Mark Sample Email & Phone Number

Dallas, Texas, United States

Dallas, Texas

Responsible for all financial functions of the health planEnsures financial records are accurately maintained from a company, statutory and contract perspective Directs the month-end close process and preparation/communication of financial statementsEnsures the timely production of quarterly and annual NAIC and State statutory financial reportsCompany liaison to TDI/HHSC and external auditors regarding financial/internal control mattersResponsible for preparing $550+ million annual company budgetInteracts with HHSC actuaries on annual revenue rate setting processPerforms various analyses on financial statements and medical cost trendsProvides financial input on existing and pending provider/other company contracts

Austin, Texas Area

Manage 15 employees covering three unique disciplines (financial analysis, contract analysis and position management)Responsible for financial and root cause analysis of trending medical costsManage the analysis and administration of provider incentive models for hospitals and physician groupsResponsible for providing hospital reimbursement analysis models for contract negotiationsDeveloped models to compare hospital reimbursement rates to MedicaidFinance team member responsible for preparing $6 billion annual company budgetCreated and implemented centralized Workday position management system recently adopted Centene-wide

Austin, Texas Area

Responsible for estimating $200 million in inpatient costs on a monthly basisProvided rate and other reimbursement analysis for contract negotiations and State inquiriesProvided special analytical support and research project expertise directly to CEOProduced numerous member/claim/provider/authorization ad-hoc reports as requestedDesigned membership/claims databases and related reports still utilized by company todayResponsible for producing several quarterly and annual State report deliverablesFinance team member responsible for preparing $2 billion annual company budgetElected Plan Champion for Enterprise Data Warehouse implementation

San Antonio, Texas Area

Negotiated hospital/physician contracts and transplant letters of agreement with managed care and other interested payorsDesigned and maintained various transplant patient databases for tracking and reporting visits, payments, LOS, organ costs, inpatient days, rehab days, and other vital statisticsPerformed financial analysis of current and potential contracts including volume and revenue/cost impact to UHS and UPGWorked with UHS and UPG Business Office staff to improve the timing/accuracy of managed care contract/LOA reimbursementDeveloped and maintained contract tracking system for all letters of agreement pertaining to transplants and other patientsPerformed Director, Managed Care Services functions until replacement could be found

Austin, Texas Area

Appointed Chief Operating Officer during company closure.Directed financial and information system operations; developed and monitored budgets for departmentsMonitored contract compliance with vendors, provider groups and affiliated entities Developed proposals and presented material at Board of Director meetingsDirected standard and adhoc financial and utilization analysis and reporting requirementsCompany liaison to the Texas Department of Insurance and external auditors regarding financial/internal control mattersSecretary of the Board of DirectorsMember of the Corporate Quality Improvement Oversight CommitteeContinued functions of Director, Finance & Information Systems position

Austin, Texas Area

Directed collection and reconciliation of premiums/ASO fees from member groups and the transfer of funds to ASO vendors and provider groupsManaged the exchange/flow of eligibility, utilization and claims data between corporation, member groups, ASO vendors and provider groupsDirected the month-end close process and preparation of financial statementsPrepared quarterly and annual state statutory financial reports Developed and implemented company-wide Y2K work plan, maintained compliance with customers and monitored progress of vendors and affiliated entitiesImplemented transition of accounting functions from outside vendorSupervised accounting and data analysis personnel Acquired, installed and maintained company servers, personal computers and hardware/software

Dallas/Fort Worth Area

Managed review and analysis of managed care contracts from legal, operational and financial perspectivesNegotiated provider contracts with managed care entitiesProvided oversight on managed care contract compliance audits and reportingDirected development of financial/statistical models for individual Letters of Agreement and package prices in areas including Transplants, Epilepsy, Diabetes, Cardiac Care and Breast Care; provided models for allocating and distributing funds receivedProvided initial development and oversight of claims processing unit for UT Southwestern Behavioral Care NetworkSupervised managed care support and financial/contract analysis personnel Directed departmental operations, task assignments, performance reviews and counseled on career advancementsProvided contract administrative support and financial updates to clinical departmentsActed as Managed Care Representative on IDX Managed Care Application Implementation team

Dallas/Fort Worth Area

Analyzed financial impact of new and existing managed care contractsProvided financial and statistical analysis support to 19 clinical departmentsDesigned computer-based reporting system that compared billed fees to reimbursement ratesDeveloped capitation models for proposal responses and designed various physician reimbursement allocation models, including sub-capitation and RVU-based methodsConverted clinical department fee schedules to RVU-based feesMaintained department personal computers and software

Dallas/Fort Worth Area

Consolidated monthly financial and statistical data for 17 HMO plansPrepared annual HMO and corporate cost center budgetsDeveloped and implemented key indicator reports for regionDesigned, prepared and presented HMO physician settlementsProvided oversight on numerous special analysis projects for senior management

Sacramento, California Area

Maintained accounting records for two HMO plansSupervised accounts receivable, accounts payable and general ledger personnelPrepared monthly journal entries and financial statementsDesigned and implemented utilization and statistical reports for senior managementPrepared quarterly and annual state statutory financial reports Developed financial settlement reports for contracted hospitals and physician groups