Mike Kirby Email & Phone Number

Massachusetts, United States

Boston, Massachusetts, United States

Chicago, Il

Responsible for all Managed Care activities for the University of Chicago Medicine ("UCM"). UCM is comprised of both the University of Chicago Medical Center ("UCMC") and the Faculty Practice of the Biological Sciences Division ("BSD"). Responsibilities also include accountability for Managed Care activities for the University of Chicago Medical Center Care Network Affiliated Physicians ("UCMCCNAP").

Greater Boston Area

Provided healthcare consulting services for a variety of healthcare clients on both the Provider and Payer sides. Significant engagements included serving as Executive Director of the Boston Medical Center Accountable Care Organization ("BACO"). In that capacity had managerial responsibility for all Managed Care functions of the enterprise including Contracting and Care Management activities. Other significant clients included providing strategic Contracting services for Harvard Pilgrim Healthcare ("HPHC"), a leading New England based Managed Care organization as well as various Contracting related services for Steward Health Care system ("Steward"), a Boston based Healthcare organization.

Boston Ma

Responsible for all aspects of the management and operations of the health plan. Full accountability for establishing strategic growth plan, including planned expansions into new market segments and products in a highly competitive and established marketplace. Full accountability for plan financial performance including revenue, medical and administrative expense. Responsible for managing in a matrix environment where certain functions are managed on a centralized corporate basis with the resulting corporate dependencies. Primary plan liaison with both regulatory authorities and legislators.

Boston Ma

Responsible for the provision of timely and accurate financial reporting and analysis in support of the revenue budgeting and payer contracting processes for the largest integrated delivery system in New England; including two academic medical centers, six community hospitals, numerous sub acute providers and over 5,000 physicians in both academic and community settings.• Designed and implemented service line pricing changes in all major insurance contracts across consolidated healthcare delivery system. Changes re-allocated over $40 million in annual revenue from higher margin services to lower margin services. Resulting changes significantly reduced system level product mix risk exposure.• Serve as primary financial resource with respect to rate and payer mix information • Development and implementation of detailed hospital pricing model