Patrick Apodaca Email & Phone Number

Austin, Texas, Us

Development, communication and execution of the company’s strategic vision and driving business initiatives and implementation efforts including:• Analyzing the market for changes, trends, competitive intelligence & production opportunities• Identifying potential ventures, targets and strategic partnership opportunities• Establishing applicable metrics and performance measures to evaluate progress• Identifying strategic risks and mitigation strategies• Identification & execution of growth opportunities including new markets, products or services• Supporting merger and acquisition (M&A) activity• Optimization of cross-functional business processes and business model innovation• Driving enterprise and user-level tech-enablement activities• Continuous improvement & advancement of payor contracting capabilities

Chicago, Il, Us

Leading the development of Government Network Solutions and Provider Partnerships, a newly formed unit of Enterprise Network Solutions, aimed at expanding HCSC's Government Programs' Value-Based and Alternative Payment Models, building and optimizing provider networks and strategies, and advancing plan performance for managed Medicaid and Medicare Advantage lines of business for all 5 state plans.

Chicago, Il, Us

Lead a team of 25+ associates responsible for the development of public and custom provider networks throughout the state of Texas for Medicare Advantage, Medicaid/CHIP, and VA/Tricare programs; including recruitment, contract negotiations, credentialing, provider accessibility and adequacy analysis, network development planning and budgeting, provider education and coordination of value-based improvement initiatives.

Franklin, Tn, Us

Coordinator of national healthcare reform initiatives for CHS' Managed Care Department, including development and support of organizational strategies related to: new Federal/State healthcare reform rules/legislation, health system provider contracting for state insurance Marketplaces, market-level expansion of Clinically Integrated Networks and related health system opportunities, and value-based provider contracting efforts associated with CHS' hospitals and affiliated providers in 30 states.

Franklin, Tn, Us

Director for managed care contract negotiations, modeling, execution of agreements, reimbursement enhancement programs, strategic provider network assessments, development of annual projected managed care revenue targets, and implementation of business development and managed care strategies for 18 acute care hospitals with an annual $2 billion in revenues and 6% growth rate.Leader for evaluation & implementation of hospital participation in government health plans: Medicare Advantage, Tricare, Workers Compensation, Managed Medicaid (STAR/Plus, CHIP) and various federal, state and municipal healthcare programs.State-wide system coordination of managed care contracting for CHS affiliated facilities, clinics, PHOs and employed physicians.

Louisville, Kentucky, Us

Led expansion initiatives for target MSAs in the Central U.S. including new UT & AZ commercial & MN Medicare market offices.Directed the assessment of underperforming regional market locations and coordination of growth & improvement strategies. Consultative meetings with prospective broker clients and leaders of partner hospitals in target expansion markets.Creation, cross-functional coordination and implementation of multi-year expansion & business development plans. Project manager for development of Sales and Marketing Strategic Plans and sales goals for target markets.

Leader of market development and economic consulting support to surgeon & hospital clients, and health plans/payers.Advisor to distributor sales force including strategic reimbursement expertise, tool development, training & education.Consultant for State Government Affairs local initiatives primarily related to Medicare & Workers Compensation markets.Representative/speaker at national, regional and local industry and medical society conferences and meetings.(Medical technologies: arthroplasty/artificial disc, arthrodesis, minimally invasive spine surgery, and osteobiologics)

Minneapolis, Mn, Us

Consultant to physicians, surgery centers, hospitals & rehab facilities in the development of product and market strategies.Development of coverage & reimbursement policies with government & private payers re: implantable neurological technology.Advisor to lobbying initiatives for continuity of therapy access for Workers Comp clients – coverage & reimbursement policy.(Medical technologies: neurostimulation including deep brain, spinal cord and peripheral nerve via implantable pulse generator; intrathecal drug delivery primarily Morphine & Lioresal via implantable infusion pump)

Louisville, Kentucky, Us

Promotional transfer to Sales Dept from Provider Network Dept (previously Director of Provider Contracting):Project Manager for launch of Emphesys, Humana's digital on-line PPO health plan, in Austin, TX.Development of Sales and Marketing strategic plan and sales goals for SmartSuite and SmartSelect products in Central TX.Coordination of Sales team in selling, broker & client education, and installation of consumer directed products.Sales presentation of SmartSuite andSmartSelect products to brokers, agents, consultants, providers and prospective clients.Product, installation and administration training to all internal Depts - Sales, Provider Network, Medical Management, Executive Administration.

Louisville, Kentucky, Us

Director of Provider Contracting (Nov 99 - Jul 02)Hospital Contractor (July 98 - Nov 99)Oversight and management of provider contracting in Central TX.Management and administration of risk group contracts.Financial analyses including utilization, funding, risk-reconciliation and reimbursement arrangements for large provider groups.Contracting for all North TX hospitals and outpatient surgery centers.Contracting multiple provider organizations including delegated, full risk and risk-sharing contracts.Facilitator for medical group operations meetings, contract/performance reviews, quarterly and annual financial settlement presentations.Performance and financial analyses identifying network savings and cost-containment strategies based on claims payment data and medical metrics.

Us

Coordinator for full-risk & delegated contracting with Columbia Provider Services 5.01(a) - 10 IPAs with 600+ physicians.Statistical & financial analyses identifying network savings and cost-containment strategies based on claim payment data.Internal expert trainer of risk-contracting for Provider Relations, Medical Management, Marketing & Sales Departments.Recruitment, negotiations and contracting of specialty and hospital-based provider groups in the Dallas-Fort Worth area.Managed the maintenance and process improvement of Primary Care Physician Capitation System for North Texas Market.

Dallas, Tx, Us

Sales & marketing of business communication services & technology-based products to commercial corporate customers.Contract proposals & negotiations with new and existing clients and maintenance of FCC regulatory compliance.Business consulting services identifying and developing potential strategic, process, data and technological needs.Public relations representative for AT&T at trade shows, industry expositions & Chamber of Commerce events.

Office administrator of all business & customer accounts (insurance, billing, payment plans, collections, A/R, A/P, taxes).Development and negotiation of contract proposals and agreements for psychological assessment & consulting services.Human Resources (recruitment, training, supervision, performance appraisals, employment contracts, payroll, benefits).