Paul Moreno

Paul Moreno Email and Phone Number

VP Network Development and Contracting @ Centene Corporation
Florida, United States
Paul Moreno's Location
Greater Tampa Bay Area, United States, United States
Paul Moreno's Contact Details

Paul Moreno personal email

n/a

Paul Moreno phone numbers

About Paul Moreno

A healthcare executive with over 25 years of experience in the industry, Has worked extensively with organizations in a myriad of financial-related roles. Some of these include: Network Development, Provider Network Optimization, Revenue cycle operations, budget development, cost saving initiatives, contract negotiations, pricing and analysis, market positioning, financial impact modeling, and statistical sampling. Holds a full scope of experience in the areas of Healthcare Finance, Provider Network Development, Payment Methodologies and Reimbursement.Extensive experience in the Payor (Centene, Blue Cross Blue Shield, Centene, and others) Provider (University of MN Hospital & Clinics) and Consulting (3M HIS, Pegasus Healthcare) arena. During the 3M tenure, the opportunity presented to co-author the book “Transparent Pricing for Retail Healthcare” Additionally, he has created several modeling tools as well as Patented Processes for benchmark analysis. Prior to joining 3M, served as the Director of Pricing and Analysis for a large HMO/PPO/TPA in the upper Midwest, and responsible for creating, analyzing, and maintaining provider reimbursement methodologies for all payors types; Medicare, Medicaid, Commercial and Self Insured products.Specialties: Network Development, Revenue Cycle Operations, Budgeting, Forecasting, Financial Analysis, Payment Methodologies, Procedure Pricing, Mathematical Modeling, Trend Analysis, Contract Negotiations.

Paul Moreno's Current Company Details
Centene Corporation

Centene Corporation

View
VP Network Development and Contracting
Florida, United States
Website:
centene.com
Employees:
33823
Paul Moreno Work Experience Details
  • Centene Corporation
    Vp Network Development And Contracting
    Centene Corporation
    Florida, United States
  • Centene Corporation
    Vp Network Development & Contracting
    Centene Corporation Apr 2024 - Present
    Saint Louis, Mo, Us
  • Centene Corporation-Envolve
    Vp Network Strategy & Management
    Centene Corporation-Envolve Oct 2019 - Apr 2024
  • Blue Cross And Blue Shield Of Minnesota
    Director, Provider Finance
    Blue Cross And Blue Shield Of Minnesota Mar 2012 - Oct 2019
    Eagan, Mn, Us
  • Pegasus Healthcare Consulting
    Principal
    Pegasus Healthcare Consulting 2010 - Mar 2012
    Assisting healthcare organizations manage all aspects of Revenue Cycle Operations, financial budgets, pricing and analysis, market positioning, financial impact modeling, and statistical sampling. Specialized in all areas of healthcare reimbursement (inpatient, outpatient, ancillary, physician and professional services, as well as monitoring pricing of all payer and provider mixes). Advised healthcare organizations when creating, analyzing, and maintaining provider reimbursement methodologies and contract negotiations. Assisted facilities in quantifying the financial impact of alternative reimbursement methodologies such as 30-day re-admission guarantee, Patient Centered Medical Home projects, PHO's, ACO's and others.
  • 3M Health Information Systems
    Sr Consultant
    3M Health Information Systems 2005 - 2009
    St Paul, Mn, Us
    In charge of overseeing all aspects of 3M Consulting’s Comprehensive Pricing Solutions and related functions. Worked extensively with healthcare organizations on financial budgets, pricing and analysis, market positioning, financial impact modeling, and statistical sampling. Specialized in all areas of healthcare reimbursement (inpatient, outpatient, ancillary, and professional services, as well as monitoring pricing of all payer and provider mixes). Responsible for creating, analyzing, and maintaining provider reimbursement methodologies and contract negotiations. Created several modeling tools as well as Patented Processes for benchmark analysis. Provided financial training and education for all C-Level executives to augment their budgetary process as well as reimbursement optimization. Hospitals under direct supervision achieved an average of $2.7 million of annual net revenue increase.
  • Preferredone
    Director Of Pricing
    Preferredone 2002 - 2005
    Golden Valley, Mn, Us
    Accountable for the creation and maintenance of inpatient/outpatient provider reimbursement methodologies and rates of all PreferredOne products (HMO, PPO and Self Insured). Supported provider contracting efforts through data analysis and communication with providers. Investigated a myriad of reimbursement methodologies, evaluating for operational issues, as well as mathematical modeling for financial impact. Worked with provider contracting to assist in evaluating contracting possibilities. Developed new system software that facilitated day to day operations. Acted as financial advisor on key issues related to trend. Provided support, guidance and validation to Network Management areas.
  • Genesis Llc
    Owner- Managing Director
    Genesis Llc 1999 - 2005
  • Medica
    Sr. Trend Analyst
    Medica 1996 - 1999
    Minnetonka, Mn, Us
  • University Of Minnesota Medical Center, Fairview
    Sr. Patient Financial
    University Of Minnesota Medical Center, Fairview 1993 - 1996
    Minneapolis, Mn, Us

Paul Moreno Skills

Healthcare Process Improvement Leadership Strategic Planning Management Forecasting Financial Analysis Analysis Medicare Health Insurance Cross Functional Team Leadership Budgets Data Analysis Team Building Contract Negotiation Contract Management Pricing Sales Hipaa Hospitals Training Medicaid Analytics Healthcare Information Technology Managed Care Revenue Cycle Mathematical Modeling Marketing Insurance Trend Analysis

Paul Moreno Education Details

  • University Of Minnesota
    University Of Minnesota
  • University Of St. Thomas
    University Of St. Thomas

Frequently Asked Questions about Paul Moreno

What company does Paul Moreno work for?

Paul Moreno works for Centene Corporation

What is Paul Moreno's role at the current company?

Paul Moreno's current role is VP Network Development and Contracting.

What is Paul Moreno's email address?

Paul Moreno's email address is pa****@****smn.com

What is Paul Moreno's direct phone number?

Paul Moreno's direct phone number is (651) 662*****

What schools did Paul Moreno attend?

Paul Moreno attended University Of Minnesota, University Of St. Thomas.

What skills is Paul Moreno known for?

Paul Moreno has skills like Healthcare, Process Improvement, Leadership, Strategic Planning, Management, Forecasting, Financial Analysis, Analysis, Medicare, Health Insurance, Cross Functional Team Leadership, Budgets.

Who are Paul Moreno's colleagues?

Paul Moreno's colleagues are Cheree Pepper, Elizabeth Gilmore, Bethany Beamer, Judith F. Auguste, Shrm-Scp, Pmp, Chris Morley, Lisa Merseal, Mahi Gebre.

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