Keith Roberson Email & Phone Number

- Led Ancillary contracting and Single Case Agreement (SCA) teams. SCA requests encompassed all provider types (hospital, ancillary, and physician). -Regulatory lead with responsibilities related to Network Adequacy including gap closure efforts, tracking, presenting, and submission of waiver requests to AHCA. - Lead for statewide Private Duty Nursing (PDN) project.

Tampa

Led Provider Performance Management team with duties that included new Value Based Contracting initiatives, ongoing education to enhance performance improvement related to existing risk agreements/P4P metrics, and ultimately tasked with improving provider HBR/MLR across the state.

Tampa, Fl

-- Lead Hospital Contracting team for Tampa and Panhandle markets

Tampa/St. Petersburg, Florida Area

- Negotiate contracts with hospitals- facilitate resolution of hospital related issues- implement performance based contracting initiatives, network assessments, network expansion, and any and all other hospital related goals that arise.

Tampa/St. Petersburg, Florida Area

- Contract w/ various provider types including physician, ancillary, and hospital based physicians.- Negotiate provider contracts to meet targeted medical costs, including ongoing financial review and analysis of contracts.- Initiate market expansion for new product types and assess networks for adequate coverage- Implement and develop action plans for various Network Initiatives that arise such as alternative payment models, incentive-based quality metric scorecard sharing, collaborative care models, etc.

Sarasota, Florida Area

- Develop and enhance business relationships with providers through education on Florida Blue processes, contracts, product guidelines and effective use of electronic tools.- Assist providers with escalated issue resolution

Jacksonville, Florida Area

- Assisted call center reps with any and all questions they had regarding claims and/or phone inquiries.- Trained and oriented new employees as they came on the floor.- Took supervisor calls and resolved escalated issues.

Jacksonville, Florida Area

- initial work as Reconciliation Specialist as part of the Principle Healthcare acquisition team that resulted in almost 90% membership retention as well as $1.5 million in overpayment recovery.- additionally took phone calls, worked fax requests and processed claims.

Jacksonville, Florida Area

- Managed 7 to 10 employees during a given shift.- responsible for staff hiring,staff terminations, daily financial reporting, stock inventory, coordinating and scheduling author book signings, and training and disciplining employees as necessary.