Lamont Brown Email & Phone Number

Work with a National IFP (Individual and Family Plan) Team that impacts facility, ancillary, and physician negotiations throughout the country. Provide deep-dive analyses to support negotiations and participate in market strategy planning sessions. ➤ Develop national trend & spend baseline reporting to be used by Senior Leadership by extracting and merging varied budgetary datasets.➤ Influence contract negotiations by collaborating with contracting partners in strategy development; offering insights as to potential trend savings pathways via varied payment rates, structures and methodologies.➤ Determine impact to trends for contract negotiations by conducting analysis on proposals as well as developing counteroffers.➤ Leverage market, regional, national, and CMS data to derive insights and business implications for requesting customers.

Columbus, Ohio Metropolitan Area

Devised strategic data analytic plan to track metrics. Met all analysis requests for reporting on healthcare providers nationwide. Analyzed, audited, researched, and presented complex provider analytics, generated reports for local market and national leadership.Lead analytical and strategic projects. Liaised between department and internal partners, including clinical services, healthcare economics, operations, advanced research analytics, network and Optum IT. Represented department in special project meetings and committees.➤ Developed and launched national reporting tools as member of Joint Application Development (JAD) team comprised of internal cross-functional stakeholders.➤ Facilitated successful, well-informed negotiations by developing and deploying tracking mechanisms and metrics to consolidate, aggregate, and present historical national/local data into single report covering total provider experience over one year.➤ Played instrumental role in establishing national physician contracting strategy initiative by developing economic model that formed basis of contracting rates. Participated with Team in multiple national training session presentations to convey new guidelines.➤ Enabled negotiations team to address and resolve complaints, while tiering providers based on performance and experience by providing national/local analytics and reporting with data points that supported physician and hospital advocacy.* Promoted from Senior Network Pricing Consultant in 2017.

Columbus, Ohio Metropolitan Area

Influenced contract development, structuring, negotiations, and management by providing financial/rate modeling, analytical support, budget trending/tracking, cost/valuation analyses, auditing, and performance reporting for network market teams. Advised negotiations team on best practice strategies that integrated competitive payer data and internal budget constraints.Held national and regional roles, including financial model peer reviewer, initial tester for corporate cost reporting/strategy tools, and Regional First Contact for modeling tool. Nominated and completed CORE and Value-Based Negotiation programs. Mentored and facilitated multiday facility modeling webcast training sessions for new hires. Served on Regional Committee that revised Physician modeling guidelines.➤ Optimized contract structures to ensure attainment of national strategic requirements and local/national budget targets by creating rate proposals, data analytics, financial models, and recommendations for hospitals, physicians, and ancillary providers.➤ Chaired committee that created new regional guidelines for facility charge master audit process. Presented webcast on new guidelines to address hospital overcharges in non-adversarial, fact-based manner to regional peers and network pricing leaders.➤ Brought regional contractual agreements into compliance with Medicare DRG changes as appointed member of national workgroup who compiled data, identified contract changes, and disseminated findings to hospitals. ➤ Enabled network negotiations team to move payers and providers to preferred payment methodologies, ensuring providers stayed within budget.* Promoted from Network Pricing Consultant in 2012

Columbus, Ohio Metropolitan Area

Led managed care analytics and reporting on facility-based contracts for Commercial, Medicaid / Medicare, and Behavioral/Transplant agreements. Developed and maintained adjustable, payer-specific utilization, cost, and revenue analyses. Prepared contract profitability models, financial analysis, and executive summary reports for department director and hospital CFOs. Monitored contract financial performance and payer compliance.Collaborated across departments, including patient account, business, and finance teams, to verify claims calculations, contract rate loads, and payer reimbursements. Chaired Committee managing creation, deactivation, and implementation of all patient registration payer codes; resolved issues and concerns. Served as product knowledge and training resource.➤ Identified and recommended contract improvement opportunities spanning payment rates, structures, and methodologies. Modeled impact of OSU and payer contract rate proposals, forecasted contractual performance, analyzed service types to identify charge and payment trends, and conducted analysis of contract financial performance, payer compliance, and claims.➤ Built and positioned hospital contracts to reach aggregate increase targets by developing models and roadmaps for every service, charge, and payment type. Configured and loaded all facility contracts for University, East, and James Cancer hospitals.➤ Ensured revenue forecast accuracy by conducting payment methodology simulations within test database; leveraged test results to resolve any contract loading discrepancies or disagreements with account management team.➤ Developed, maintained, and used Oracle-based decision support/cost consulting system—for financial analysis.* Promoted from Managed Care Analyst in 2005