J.R. Long Email & Phone Number

Texas, United States

Dallas, Tx, Us

CEO of portfolio of companies that include IX Global, IX Solutions and IX Care

New York, Ny, Us

Provide executive ownership of a group of Ciox CDAI (Clinical Data Acquisition & Insight) clients representing an enterprise client portfolio that includes responsibility for Risk Adjustment Chart Retrieval and Coding projects. Responsible for driving client satisfaction to capture growth (sales), enhance core product delivery and provide overall escalation support/direction to meet and exceed client expectations. This includes extensive collaboration with internal executive leaders in Sales, Operations, Technology, Corporate Support, and Product Strategy as well as overall P&L responsibilities. Oversee teams of Client Success Account Managers and Client Project Managers to execute on client projects providing overall client/project governance.

Ciudad Autónoma De Buenos Aires, Buenos Aires, Ar

Duties • Strategic leadership and oversight of business development, client services and day-to-day operations for all of Conexia’s United States sales and business operations.

Saint Louis, Mo, Us

Duties• Oversee all activities of the provider relations staff acting as liaisons between the plan and providers supporting multiple managed care products interacting with CEOs, CFOs, to Clinicians to billing/collections staff while representing Superior HealthPlan in a variety of capacities.• Development of tactical plans to align strategies and technologies for provider relations maintaining ultimate focus on the level of care and service provided to members.• Development, implementation, and monitoring for adherence of departmental policies and procedures.• Perform financial analyses to identify medical cost improvement opportunities and initiate action plans to achieve successful results with targeted providers.• Prepare and analyze reports on departmental and organizational activities and recommend improvements.• Ensuring timely Provider set up processing, auditing and distribution of Provider Relations data management.• Develop and oversee the training program for the Provider Relations Department. Key Accomplishments• Partnered with key providers to reconcile and/or negotiate settlements reducing over 2,500 accounts totaling over 15 million dollars in accounts receivables that were aged more than 60 days down to less than 500 accounts totaling less than 1 million with majority aged less than 60 days.• Developed, implemented, and monitored provider relations strategy to support managed care contract expansion supporting thousands of providers ranging from specialists to large hospital systems.

Duties• Responsible for the leadership of various full service unit operations (claims, customer service, enrollment) for a geographically diverse team of up to 500 FTEs. • Scope of responsibility included (not limited to): developing/leading employees, handling high profile providers/accounts with complex contracts/service needs, leading large/dynamic teams in a goal oriented environment, attracting and maintaining talent, accountability for performance against contractual benefits (design/coding, claim processing, inquiry resolution, system logic, complete system and procedural responsibility), with adherence to all federal and state regulations. • Complex human resources accountability including responsibility for recruiting, training, performance management, compensation, corrective action, and terminations.Key Accomplishments• Led cross organizational project team (100 plus team members of varying disciplines) to successfully complete a complex system conversion impacting over 1,000 full time employees and interfacing with multiple internal and external platforms. Accelerated and drove the project to finish ahead of schedule, under budget by 15%, resulting in over 1 million dollars saved.• Oversight of Member Loyalty measurement with success maintained above 87% likelihood to recommend the plan while competitors experienced significant erosion in same measurements.• Divisional Quality Council champion leading over 100 employees with a focus on automation and process improvement implementations impacting over 3,000 full time employees. Success evidenced by divisional quality maintaining over 99% during my leadership tenure.• Development and implementation of automated tool with over 20 departmental implementations. Responsibility for measuring adoption of the tool resulting in over 2 million dollars in savings achieved by reducing handle time and creating quality improvements.