Jay Hedges Email & Phone Number

Louisville, Kentucky

Louisville, Kentucky Area

Indiana, Kentucky

Louisville, Ky

Direct and implement strategies relating to development and management of the provider network. - Identify gaps in network composition and services. - Guides the network contracting staff in prioritizing contracting needs. - Identify and remediate operational gaps. - Track, trend, and proactively manage Provider inquiries / issues and network adequacy issues. - Set team direction, resolve problems and provide guidance and coaching to members of own team. - Influence or provide input to forecasting and planning activities. - Document operational processes and develop policies and procedures to ensure compliance with state and federal regulations. - Identifies, manages, and improves quality metrics. - Overall management of assigned provider network process: contract analysis, negotiation, enrollment, training, provider satisfaction maintenance and data collection, analysis, and reporting. - Participation in applicable external Provider committees, workshops, conferences. - Represent and / or drive, where appropriate, internal committees and initiatives for the team. - Perform other duties and projects as assigned.

Watterson Towers

Manager/Managed Care Contract Administrator• Responsible for the management of identification and collection of third party payor underpayments for hospitals. Duties include:o Activity and metric reportingo Operational reportingo Identifying trends in payment variance and seeks resolution with the appropriate associates within the health system and external third party payors. • Responsible for the oversight, integrity and overall effectiveness of the contract management system for hospitals. Duties include: o Contract loads, contract audits, contract reimbursement tableso Maintaining excellent relationship with vendoro Coordination between all parties who have a part in the general maintenance of the system• Responsible for the coordination and facilitation of issues and concerns from across the revenue cycle for hospitals in regards to Managed Care. Duties include:o Oversight of monthly meetings with payorso Central point of contact for miscellaneous concerns from Revenue Cycle areas• Participate in negotiations and administration of new contracts. Duties include:o Overseeing auditing of contract simulationso Providing input and ideas into methodology, rates and languageo Ensuring that processes are in place to minimize any problems that may occur as a result of a new contract• Assists other departments as necessary when managed care expertise is required.

Louisville, Ky

• Assisted with the operation of 40 restaurants throughout the states of Indiana, Ohio, Kentucky and Tennessee.• Develop and implement new training programs and oversee training and development of hourly employees, managers and supervisors.• Organize, develop and implement leadership classes for managers and supervisors• Implement plans to solve problems in individual units. (high food cost, high labor, etc.)• Follow up on Health Inspections and Food Safety Audits in the field• Update and distribute all company specs for food and specialty drinks• New Restaurant Openingso Ordered all kitchen equipment, small wares, food and liquor for new locations.o Established par levels for ordering food, and liquor for new locationso Oversee final stages of construction and begin piecing together the new restaurant.o Oversee the training and scheduling of 75 – 150 employees per new restaurant

Louisville, Kentucky Area

• Duties in the restaurant includedo Ensure the successful operation of the restaurant on a daily basiso Employee schedules, hiring of new employees, oversee training of new employees, handle any disciplinary actions of employees, handle all customer complaints, execute promotions inside and outside of the restaurant, store budgets, P&L review, ensure all operating costs are in-line

Louisville, Kentucky Area

• Duties in the restaurant includedo Ensure the successful operation of the restaurant on a daily basiso Employee schedules, hiring of new employees, oversee training of new employees, handle any disciplinary actions of employees, handle all customer complaints, execute promotions inside and outside of the restaurant, store budgets, P&L review, ensure all operating costs are in-line

General Studies, Biology, General

Education record