Robert Hager Email & Phone Number

Purcellville, Va, Us

Miami Gardens, Fl, Us

Miami Gardens, Fl, Us

OVERVIEW:I was slated to serve as the Chief Executive for the potential implementation and start-up of a Veterans Administration Community Care Network Health initiative in Region 4.

Long Beach, California, Us

OVERVIEW:As Plan President, I was hired to establish brand recognition and Network Adequacy for entrance into the Health Plan market in Virginia. I pursued RFP contracts for MLTSS, TANF, and Medicare Advantage populations, serving as the lead executive and the face of the program with the Medicaid agency in Richmond during the RFP process. Additionally, I represented Molina’s interests in Medicaid policy development and legislation.As Chief of Staff, I served as a key partner to the CEO on the Pathways by Molina divestment project (6,000 employees) involving the financial turnaround and divestment of a behavioral health organization with 9-figure annual revenues. In this position, I established KPIs for HR, IT, Finance, Revenue Cycle Management, and Compliance / Quality functions as the Corporate Services Executive Leader. I directed a team of 6 and managed 8-figure annual budgets of Shared Services allocations.HIGHLIGHTS:☑ Achieved Provider Network Adequacy for Medicare and Medicaid (6K contracted providers, 4K under LOL, and 19K+ practice locations state-wide). Captured contracts with 4 regional health systems and instituted a risk-based contracting model with multiple clinics in Richmond, VA for Medicare Advantage.☑ Paved the way for anticipated billion-dollar revenues through MLTSS and TANF populations by developing and directing the growth strategy of the potential health plan.☑ Improved hiring time of key clinical staff (600 hires in the first 6 months) from 40 to 22 days by implementing an applicant tracking system and a centralized recruitment process. ☑ Increased awareness of the Molina brand in Virginia with state agencies, local government agencies, members of the legislature, the provider community, eligible members, and community organizations.☑ Served as the primary liaison to the interim CEO throughout the entire divestment process.

Indianapolis, Indiana, Us

OVERVIEW:I was hired to direct the overall performance and growth of Anthem’s Dual Eligible product as the Lead Executive. Managing a base of 14K members, with full P&L responsibility for 9-figure annual revenues, I led a team of 5 direct reports and oversaw clinical and support teams of ~100 FTEs. I served as the primary point of contact representing the Duals program with stakeholders, including VHCA, VAHP, and VAHCH. In this position, I managed the highest market share of the 3 managed care organizations participating in the Commonwealth Coordinated Care (CCC) program. My accountability spanned all aspects of product success, including network adequacy, claims adjudication, cost of care, contract compliance, care coordination, quality assurance, marketing, and outreach efforts.HIGHLIGHTS:☑ Improved clean claims paid from <50% to 90% through partnering with a regulatory agency and provider associations to educate providers on managed care processes, including proper submission of clean claims.☑ Contributed to 6-figure emergency room cost savings in the first 6 months through collaborating with the Medical Director in creating a process for physician review of 100% of hospitalizations.☑ Achieved compliance goal of turnaround times for authorizations and services by combining siloed Medicare and Medicaid management teams into a single unit.☑ Facilitated an additional 8-figure revenue total through spearheading community and marketing efforts to increase membership from 12K to over 14K.☑ Reduced initial MLR from 106% to 96%.

Falls Church, Virginia, Us

OVERVIEW:I served as the Operational Lead for a 360-bed long term care facility, a for-profit Assisted Living operation with 530 beds, and a PACE Program, with mid 8-figure annual revenues. In this capacity, I led a team of 421 direct reports, with over 425 direct and indirect reports through a single management agreement of 5 AL facilities (800+ total team). HIGHLIGHTS:☑ INTOTAL HEALTH (MEDICAID MCO): Led successful transition and integration of a 57K-member Medicaid Health Plan. Facilitated transition of Amerigroup VA to InTotal Health. Achieved a successful DMAS readiness review and rebranding of the plan in 6 months. Negotiated SLAs and led work teams for the successful transition of services, regulatory filings, and IT platforms. ☑ PACE PROGRAM: Pioneered 2-year journey from feasibility/market analysis to final CMS and State Medicaid approval of the deployment of the Northern Virginia PACE Program. Fostered partnership with county representatives that reduced financial start-up risk and enabled the expansion of Adult Day Health services. Provided the leadership for all aspects of a multimillion-dollar start-up.☑ LONG TERM CARE: Achieved million-dollar increase in new revenues by improving average rehab productivity from 39% to 67%. Raised clinical outcomes by 100% through clinical improvements in multiple indicator areas. Produced 6-figure savings in annual pharmaceutical expenses and lowered annual payroll costs by a mid 6-figure total. Achieved Inova Health System Bronze Award (first time) in recognition of improved processes and the success of multiple initiatives. Negotiated employment and transfer of 421 team members for LTC divestment.☑ ASSISTED LIVING: Increased YOY EBITDA by 12%, resulting in 38+% profitability. Achieved 4 consecutive quarters w/ zero repeat deficiencies, elopements, or negative clinical outcomes. Restructured a management agreement to add an effective pay-for-performance metric for meeting clinical and financial benchmarks.

OVERVIEW:I negotiated and secured multiple health care contracts with for-profit and non-profit hospitals and long-term care providers throughout this 4-year period.PRIOR POSITIONS:☑ Nursing Home Administrator, Integrated Health Services – Led a full-scale turnaround for an abuse-ridden facility by implementing numerous quality and cost improvements.☑ Administrator, Wayne & Lincoln Continuous Care Centers, American Medical Facilities Management, Inc. – Managed a 60-bed nursing facility, maintaining a steady 96% occupancy rate.