Advising Health Plan Clients
Rob is a health care executive with expertise managing the startup of managed-care organizations and the ability to develop and implement strategy in a rapidly changing health care environment. He is a skilled operations leader with a record of success managing the various areas of operations within a health plan including network development, provider relations, claims, call center, system configurations and provider information.
Rob has been part of the executive team leading the successful startup of two pediatric managed-care organizations. As Vice President of Operations with Children’s Medical Center Health Plan, he was instrumental in readying the plan to accept members, including developing a strategy and securing a Medicaid contract. He structured and negotiated contracts with vendors to provide vision and behavior health services, pharmacy benefit manager (PBM), and health risk assessment software. He also oversaw Network Development, Provider Relations, Systems Configuration, Credentialing, Network Administration, Claims, Marketing, Outreach, and Call Center operation.
Previously, as Director of Network Development for Cook Children’s Health Plan, Rob was part of the executive team managing the startup, led staff in the implementation of the CHIP and STAR programs, chaired the Delegation Oversight Committee, and served on Process Improvement, Medical Management, Quality, and Corporate Compliance Committees. He was also a founding member of the Texas Association of Community Health Plans (TAHP), a consortium of provider-owned or community-sponsored health plans that jointly contracted with vendors.
Rob also has served as Director, Managed Care Contracting, Network Development for Cook Children’s Health Care System, as one of five initial employees hired for the development of the Children’s Health Care System Managed Care Department. In that capacity, he helped develop a contracting strategy and managing relationships between national and regional managed-care organizations and Cook Children’s Health Care System. He also developed relationships and negotiated contracts for CCHCS’s Bone Marrow to become a Center of Excellence program.
Rob holds a Bachelor of Science in Business Administration and Management from Kansas State University.
Rob has served as a Board Member and President of the DFW Alliance for Healthcare Excellence and on the Navitus Client Advisory Board. He is also a recognized national speaker on managed-care contracting and provider-relationship development, presenting at key industry conferences, including the Medicaid Innovations Forum, World Congress, Institute for International Research, and Network Development Congress.
- Health plan implementations and operations
- Pediatric managed care
- Provider network management
- PBM contracting