Todd Ray Email and Phone Number
SVP - Government Programs at BlueCross BlueShield of Tennessee at
@
BlueCross BlueShield of Tennessee
Todd Ray's Location
Chattanooga, Tennessee, United States, United States
Todd Ray's Contact Details
Todd Ray work email
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Todd Ray personal email
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About Todd Ray
Executive leader and experienced healthcare professional with over twenty-five years experience in numerous aspects of health care administration and delivery, with a focus on: Provider Engagement, Product Design, Value Based Contracting, Financial Performance, Strategic Planning, Network Development, Operational Execution, Risk Adjustment and Quality Improvement
Todd Ray's Current Company Details
Bluecross Blueshield Of Tennessee
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SVP - Government Programs at BlueCross BlueShield of Tennessee
Todd Ray Work Experience Details
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Svp - Government ProgramsBluecross Blueshield Of Tennessee Oct 2022 - PresentChattanooga, Tn, UsGovernment Programs executive responsible for leading our Medicare, Medicaid and Shared Health lines of business.
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Svp - Medicare Products And Corporate Provider Network ManagementBluecross Blueshield Of Tennessee Nov 2019 - Oct 2022Chattanooga, Tn, UsCorporate Executive responsible for all network activities of all lines of business - innovation, contracting, loading, administration. Continued responsibility for the Medicare line of business.• Led the response, rollout and execution during COVID for our provider contracting/reimbursement initiatives• Creation and administration of BCBST's enhanced telemedicine policy and reimbursement• Successful renegotiation, contracting and loading for several health systems in TN• 5.0 STAR rating for 2023• 4.5 STAR rating for 2022• Membership growth to 140,000
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Svp - Senior ProductsBluecross Blueshield Of Tennessee Oct 2017 - Nov 2019Chattanooga, Tn, UsMedicare business segment profit and loss owner directly responsible for all aspects of the performance of the Senior Products business segment (Medicare Advantage and Medicare Supplemental Products).• 4.0 STAR rating for five consecutive years• 3rd best audit score in the country for 2017 CMS Parts C and D Operational audits (.44) • Membership growth to 130,000 (largest MA plan in Tennessee)
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Vice President And General Manager - Senior ProductsBluecross Blueshield Of Tennessee Nov 2014 - Oct 2017Chattanooga, Tn, UsLead the Senior Products division for BCBST, which includes Medicare Advantage and Medicare Supplemental products. Responsible for the overall segment P&L, strategic planning, STARs strategy, risk adjustment, clinical operations, provider engagement, product development and plan operations. Recent highlights include:• Grew MA membership from 75,000 to 114,000 (2014-2017)• Attained 4.0 STAR rating on our PPO plan for three consecutive years through strong collaboration with providers and a focus on clinical data exchange • Improved risk adjustment processes to better align revenue with incurred claims risk• Dramatically improved financial performance (2015 - 2017)• Significantly increased associate engagement scores
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Director Of Product Strategy And Finance - Senior ProductsBluecross Blueshield Of Tennessee Aug 2013 - Nov 2014Chattanooga, Tn, UsResponsible for the design and development of our Medicare Advantage HMO and LPPO products, resulting in continued year over year membership growth (53,000 to 75,000). Also responsible for our CMS product filings and developing our required marketing materials.Led the development of engaged provider relationships through enhanced value-based contracting while developing new strategic relationships with key providers in the market.Drove collaboration with Sales, Marketing, Actuary and Network to create a growth strategy for Medicare Advantage and Medicare Supplement products.
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Regional Director - Risk Adjustment And Strategic PlanningHumana Apr 2012 - Aug 2013Louisville, Kentucky, UsLed the market Medicare Risk Adjustment (MRA) department for the seven state Intermountain Region, managing a staff of 38. Brought in to reorganize the department operations, increase associate engagement and improve both coding efficiency and accuracy resulting in greater alignment between member medical conditions and reimbursement. First year results yielded a significant increase in both associate engagement and overall risk scores.Responsible for the strategic planning process within the Intermountain Region for 2011-2013 benefit plan years (35 plans in 120 counties). This process consists of: planning and filing benefit level changes for new and existing products with CMS, analyzing competitor positions/changes, forecasting financial viability through premium/benefit analysis positioning, anticipating membership gains/losses, and working with risk provider groups to jointly agree on changes. Additional responsibilities include coordinating and garnering buy-in from the Actuary, Sales, and Network organizations on expansion/retraction counties, benefit changes and network changes. -
Regional Market LeaderHumana Dec 2009 - Jul 2012Louisville, Kentucky, UsOversaw Humana’s Medicare Operations for the State of Nevada with responsibilities for overall market growth, market management and profit/loss ($350 million in 2012 annual revenue and $2M budget surplus). The 2012 Annual Election Period resulted in a 22% increase in membership driven through: close coordination with our Medical Providers and our Sales department, provider expansion into new areas, new C-SNP product launches, benefit adjustments, and a targeted/focused marketing campaign. Additionally, championed an overall market commitment to consistent and timely member/provider resolution of problems resulting in the lowest market disenrollment in Nevada to date. Additionally responsible for managing the relationship between HealthCare Partners and Humana, collaborating directly with the CEO.Oversaw Humana’s Medicare Operations for California from 2009-2010, resulting in the implementation of two large provider risk deals and organic member growth of 5,000 new HMO Medicare members in a new market expansion. Managed the Humana relationship for both IPA groups, working to ensure financial and operational success.Improved market profitability and exceeded membership growth for both Nevada and California.
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Market Finance DirectorHumana Oct 2008 - Dec 2009Louisville, Kentucky, UsOversaw Humana’s Medicare financial results in Nevada for 27,000 members and $310M in annual revenue (HMO, LPPO, PFFS, and Medicare supplemental products). Responsible for financial analysis and revenue enhancement for all products, including medical expense, underwriting margin, administrative margin and profit.Created the corporate process for analyzing and loading delegated claims into Humana’s claims system, ensuring proper accounting and forecasting capabilities. This process drove a 20% variance in HCC codes down to less than .5%, resulting in additional and appropriate funding from CMS for Humana. Coordinated all financial MRA activity between HealthCare Partners and Humana including HCC changes, logic changes, and procedural changes with data submissions.
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Cfo - Humana EuropeHumana Apr 2007 - Oct 2008Louisville, Kentucky, UsReported to the CEO of Humana Europe, providing Strategic and Financial leadershipPrimary architect of the Humana Europe strategic business plan, culminating in the decision by Senior Leadership and the Board of Directors to create Humana Europe as a new business segmentDeveloped, managed, and oversaw the £10M 2007 and £15M 2008 operating and capital budgets, ensuring under budget performance for 2007Responsible for pricing all bid submissions, products and services to the National Health ServiceResponsible for the design and build out of the Finance function, including AP/AR/GL/FA activities and functionsOversaw all AP/AR/GL/FA activities for Humana EuropeContract negotiation lead for all commercial and legal aspects of revenue contracts and strategic partnershipsResponsible for all legal contracts and agreements working with both internal and external counselsCreated the revenue contract terms and conditions for all revenue engagements
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Various PositionsHumana May 1996 - Apr 2007Louisville, Kentucky, Us
Todd Ray Skills
Leadership
Strategic Planning
Strategy
Medicare
Cross Functional Team Leadership
Healthcare
Management
Project Management
Business Analysis
Budgets
Analysis
Financial Analysis
Sales
Business Development
New Business Development
Marketing
Business Process Improvement
Contract Negotiation
Strategic Partnerships
Forecasting
Product Management
Business Planning
Six Sigma
Product Development
Health Insurance
Budgeting
Pricing
Team Leadership
Project Planning
Managed Care
Insurance
Operations Management
Product Design
Network Development
Quality Improvement
Todd Ray Education Details
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University Of LouisvilleHealthcare Concentration -
University Of LouisvilleBusiness Administration - Computer Information Systems And Finance Majors
Frequently Asked Questions about Todd Ray
What company does Todd Ray work for?
Todd Ray works for Bluecross Blueshield Of Tennessee
What is Todd Ray's role at the current company?
Todd Ray's current role is SVP - Government Programs at BlueCross BlueShield of Tennessee.
What is Todd Ray's email address?
Todd Ray's email address is to****@****bfi.com
What schools did Todd Ray attend?
Todd Ray attended University Of Louisville, University Of Louisville.
What are some of Todd Ray's interests?
Todd Ray has interest in Economic Empowerment, Investing, Cycling, Reading, Board Member, Strategic Planning, Golf, Financial Planning.
What skills is Todd Ray known for?
Todd Ray has skills like Leadership, Strategic Planning, Strategy, Medicare, Cross Functional Team Leadership, Healthcare, Management, Project Management, Business Analysis, Budgets, Analysis, Financial Analysis.
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