John Henry Email & Phone Number

Oversight of the performance of delegated participating medical groups.

Woodland Hills, California

Implement strategies to ensure compliance with federal and state regulators as well as enterprise policy and proceduresProvide support to legal, management and executive level associates to a hive business objectivesConducts research and analysis and recommends appropriate course of action and process improvements

Woodland Hills, California

Glendale, California

Enter demographic and screening information from a requesting physician office or provider via telephone or facsimile into the preauthorization computer systemScreen preauthorization requests using approved criteria and guidelines Identify and appropriately refer cases to preauthorization nurses for clinical review Provide information to referring/rendering physician offices and network imaging centers regarding program requirements Maintain current personal client files updated with the most current client fact sheets provided Monitor department voice mail and process preauthorization requests in accordance with departmental guidelines Maintain telephone service standards in accordance with departmental goals

Managed the daily coordination for home and hospital delivery of respiratory and durable medical equipment.Responsible for visiting doctors’ offices, skilled nursing facilities and medical centers to generate and increase new business in assigned territory.Respond to and resolve patient and/or referral questions and concerns in a timely manner either with face-to-face contact or by telephone.

Research, recommend and qualify patients’ medical equipment approval with clinical contribution.Direct guidance and relationship management with cross-functional partners. Ensure timely referral processing in compliance with government timeframes and regulations.Negotiate and determine pricing structure for non-contracted payors.Identify challenges, determine solutions and resolve problems faced with clinical home care.Secured new account contracts within assigned territory to increase revenue.

Apply and implement new sales processes to achieve organizational excellence in departmental goals.Manage, motivate and train account liaisons (7 plus people) to meet and exceed determined sales goals.Maintained budget analysis and reporting for supported sales department.Performed employee evaluations in accordance with company guidelines and standards, recommending corrective action plans as necessary. Ensure sales department operates in an efficient and effective manner while adhering to CMS and DHS regulatory guidelines.

Medicare Appeals and GrievancesReviewed daily case inventory reports determining 95% compliance goal. 96% accomplished in the year 2001.Established performance goals to exceed efficiency levels. Maintain cohesive department through staff development, conflict resolution, promotion and necessary counseling.Assisted with implementation of new case load processing system.