Rob Bauer Email and Phone Number
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Career Profile:Collaborative leader linking people, processes and programs in the healthcare industry with 15 years of progressive responsibility and experience. Expertise in oversight of health plan operations from inception through deployment. Spearheaded organizational commitment to quality improvement for health plans through effective benefit design and patient engagement initiatives. Directed cross functional teams of departments and vendors toward organizational collaboration in meeting shared goals.Areas of Excellence:Commercial, Medicare and Medicaid OperationsProject ManagementStaff Supervision, Recruiting and HiringClaims OversightMerger and Acquisition ImplementationRequest for Proposal ManagementPharmacy Benefit ManagementContracting and NegotiationsOversight of External VendorsBudgeting and Analysis
Kaiser Permanente
View- Website:
- kaiserpermanente.org
- Employees:
- 120876
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Program Lead, National MedicaidKaiser Permanente Jun 2022 - PresentPortland, Oregon, United States
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Medicaid Business And Strategy Consultant, Nw MarketKaiser Permanente Jan 2021 - May 2022Portland, Oregon, United States
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Medicaid Program Manager, Nw MarketKaiser Permanente Oct 2016 - Jan 2021Portland, OregonFacilitate partnerships across multiple Kaiser Permanente Program Office and NW Region operational areas and care delivery settings to meet contractual requirements, submission deadlines, and foster alignment with One KP initiatives. Maintain relationships with Oregon Health Plan contractors and associated plan partners to meet Coordinated Care Organization (CCO) objectives in the communities we serve. Responsible for negotiating delegated agreements with CCO contractors and developing service level agreements with internal functional areas to ensure obligations are met.
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Medicare Compliane OfficerModa Health Feb 2016 - Sep 2016Portland, Oregon AreaDirect the Medicare Compliance Program, ensuring compliant operations for all business areas. Chairman of the Corporate Compliance Committee. Ongoing reporting to the Board of Directors. Manage the relationship with CMS Central and Regional Offices. Risk analysis and mitigation. Oversee the internal monitoring program and response to CMS audits. -
Director Of Quality AssuranceAtrio Health Plans Nov 2011 - Sep 2015Salem, Oregon AreaResponsible for the Quality Assurance, HEDIS, Claims Administration and Pharmacy Benefits divisions having oversight of multiple staff and contracted vendors. Through my budget management of these divisions and contract negotiations with outsourced partners the company realized Quality 'Stars' bonus revenue maximization, effective utilization management and efficient claims payment processes. I lead service area expansions that resulted in multiple Medicare plans entering new service areas in the State of Oregon. I have directed the conversion to a new case management system, managed multiple yearly Plan Benefit Package (PBP) submissions and had key responsibilities in the annual Bid development process.Other projects of focus include managing the development and implementation of the Claims Payment and Pharmacy Benefits Administration programs as well as Quality Improvement outcomes and Accreditation for new Commercial health plan products both on and off of the Public Exchange. I led the Risk Adjustment program to positive results in risk score improvements and revenue including expansion of the prospective model into a new service area. -
Health Plan Operations ManagerWvp Health Authority (Formerly Mid-Valley Ipa) Nov 2007 - Nov 2011Directed the operations and outsourced activities for WVP Health Authority's health plan products. Led the timely and successful submission of multiple Medicare Advantage annual plan Bids that met executive defined profit margins and member premium targets. Managed CMS and State of Oregon routine contract focused audits. Critical path merger implementation and integration with ATRIO Health Plans that resulted in onboarding 2 new Medicare Contacts with multiple Medicare Advantage plans. Other duties included: benefit design, new business development, aligning marketing strategies and navigating projects toward operational integration. -
Project ManagerMid-Valley Ipa Nov 2004 - Oct 2007Attained reward of 2 Medicare Advantage contracts that allowed initial launch into the Medicare market. Directed the request for proposal (RFP) application for State of Oregon PEBB line of business. Developed and managed the implementation of Mid-Valley IPA's many operational and quality improvement programs. Coordinated internal and external staff to meet deadlines in launching new business products and responded to governmental entity audits.
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Financial AnalystMid-Valley Ipa Nov 2001 - Oct 2004Database management, reporting, reconciliation and analysis responsibilities via multiple data sources to ensure operations stayed within budget and well managed industry benchmarks for multiple Medicare, Medicaid and Commercial health plans.
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Health Plan AnalystSamaritain Health Plans Jul 1999 - Oct 2001Corvallis, OregonDeveloped and analyzed scheduled and ad hoc reports to support management decision making and quality improvement activities.
Rob Bauer Skills
Rob Bauer Education Details
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Health Care Administration -
Business Administration
Frequently Asked Questions about Rob Bauer
What company does Rob Bauer work for?
Rob Bauer works for Kaiser Permanente
What is Rob Bauer's role at the current company?
Rob Bauer's current role is Medicaid Program Manager.
What is Rob Bauer's email address?
Rob Bauer's email address is ro****@****ohp.com
What is Rob Bauer's direct phone number?
Rob Bauer's direct phone number is +154167*****
What schools did Rob Bauer attend?
Rob Bauer attended Oregon State University, George Fox University.
What are some of Rob Bauer's interests?
Rob Bauer has interest in Marketing, Golf, Home Improvements, Project Managment.
What skills is Rob Bauer known for?
Rob Bauer has skills like Healthcare, Medicare, Analysis, Management, Healthcare Management, Process Improvement, Managed Care, Leadership, Project Management, Strategic Planning, Program Management, Operations Management.
Who are Rob Bauer's colleagues?
Rob Bauer's colleagues are Russ Frisk, Perla D, Nicole Bang Pt, Dpt, Mylinh Doan, Alexis Mcnitt, Diane Wallace, Harvinder Singh.
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