William C. Bell Sr. MHA

Experience

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  Central Texas Veterans Health Care System

  Jun 2014 - Aug 2014

  Administrative Intern

  • Developed recommendations for organizational change strategies that maximized patient outcomes for Home Telehealth. • Streamlined data entry by applying Lean Six Sigma concepts to eliminate inefficient practices• Improved clinical outcomes data collection by implementing the use of Microsoft Access • Helped introduce user-friendly updates of our current Home Telehealth equipment to our employees and patients.

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  Cigna

  Jun 2015 - Jun 2017

  Network Operations Senior Analyst

  • Was responsible for negotiating contracts and managing the relationships of ambulatory surgery centers, dialysis facilities, skilled nursing facilities, and home health agencies • Worked with senior leadership and medical directors to develop cost effective strategies for managing members in our managed care network• Identified cost saving opportunities by developing financial reports, utilization analysis, and claims trend detail by means of using QNXT• Improved managed care payment integrity by performing root cause analyses to identify provider billing issues• Ensured that contracted skilled nursing facilities were in compliance with Cigna-HealthSpring guidelines by conducting quarterly reviews to monitor metrics of interest • Improved member access to healthcare by means of stimulating adequate network expansion• Assisted senior leadership in the supervision of direct reports to maintain CMS compliance Show less

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  Optum

  Jun 2017 - Nov 2021

  • Responsible for contributing to $1 million of payment integrity software revenue by means of supervising the service account management of 19 accounts• Conduct periodic meetings to keep clients aware of Prospective Payment System (PPS) and Claims Editing System (CES) software issues and updates• Use data analysis to create quarterly business review (QBR) reports that track the performance of PPS and CES software issue management initiatives and report findings to the Client Directors• Escalate, manage, and monitor issue management and resolution of PPS and CES software defects and enhancement requests• Provide training and demonstrations on newly developed software applications to managers and colleagues• Collect data and create tools via SharePoint to capture the unique aspects of each book of business to increase client retention, and improve overall service account management experience• Create user-friendly SharePoint Site Pages to assist colleagues in accessing important service account management documents Show less • Responsible for managing the authorization education for 100+ therapy clinics in Texas• Performed Healthcare IT consulting duties by means of explaining the technical component of the Optum Physical Health authorization submission process to contracted providers• Worked with clinical staff and senior leadership to develop strategic managed care policy initiatives pertaining to network maintenance and state Medicaid compliance• Recruited providers to expand the provision of Medicare and Medicaid services nationwide• Worked as a liaison for both Optum Physical Health and UnitedHealthcare to improve payer/provider relationships by means of conducting technical root-cause analyses for provider billing disputes by means of using Salesforce• Managed the implementation of Texas Medicaid cost saving initiatives via SharePoint• Won 8 employee recognition awards for outstanding performance in provider relations and network management Show less

  • Senior Client Services Manager

    Feb 2019 - Nov 2021

  • Network Program Consultant-Public Sector

    Jun 2017 - Feb 2019
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  Cigna

  Nov 2021 - Feb 2023

  Performance Operations Advisor- Medicare

  • Responsible for managing local market affordability initiatives and researching cost savings initiatives for respective markets• Developed and maintained strategic plans that supported Medicare Advantage revenue and affordability initiatives for Ohio and Connecticut markets• Project Managed marketing initiatives to increase Cigna Medicare brand awareness in emerging markets. • Improved Network Management performance by discovering and fixing provider load issues with large-scale hospital systems• Worked with Medical Directors to develop strategies to reduce overutilization Show less

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  Kelsey-Seybold Clinic

  Mar 2023 - now

  Strategic Account Manager

  • Responsible for the penetration and retention of in-force commercial accounts. Client base includes, but not limited to school districts, municipalities, healthcare systems, and universities• Serves as the key liaison between the commercial client, broker, health insurance carrier and the KelseyCare Account Administration team• Responsible for tracking and monitoring service issue resolution, and education for the customer and their employees• Develops and maintains relationships with carrier partners, executive management, and key personnel at the health plans in support of Kelsey ACO Health Plan account acquisition, retention and renewals• Increased account membership by 29% by means of communicating Kelsey ACO Health Plan value story Show less