Luke Bradley Email & Phone Number

Massachusetts, United States

Remote

Oversaw high performing network contracting team responsible for access to care, cost of care, value based / alternative payment model ideation and execution, and network adequacy, for Magellan Healthcare's Behavioral Health Commercial and Health Plan business segments.Converted over $650M in claims spend from fee-for-service to value based reimbursement.

Boston, Massachusetts, United States

Responsible for the merger of Anthem, Inc. behavioral health networks with Beacon Health Options, Inc. networks, including government relations strategy, provider contract alignment and consolidation, credentialing delegation, new provider onboarding processes, and provider data exchanges.Collaborate across Anthem, Inc. and two of its subsidiaries to align.

Boston, Massachusetts, United States

Standardized and streamlined the provider onboarding process, by reducing the provider intake channels and reducing cycle time. The new onboarding process introduced workforce management reporting, cycle time reporting, a provider-facing status dashboard, data automation, and elimination of redundant data.

Greater Boston Area

Responsible for providing legal advice and support on a variety of legal issues to the staff of Beacon entities;Legal issues applicable to health care, insurance, privacy, regulatory compliance, and to client, provider and vendor contracting;Supported corporate governance, internal controls, compliance and enterprise risk management.

Greater Boston Area

Functioned as a subject matter expert (SME) for the Business Operational section of proposal responses for all lines of businessPerformed analysis of solicitations (RFP’s, IFB’s, RFI’s, RFQ’s, etc.)Coordinated with Business Operations functional leads to solicit clarifying questions and comments for submission to clientsCoordinated with Business Operations.

Greater Boston Area

Served as project lead on assigned implementation tasks; assisting Implementation Managers, Executive Sponsors, and Program leads with client relationsCoordinated with operational leaders to ensure that processes are standardized and align with clinical and organizational strategic objectivesManaged a structured transition plan ensuring that the.

Greater Boston Area

Proactively engaged district and school level administration to support compliance with legal obligations and guidance including, but not limited to, M.G.L. Ch 69, Section 1J: An Act Relative to the Achievement Gap Process for “Underperforming” Schools.

Greater Boston Area

Greater Boston Area

• Draft motions, pleadings and discovery requests for a small law firm specializing in family law, estate planning, and general civil litigation
• Prepare documents in response to discovery requests
• Provide administrative assistance including record retention, client communications, and scheduling
• Conduct intake conferences with potential clients

Greater Boston Area

• Drafted briefs, prepared witnesses, and analyzed discovery documents in preparation for arbitration in support of the Commonwealth’s supervisory staff for ongoing labor disputes
• Provided advisory support to the Commonwealth’s supervisory staff to minimize labor disputes

Washington D.C. Metro Area

• Participated in mediating civil rights disputes
• Drafted conciliation agreements for complaints settled during mediation
• Drafted letters of determination for investigated complaints

Greater Boston Area

• Interviewed, hired, and trained new member service representatives for a staff of 20 – 25 employees
• Coordinated training initiatives with other departments to improve quality of service and interdepartmental communication

Woburn, MA

1. Staff all Member Service ACD queues and adhere to telephone performance requirements for call response times and abandonment rates 2. Respond to questions about eligibility, benefits and procedures for accessing behavioral health services3. Respond to requests for referrals to network providers4. Determine which calls need to be transferred to a.

Jd

Bachelor Of Science, Criminal Justice