Mark Ridenour Email & Phone Number

Mission: Apply statistical training and experiences in managed care and healthcare to aide in the achievement of improved health outcomes via efficient effective promotion, delivery, and implementation of wellness and productivity management solutions to a variety of customers: employer/employee, provider, and community. Clients include OSU Health Plan, Ohio Optometric Assn., Adena Health System, Mercy Health/HealthSpan, Findley Davies, Ohio Insurance Services, School Employees Health Care Board, Quality Care Partners, Ohio PPO Connect, Fraternal Order of Police #9, ABB Optical/Diversified.

Planned, created, and developed MCCH&W, a wholly owned division of Mount Carmel Health System, a member organization of Trinity Health, as its chief executive. Became local market leader with a $6.5M operation with over 110 employees serving over 3000 employer clients and thousands of retail customers. Maintained oversight and regular communication for clinical and business aspects of the organization. Represented MCCH&W with employers, payors, and consumers via direct marketing, proposal development, contract negotiation and contracting of all product lines: occupational; behavioral; preventive and wellness. In collaboration with the Board and management team, develop the organizational goals, objectives, fullfillment of mission, and strategic plan for MCCH&W.

Responsible for contract negotiations with multiple payors for HMO, PPO, and other managed care arrangements on behalf of the hospitals, its affiliated businesses and physician organizations. These range from a new entry to the central Ohio market to those representing $65 million annually to the hospital system. Developed and maintained relationships with the representative of the payors as key responsibility. Special negotiation assignments included the representation of new freestanding, physician-hospital, joint-venture ambulatory surgery centers and imaging centers. Required the development and maintenance of strong relationships with physician leaders and the presentation of offers to their Boards.

Responsible for all provider network development and maintenance on behalf of the employer clients participating in managed care products. Also responsible for all actuarial project and consulting services requested by employer clients. Regular duties included leading an employer representative coalition committee in the development an enhancement of the employer owned network, Accountable Health Plan of Ohio (AHPO), containing significant central Ohio employers (e.g., Borden, State Auto, Battelle, Mead). Consulting projects included lead on the assistance in the development of the St. Ann’s PHO, and actuarial analysis of the City of Toledo experience for financial projections and benefit negotiations.

Responsible for contract negotiations for all hospital contracts, at times in conjunction with the Vice President, Provider Affairs or CFO. Supervised a staff responsible for all financial projections and modeling of hospital arrangements, coordination of provider systems transition and strategic planning for Ohio managed care development.

Staff of eleven Actuarial department associates, including two supervisors. Responsible for the renewal rating of all health lines, including traditional medial, PPO, partial self-funded, associations, TPA arrangements, prescription drug, dental and vision encompassing $250 million of annual premium on 200,000 contracts in thirteen states. Duties included primary support to sales, TPA representatives, brokers and consultants. Regular presentations of premium rate renewals to clients, including employer representatives. Also, established and implemented diagnoses code based rating of small groups

Bs, Math&Stats

Graduate Studies