Michael Radu Email & Phone Number

Baltimore, Md, Us

Baltimore, Md, Us

Tampa, Florida, Us

Responsible for the P&L performance and strategy of nation's largest standalone PDP of 4.4 million members. Also, manage overall pharmacy trend and operations for over $20 billion in Medicare and Medicaid pharmacy spend including all key areas such as: operations, clinical, formulary, along with the Company's standalone PBM and specialty pharmacy businessesOverall functional lead for national Medicare and Medicaid quality and risk adjustment programs including Stars, RAPs and Medicaid HEDIS. Responsible for growing Medicaid revenue through business development and Medicaid RFPs securing new contracts and rebid of existing contracts.

Tampa, Florida, Us

Responsible for the Company's centralized inpatient and outpatient UM functions, telephonic care management, and behavioral health for Medicare and Medicaid Led medicare PDP and national pharmacy functions to manage all Medicare and Medicaid pharmacy spend.Secure new and renew the Company's strategic contract with state's Medicaid agency.

Founded in 1996, Health Essentials is a physician-driven healthcare organization that is focused on caring for frail elderly, medically complex and high-risk patients. Its family of companies includes a medical group, three Medicare-certified and CHAP-accredited hospices, a pharmacy, and a DME company. Its integrated care model is designed to partner with health plans, hospitals and provider groups to provide coordinated care to improve communication, patient satisfaction, clinical outcomes and financial results to individuals in their homes and nursing facilities. It's family of companies include GeriNet Medical Associates, HospiceTouch, Comfort Rx, and RX Essentials.www.healthessentials.com

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Part of the management team that created and operated a physician care delivery division withinOptum, a wholly owned subsidiary of UnitedHealth Group, to establish and operate high performing networks, IPAs, ACOs as well as staff physician, medical group practices. The division served commercial, Medicare, Medicaid and private pay individuals funded primarily through bundle payment or capitation in 8 states and close to 20 markets.Responsibilities included P&L accountability for all markets. Led development of corporate IPA and medical group functions such as practice management operations, sales/marketing, network development, medical management, quality, claims, call center, new market development and oversight of matrix corporate functions.

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Part of the senior management team of Unitedhealthcare's Medicaid and Medicare Duals health plan division..Led Medicaid, CHIP and Medicare dual eligible health plans in 6 states serving 1 million members with supervision of employees representing utilization management, care management, provider relations, outreach, marketing, sales, quality, compliance, and operations. Directed a regional team of functional experts to drive integration between field and national initiatives including regional CFO, COO, CMO, CIO, HR, nursing, marketing, and Medicare product.

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Responsible for all state lobbying and policy issues for Unitedhealthcare’s Medicare division primarily focused on Medicare, Part D, Medicaid,long term care and health care technology including the interplay of federal programs on state policy. In addition, the position required working with business owners to achieve new market or product development (often through State and federal procurement) and enhance program revenue..

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A member of Evercare’s senior management team, an organization serving chronically ill individuals through Medicaid and Medicare. Responsibilities included developing new market opportunities for SSI and Medicaid long term care programs along with securing the Company’s participation.

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Operational and P&L responsibility for health plans serving chronically ill Medicare and Medicaid members in 5 states.

Mba, Finance

Bachelor Of Arts (B.A.), Psychology

Master Of Business Administration - Mba