff in regards to contracting. Interprets contract language, interprets Reimbursement methodologies, troubleshoots reimbursement issues, and creates summaries of reimbursement by network or specialty. Responsible for monitoring contract compliance and works directly with Network Manager with audit preparation. Works closely with Decision Support staff to analyze and study financial implications of provider reimbursement proposals. Responsible for analyzing network needs and recommending pursuable providers to seek contracts with.

Responsible for contracting and renewals of contracts for Third party and Self Funded prescription insurance clients. Managed client relationships as contact person for the entire book of business. Assisted clients with complex issue resolution by being a liaison to the client and my internal departments. Responsible for strategic planning, project planning, client visits, implementation of client contracts and analysis of benefit design, up selling new products and services to existing business. Managed several clients while the company went through a major system conversion. I was rated on the accuracy and quality of the conversion of clients to the new operating system and received excellent reviews by all clients.

Master Of Public Administration - Mpa, Graduated Summa Cum Laude, 4.04 Gpa

Activities and Societies: Member of Pi Alpha Alpha, an honors society for Public Affairs and Administration.

Bachelor Of Liberal Arts, Minor In Management, Graduated Summa Cum Laude, 3.9 Gpa.

Associate Of Arts And Sciences (Aas), Business Administration, Graduated With Honors, 3.8 Gpa.