Samuel Willis Email & Phone Number

I plan, coordinate and update administrative rules that incorporate provider billing and reimbursement policies for Florida'sworkers' compensation health care providers. This requires researching appropriate statutes, rules and other relevant authoritative sources for developing policy and supporting reimbursement methodology. When appropriate, I consult with other states regarding their workers' compensation reimbursement methodologies and policies. I write reports as required by the Director’s office or by my program administrator. These work products have included the large portions of the 2009, 2011, and 2013 Three-Member Panel biennial report to the legislature. In addition, I make recommendations to improve the effectiveness of the workers' compensation medical services programs and conduct research on topics to include electronic medical billing and payment for repackaged medications. Recently, I have taken on certification of health care providers and assisting in the assignment of temporary expert medical advisors.

In this capacity, I supervised the activities of the Office of Medical Services. I drafted the Division's Medical Reimbursement Dispute Resolution Rule; reviewed reimbursement dispute determinations for quality control purposes; developed and delivered presentations on behalf of the Division of Workers' Compensation; prepared performance appraisals for designated staff within the Office of Medical Services; conducted employment interviews; coordinated training and performance related issues with HR; and, chaired staff meetings for the Office of Medical Services. In addition, I reviewed provider certification and expert medical advisor (EMA) certification materials and developed policies. I researched and clarified policy issues as assigned by the Director's office. I also meet with outside vendors as requested or as instructed by the Director's office to gather information to share with identified personnel.

I lead and directed the daily operations of the Agency for Health Care Administration’s Workers' Compensation Unit. I supervised 14 professionals in the Workers' Compensation Medical Services and Managed Care Unit. I planned, organized and coordinated the major operations of the unit which included: resolving medical reimbursement disputes, certifying health care providers and expert medical advisors, in addition to authorizing workers compensation managed care arrangements. I provided recommendations to the bureau chief for determining the allocation of the unit’s resources to include its operating budget of more than 2 million dollars. I drafted and reviewed administrative rules related to the programs within the unit. I prepared personnel performance appraisals and ensured that staff had the resources and training necessary to perform their respective jobs. I wrote and/or reviewed policies and procedures for the program and ensured that the agency's personnel policies were understood and followed by staff. I worked with the agency's office of general counsel on legal matters involving the programs within the unit. I provided deposition testimony on program related matters and I interpreted and applied statute and rules related to the workers' compensation program. In addition I approved purchases in MyFloridaMarketPlace.com and in FLAIR. I also received, reviewed and approved the unit's expense report. In addition, I established performance standards for answering incoming calls on the unit’s primary phone lines (six lines). I also, meet with external vendors and association representatives seeking to better understand the program and opportunities to participate in it.

I was the company's regulatory compliance officer. I directed the company's regulatory compliance initiatives and oversaw its state reporting activities and licensure obligations. I stayed abreast of state and federal legislative initiatives that might impact the Health Maintenance Organization's programs and policies. I cultivated professional relationships with internal and external personnel, researched group service agreements for coverage limitations, and worked with the companies risk manager to identify, log, and report issues related to patient safety. In addition, I initiated dialogue with regulators to ensure that the plan’s compliance efforts were in accordance with existing statute or rules. I meet with senior managers for internal policy clarification and long range strategy meetings. I attended compliance seminars and meetings as appropriate. I was the plan's representative at a number of ancillary health initiatives such as Healthy Start and Healthy Kids. I was responsible for compliance with Medicaid reporting obligations for the health plan. I served on the plan's grievance and provider review committees and helped make recommendations regarding subscriber and provider disputes. I also supervised the plan's Grievance Coordinator and Risk Manager.

Doctor Of Law (J.D.), Law

Bachelor Of Science (B.S.), Health/Health Care Administration/Management