Lisa Dugan Email & Phone Number

Pennsylvania, United States

Contributing and coordinating activities associated with our national growth agenda through oversight of a government relations team, a comprehensive channel partner program, and a payer product marketing strategy in support of state Medicaid and health plan business development efforts resulting in the deployment of our purpose-built SaaS solutions for better home care, better health.

Responsible for HHAeXchange payer business development activities of our payer homecare SaaS solutions within various markets throughout the country, including new payer products and upsells.

Camp Hill, Pennsylvania, United States

With increasing responsibility and accountability through three career advancing promotions (Regional Director, Senior Program Director, Program Director), managed contracting, budget, procurement, compliance, client satisfaction, sales, and operational excellence for state agency/government/MCO healthcare program regional contract scopes of work. Led portfolio staff and operational collaborations while overseeing $30,000,000 annual budget and fulfillment of objectives and key results. •… Show more With increasing responsibility and accountability through three career advancing promotions (Regional Director, Senior Program Director, Program Director), managed contracting, budget, procurement, compliance, client satisfaction, sales, and operational excellence for state agency/government/MCO healthcare program regional contract scopes of work. Led portfolio staff and operational collaborations while overseeing $30,000,000 annual budget and fulfillment of objectives and key results. • Convinced client under union environment to outsource functions/redeploy staff to implement innovative best practices, increasing annual revenue by an average of 194% over the next three fiscal years.• Coordinated proof of concept recovery project with results leading to national deployment of project with recovery potential of over $175,000,000.• Negotiated with large commercial carrier on behalf of client that resulted in over $10,000,000 in recoveries and continued carrier compliance.• Expanded services to client populations that resulted in an increase of 175% in contract revenue.• Responded to and closed federal audit conducted over 2 1/2 year period, resulting in no monetary penalties.• Received consistent top line scores on customer satisfaction surveys across multiple clients.• Mentored new program director replacement staff to ensure smooth transition, enhance long-standing client relationships, and preserve top client satisfaction scores.• Supported clients with major systems/IT enterprise-wide initiatives in consultative role to ensure efficiency of development, testing efforts and compliance.• Collaborated with client to integrate sensitive populations into reclamation projects, resulting in additional $10,000,000 on average in annual recoveries.• Introduced revenue maximization strategies in two states with recoveries exceeding $44,000,000.• Developed and established medical support enforcement pilot project for state child support enforcement agency. Show less

Camp Hill, Pennsylvania, United States

Coordinated daily operations and business development of a management services start-up within the Pennsylvania Children and Youth (C&Y) agency market. Provided oversight for IT development project, as well as oversaw ongoing development and implementation of managed service delivery model. Conducted educational assistance programs for public and private providers and developed and managed organizational business plans and pro forma projections to reflect emerging market trends.• Directed… Show more Coordinated daily operations and business development of a management services start-up within the Pennsylvania Children and Youth (C&Y) agency market. Provided oversight for IT development project, as well as oversaw ongoing development and implementation of managed service delivery model. Conducted educational assistance programs for public and private providers and developed and managed organizational business plans and pro forma projections to reflect emerging market trends.• Directed a marketing campaign to 350 public/private children and youth services and juvenile justice providers.• Supported The Laurel Group's "BerkServe" which was the only operational managed delivery model within the Pennsylvania C&Y market. Show less

Harrisburg, Pennsylvania, United States

Oversaw network development strategy and provided ongoing management of five point-of-service programs, including provider recruitment, contract negotiation, vendor management, and policy formulation and implementation. Initiated use of risk-sharing concepts and creative negotiating to recruit providers and strengthen access standards. Served as liaison with state regulatory agencies to oversee state filing process for program expansion and provider and member grievance/appeals… Show more Oversaw network development strategy and provided ongoing management of five point-of-service programs, including provider recruitment, contract negotiation, vendor management, and policy formulation and implementation. Initiated use of risk-sharing concepts and creative negotiating to recruit providers and strengthen access standards. Served as liaison with state regulatory agencies to oversee state filing process for program expansion and provider and member grievance/appeals processes.• Initiated the use of risk-sharing concepts and creative negotiating to successfully recruit providers, close a large network gap and strengthen network access standards resulting in a positive relationship with a 120-member physician organization that previously declined network participation.• Managed a staff of five direct reports and 6 vendor relationships. Show less

Harrisburg, Pennsylvania, United States

Chief Administrator Officer: Created, implemented, and managed administrative services division of provider-sponsored Administrative Services Organization (ASO). Provided claims processing, membership, utilization management, financial management, systems management, and other third-party administration functions for risk-sharing products.Consultant: Developed and managed five physician organizations (PO), including implementation of all administrative functions in preparation of… Show more Chief Administrator Officer: Created, implemented, and managed administrative services division of provider-sponsored Administrative Services Organization (ASO). Provided claims processing, membership, utilization management, financial management, systems management, and other third-party administration functions for risk-sharing products.Consultant: Developed and managed five physician organizations (PO), including implementation of all administrative functions in preparation of accepting risk in managed care environment. Facilitated and conducted payer (HMO and PPO) contract reviews and negotiations on behalf of clients. Executed promotion and streamlining of PMSCO business operations.• Established a claims processing system to handle the anticipated 290,000 lives to be administered through the ASO on behalf of PO clients.• Secured several PO management agreements resulting in potential annual revenue of $4,500,000.• Streamlined the PO reimbursement policy function resulting in a more efficient process eliminating 2-3 months from the entire PO development process.• Participated on behalf of PO clients in the negotiation efforts related to 10 PPO/HMO risk-sharing contracts. Show less

Harrisburg, Pennsylvania, United States

Identified, researched, and formulated products, services, programs, and opportunities to enhance overall member value. Managed society’s non-dues income generation ventures.• Negotiated a non-dues income program renewal contract resulting in a 250% increase in non-dues revenue to the Society in the first renewal year of the contract.• Facilitated the decrease of annual implementation expenses by $16,000 associated with two non-dues revenue generating products.• Assumed complete… Show more Identified, researched, and formulated products, services, programs, and opportunities to enhance overall member value. Managed society’s non-dues income generation ventures.• Negotiated a non-dues income program renewal contract resulting in a 250% increase in non-dues revenue to the Society in the first renewal year of the contract.• Facilitated the decrease of annual implementation expenses by $16,000 associated with two non-dues revenue generating products.• Assumed complete responsibility for the Department of Physician Services development activities within the first year of employment allowing the Director to focus on other Society initiatives. Show less

Bachelor Of Business Administration - Bba, Finance And Management

Associate Of Arts - Aa, Business Administration

Public Administration

Completed 60 credit hours of graduate level coursework.