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* Highly motivated and experienced executive skilled in orchestrating business strategy and operations for major enterprise corporations, with focused subject matter expertise developed in leadership roles in the Healthcare Industry * Offers a demonstrated record of results in a complex business environment. Skilled in revenue growth, relationship building, team management, account retention, and process improvement* Visualizes broad situations and executes focused strategies through exceptional leadership, with a command of the details necessary to ensure the successful resolution of complex issues. Skilled in quick-thinking and devising creative solutions to complex problems, capturing increased efficiency and productivityAreas of Expertise:* Government Programs* Operations Management* Risk Adjustment Strategy and Programs* Program and Project Management* Key Performance Metrics* Long Range Planning* Team ManagementCareer Achievements:* SS&C Health - Launched a formal Revenue Management organization to focus on the encounter submission and risk adjustment product portfolio, sparking improved client support and increased sales. Defined a multi-year strategic product roadmap that increased revenue while reducing costs by $720K* Florida Blue - Led product strategy for the Medicare Advantage and Medicare Supplemental Products offerings, with a $16M annual budget and over $1B in revenue, with full P&L accountability* Florida Blue - Developed a three-year roadmap governing the integration of Quality, Stars, and Risk Adjustment to save $26M in third party expenses
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Avp, Revenue Program ManagementBlue Cross Nc Aug 2021 - PresentDurham, Nc, Us -
Executive Director Revenue Management StrategySs&C Technologies Oct 2016 - Sep 2021Windsor, Ct, Us• Set strategy and vision for product and business development for revenue management programs, including risk adjustment, encounter submissions, client management, operations for Affordable Care Act, Medicare Advantage, and Medicaid product lines.• Manage strategic partnerships and third-party relationships• Provide executive level leadership and oversight for more than 20 clients providing services for multiple components of risk adjustment and encounter submissions including direct interaction with state and federal regulatory entities to ensure compliance, resolve issues, and sustain relationships.• Work closely with sales to establish go-to-market plans, build competitive intelligence, industry trends, and develop contracts. -
PresidentNemeth Consulting Apr 2016 - Mar 2021
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Sr. Consultant, Risk Adjustment SolutionsGorman Health Group Apr 2016 - Oct 2016Fort Lauderdale, Fl, Us -
Sr. Director Market Segment Product And OperationsFlorida Blue 2014 - Mar 2016Jacksonville, Florida, Us -
Director Medicare Revenue ManagementFlorida Blue Oct 2010 - Oct 2014Jacksonville, Florida, Us
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Business Development ConsultantFlorida Blue Sep 2007 - Oct 2010Jacksonville, Florida, Us
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Director Of OperationsFlorida Blue Jun 1992 - Sep 2007Jacksonville, Florida, Us
Michael Nemeth Skills
Michael Nemeth Education Details
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Florida State University - College Of BusinessRisk Management And Insurance -
Jacksonville UniversityOrganizational Leadership
Frequently Asked Questions about Michael Nemeth
What company does Michael Nemeth work for?
Michael Nemeth works for Blue Cross Nc
What is Michael Nemeth's role at the current company?
Michael Nemeth's current role is Strategic Business Executive.
What is Michael Nemeth's email address?
Michael Nemeth's email address is mn****@****oup.com
What is Michael Nemeth's direct phone number?
Michael Nemeth's direct phone number is +190450*****
What schools did Michael Nemeth attend?
Michael Nemeth attended Florida State University - College Of Business, Jacksonville University.
What skills is Michael Nemeth known for?
Michael Nemeth has skills like Medicare, Health Insurance, Leadership, Managed Care, Insurance, Hipaa, Process Improvement, Healthcare Industry, Strategic Planning, Business Analysis, Vendor Management, Business Development.
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