Robert E. Lehman Email & Phone Number

United States

Owner / operator of this small business healthcare management consultancy. Primary focus is on assisting health care organizations and/or device and drug manufacturers with gaining market access into the Department of Defense's (DoD) TRICARE® program as a provider.TRICARE is a registered trademark of the Department of Defense (DoD), DHA. All rights.

Franklin, TN, US

Leading a team compromised of 10 application systems analysts and/or specialists, I serve as the corporate Infrastructure and Technology department's Business Application Support team manager focused on integrated service support across the corporate enterprise's IT operations environments.Work closely with corporate and regional clinical service line and.

I was let go of my last job of 15 years with Health Net Federal Services as a wholly-owned subsidiary of Centene Corporation solely for my failure to meet Centene’s new general condition of employment that all employees be vaccinated against COVID 19. I was terminated despite my having earned yearly strong performance appraisals and a really good.

Rancho Cordova, CA, US

• Manage URAC & ISO accredited UM program for US Department of Defense/Military Health System (MHS)/Defense Health Agency’s (DHA) TRICARE managed care support contract, serving over 3-million-member beneficiaries.
• Serve as a primary POC and UM program SME to integrate UM program with business partner owners in provider network management, customer service, field-ops and MTFs, J-10 Clin-Ops/TRICARE Health Plan West, appeals and.
• Develop and monitor guidelines for working with military treatment facilities, providers, patients, and families to determine appropriate and cost-effective care plans.
• Support medical policy unit on MMS adjudication logic and benefit rules to achieve a systematic handling of benefit review on prior authorization requests and determination outcomes.
• Oversee UM review outcomes for a team of 50 clinical review staff, comprising of 5 supervisors led RN review teams.
• Lead various projects related to contract change management, process improvement, and quality assurance.

US

• Increased average residents' quality of life scores across CCRC as well as SNF’s CMS quality measures outcomes working in partnership with Medical Director, Nursing Department.
• Improved staff awareness of workplace personal safety practices as well as resident use of community's primary care clinic.
• Increased incident reporting compliance for all types through initiation of revamped incident reporting process.
• Integrated quality/risk surveillance plan & incident reporting system for entire community working with department leaders.
• Recruited to administer development and implementation of new comprehensive and integrated risk management program for a Continuing Care Retirement Community (CCRC).
• Worked with Director of HR and worker’s compensation insurance carrier on employee return to work case management.

Dallas, Texas, US

• Oversaw daily performance of all home care related services of the Medicare certified home health agency and collaborated with area's senior administrator on growth and development of business in the markets covered.
• Supported various agency performance and planning initiatives with marketing team, administrator, training team, head case manager, and CNA supervisor.
• Understood and anticipated the direction of the business area by identifying opportunities and making recommendations to support and achieve the desired future state.

• Decreased costs and improved classification process for jail client without concomitant rise in TB cases by lowering misutilization of PPD testing on jail admission through improved medical records retrieval and.
• Decreased inmate grievances related to sick call and med-pass through healthcare service performance management.
• Lowered off-site healthcare costs and pharmacy spend through improved inmate patient access to onsite sick-call and chronic care using improved nurse triage assessment and chronic care treatment protocols.
• Got the organization NCCH Accreditation.

Independent executive consultant working to provide comprehensive startup clinical and business operations for new Life-Bridge Pain Institute which was a joint venture between M.D. Pain Clinics, Northwest Hospital of Baltimore, and Life-Bridge Health.

Worked as supervisor of clinical services and case management for this locally owned Medicare & Medicaid certified home health care agency.

US

Staff RN for 16 bed medical ICU for 650 bed teaching hospital.

US

Maintain par-level consumable and reusable supplies for various clinical units within 650 bed teaching hospital. Clean and sterilized and wrapped custom surgical instrument trays for surgical services department.Delivered and set-up prepackaged vendor provided custom surgical packs in O.R. prior to scheduled procedures.Served as weekend night shift's.

Master Of Science - Ms, Community & Environmental Health / Healthcare Management

B.S., Nursing

Associate Of Science (As), Registered Nursing/Registered Nurse