John Cressler, Mha Email & Phone Number

San Diego, California, United States

San Diego, California, United States

Greater San Diego Area

Greater San Diego Area

Director of Clinical Operations for Altegra's Risk Adjustment Program for Medicare, Medicaid & Marketplace Patient Assessments. • Helped drive a 1000% growth in our provider network and production capacity within the first year at Altegra.• Accountable for developing and executing strategic plans through the coordination of multiple internal and external functional areas and manipulating project activity towards project goals. • Oversee and drive the orientation, credentialing and implementation of our Provider network as well as consistently revising the internal work flow process for more efficiency. • Keeping abreast of CMS/Risk Adjustment/Medicare Advantage regulations and payment changes in order to provide provider training and present industry changes and guidance. • Maintain a thorough understanding of company software and reports and assist in promoting new products and expanding current relationships. • Interact with multiple functional areas and lead and/or coordinate projects among those areas on behalf of Provider Operations. • Track and monitor client issues through analyzing data, reporting, and recommending and/or implementing process and procedure improvements.• Responsible for effectively communicating and documenting detailed technical report specifications and data processing protocols through various levels of the organization to ensure client needs are met. • Manage the expectations of our field of Physicians, Nurse Practitioners and Physician Assistants. • Oversee the efficiency and optimization of Provider Consultations while generating data and analysis to deliver to our Executive Team.

Greater San Diego Area

Promoted from the Director of Recruiting position to lead and assist our clinical team in our newly minted Prospective Medicare Advantage line of business. Oversaw the orientation, credentialing and implementation of our Provider Network. Maintained a thorough understanding of company software and reports and assist in promoting new products and expanding current relationships. Tracked and monitored client issues through analyzing data, reporting, and recommending and/or implementing process and procedure improvements.Managed the expectations of our field of Physicians, Nurse Practitioners and Physician Assistants.

Working directly w/ Hospitals, Health Systems, Health Plans and other Healthcare Entities to identify and locate professionals. Work with accounts to assure client satisfaction as well as as employee satisfaction. Manage over 100 employees on multiple issues from start to finish helping reduce attrition.

Sell and manage Health Plans nationally in an effort to assist in optimizing reimbursement for the Risk Adjustment Program for Medicare Advantage. Contact and work with Acute Care Health Facilities, DoD and Veterans Affairs Hospitals to sell and manage a solution to challenges that lie within the Medical Record department and more specifically the Coding Department. Work directly with C-Level Managers and Directors of HIM to coordinate IT and workflow adjusting to coding related issues. Manage daily productivity of employees working an account. Make sure the operations and functionality of an account are maintained along with client satisfaction.

Bachelor Of Business Administration (B.B.A.), Finance, General

Master Of Health Administration - Mha