Joe Ware Email & Phone Number

Jupiter, FL, US

Jupiter, FL, US

Arlington, VA, US

• Subject matter expert (SME) on healthcare pricing and reimbursement
• Played a key role in the development of 2 brand new provider owned health plans in under 6 months
• Contracted for multiple products including Commercial, Medicare, and EPO’s
• Responsible for the creation of all provider pricing reimbursement for all provider types for all health plan clients.
• Oversee all pricing updates including quarterly and annual Medicare updates
• Provide strategic and analytical support for our health plan clients

Pittsburgh, Pennsylvania, US

• Responsible for negotiating all managed care contracts for a 5 hospital, 700+ provider health system
• Point person for negotiating and implementing several high performance networks
• Created a user friendly internal SharePoint site to communicate managed care information to all employees
• Obtained delegated credentialing agreements with all major carriers
• Supervised a 13 member staff responsible for negotiating contracts, contract analytics, and provider enrollment and credentialing
• Assisted revenue cycle with identification and resolution of claims issues

• Responsible for all provider contracting in a 16 county service area with emphasis on hospital contracting
• Successfully expanded our Medicare product by 7 counties in a 3 month time span

Pittsburgh, Pennsylvania, US

• Developed very strong, positive hospital relationships in the western Pennsylvania area
• Negotiated and administered all hospital contracts
• Successfully doubled our hospital network
• Developed market competitive hospital outpatient fee schedules
• Responsible for negotiating reimbursement rates with large physician and ancillary practices
• Managed a staff of seven provider contractors

• Supervised the development of utilization management software, effectively matched referrals and prior- authorizations with claims
• Created specialized reports from Access and Excel, including a medical expense profile report that calculated the per member per month cost for our primary care physicians
• Created and monitored our preventative and outreach care programs
• Updated information on our website and educated physician’s office personnel of its functions
• Managed all aspects of network reimbursement

• Negotiated contracts with traditional and managed care insurance companies
• Managed accounts receivable and reconciled insurance payments to contract terms
• Maintained all liability files, including malpractice claims
• Updated credentialing files for all practitioners
• Educated staff on specific insurance payer issues and procedures

• Successfully transitioned electronic claims transmissions to Madras, India office via video Tele-conference and email
• Set up 25 facilities simultaneously in ten states; included electronic transmission agreements and provider enrollment issues for over 100 physicians
• System administrator for our billing (Medic) computer system
• Managed accounts payable and assisted in company payroll

Mba, Health Systems Leadership

Bachelor Of Science - Bs, Health Policy And Administration