Professional Summary
Though this site is primarily used a social networking tool, I felt it necessary to include a professional component since I’ve included this domain on my curriculum vitae. As such, below, please find a history of my professional experience:
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Career summary:
As I neared the completion of my first year at the State University of New York at Stony Brook, and as I needed to find summer employment, my father managed to help me with securing a paid summer internship at Health Insurance Plan of Greater New York (HIP). That first summer turned into three consecutive summers working for HIP. My functional responsibilities were somewhat clerical as I initially worked in a Research and Statistics area helping with an automated system for capturing patient/provider encounter information, followed by working for the Claims Department to identify systemic problems with category-specific clinical areas.
As I neared the completion of my final year at Stony Brook armed with plans to graduate with a Humanities degree which, to the best as can I recall, was akin to a Liberal Arts degree, I realized that I needed to set up the next chapter of my life. I eventually became close with one of the university professors who helped guide me in completing an undergraduate thesis which focused on the birth of compulsory health insurance in the 1880s in Germany by Otto Von Bismarck. It should be noted that my original plan was to designate music as my major, but thanks to the advice of my brother and sister, I realized that financial stability and professional success would be incredibly difficult as a classical pianist, let alone the talent that I perhaps lacked. I instead focused on music as a minor but since it also required a fair amount of performance prerequisites, I didn’t complete that particular minor; I did, however, minor in English and American History.
Even before graduation and including the weeks afterwards, I applied a full court press to finding a job. I tried everything I could as I was not willing to settle for an entry-level position based on the experience and knowledge I believed I possessed. One idea that my father and I had was to read trade journals and write to those executives who were mentioned or highlighted. Indeed, I wound up writing to a gentleman at Sanus Health Plan’s corporate parent who was promoted to a Senior Vice President position. I congratulated him on the promotion and asked him to consider sharing my resume among his colleagues. He did so and I eventually both secured an interview and landed the job. It was a good first job; I was selected to be the Supervisor of Enrollment which entailed overseeing a staff of ten.
I had no managerial experience, but I am a natural extrovert and though I had to fight through some initial backlash (I am white and the entire staff was mixed between black and hispanic), I won them over and we wound up performing incredibly well. We were regularly recognized locally and by the corporate parent for our accomplishments in accuracy and efficiency. It should be noted that I wrote a thank you note to the corporate guy who helped me get the job, but he had just left to start up a new company. His name is Paul Dickstein and he helped found HealthFirst, one of the largest health insurance companies in NYC. Paul has since passed away after a long illness.
Less than a month after working at Sanus, I managed to get my college roommate, Brian Marmor, an interview for a customer service representative position. He was instantly hired and in very short order became the supervisor of the department. He’s since gone on to become Chief Operating Officer of a very successful ambulatory surgical center in Brooklyn as well as set up several other management interests.
After only 18 months at Sanus, Brian and I were recruited by our boss to a start-up Medicaid health insurance company called the New York Health Plan. The three of us left almost simultaneously and began a difficult chapter working for an unestablished, unprofessional, and unpredictable company led by an equally unstable chief executive. While we enjoyed overcoming the initial challenges that are inherent to a start-up environment, the company eventually folded thanks to marketing abuses throughout the industry with respect to attracting Medicaid enrollees and reimbursement practices relating to primary care physicians. The principals worked hard to salvage their business interests with attempts to create a national commercial health insurance company as well as other pet projects but in the end, all were doomed to failure. My responsibilities were many and included Human Resources. As such, I had the unfortunate task of letting people go each week until, ironically, my time was up.
Within three weeks, I landed a job at Royal Health Care, the MSO arm of a Medicaid health insurance company called Neighborhood Health Providers. The position was an unexpected one as I was in charge of all finance functions under the direction of the Chief Financial Officer. It was a tough job that often required late night and weekend hours, but I didn’t mind it since I lived a mere 13 blocks away. I eventually took on a self-motivated plan to switch our 401(k) plan to a new firm. That spirit was not singular: I also swapped phone system vendors and health insurance plans for employees. Eventually, the CFO was let go by the President which promptly led to my dismissal.
Within two weeks, I began working at a Management Services Organization (MSO) called MedFirst. Primarily, MedFirst managed two IPAs in Manhattan and Queens but, like most start-ups, they had aspirations of growing their business beyond mere physician management services. But again like most start-ups, funding was difficult and margins were slim. I was promoted to Director of Operations and I had full responsibility for every internal function within the company. But, again, I had to lay everyone off until indeed, my time came. I, in fact, was the last person to close and lock the office doors once the company closed for good.
One of the IPAs still needed management services, so I set up a mechanism where, along with a new funding and management source that was somewhat partnered with Columbia Presbyterian Hospital, I was retained as an independent consultant. The offices were 12 blocks from my apartment and the environment was excellent, but without job security and no defined path for career growth, I needed a new direction.
In yet another irony, I landed at HIP once again, this time as the Assistant Director of Contract Administration which essentially required management over the disbursement of funds to HIP’s risk groups and staff model practices. It was a complex function and was contained within a very difficult management atmosphere as the union/management relationship was clearly strident. That led to inefficiencies and time delays; ultimately, I was unhappy to not blaze a trail and to not have leadership to mentor me.
After answering an ad in the New York Times classified section, I secured an interview for the North Shore Health System. To my great surprise, I landed the job on that first interview. After having worked for so many companies in my short career and with all of them on the payor side, I set it in my mind that I’d make this position and opportunity work for me for at least five years. Indeed, under the senior leadership of Howard Gold and Brian Currie, we were a very strong and independent department with enormous successes negotiating managed care contracts on behalf of 10 tertiary and community hospitals, 17ish ancillary entities, and two staff physician practices. I was specifically tasked with managing some of our largest deals including Empire Blue Cross Blue Shield; the last re-negotiation I worked on was worth over $200m. The company has since rebranded to Northwell Health and now encompasses 17 or more hospitals in the downstate region as well as a variety of other health care properties.
During my time at North Shore, I moved from Astoria, Queens to northern NJ and wound up with significant commuting time and expenses. I had no choice but to remain in NJ for several more years, but the lifestyle was extremely difficult to maintain and eventually I came to the very difficult decision to resign. Ironically, I was set to be promoted on the day I resigned, but the choice was already made.
I accepted a position as the Director of Managed care for the Kessler Institute for Rehabilitation. Though owned and somewhat supported by Select Medical Corporation, they had virtually no managed care strategy or organization. With Kessler’s needs requiring a full-time approach to managing it’s payor relationships, I was brought on board. The successes were instantaneous; within six months, I had negotiated a dozen new commercial deals , unbundled hospital/physician financial arrangements, and refined a set of care categories into separate revenue generators. Within a year, I had demonstrated a 12% rate of commercial revenue growth. That northward trend continued throughout my years there.
After about 18 months, I was asked to take on a concurrent function as the Corporate Director of Managed Care for Select Medical’s interests in Pennsylvania, Delaware, and New Jersey. While it was initially suggested that this would only require about 20% of my time, it was more like 90% and it was suggested that this would be a role that the organization would see me in for the future. It would be, however, situated in central Pennsylvania, and an option that I was not fond of given my recent purchase of a condominium in Harlem.
In July of 2008, I separated from Kessler and Select Medical and took on consulting activities on behalf of a management consulting company representing ASCs and anesthesia practices in the local market. This was designed to be an interim assignment that allowed me the necessary time to focus on finding a new direction while still generating income. Over the summer of 2008, I was considered a final candidate for several senior management positions across providers and payors alike but ultimately chose to accept a position at Health Net.
As the Director of Hospital Contracting in NY, I had functional oversight, along with a co-Director, of hospital contracting for nearly 100 hospitals and related ancillary entities. A mere three days into my employment with Health Net, it was publicly announced that Health Net Corporate would be looking to divest its operations and businesses in the northeast US. Naturally, I was shocked, but I knew that the process to do so would be lengthy. Indeed, it was; my employment with them ended in March 2011. During that time, I took over the NJ market and managed the wind down of the provider network in both states.
With Health Net having offered considerable notice in advance of the final employment date, I had amble time to engage the job market. At some point in 2010, I had spoken to folks at MagnaCare about joining their company, but the position and timing weren’t right and we agreed to table the discussion for some date in the future. In April of 2011, I was ready to accept a role at a NJ payor and let my friends at MagnaCare know as a courtesy given continued discussions since 2010. It seems as if that ignited some fires and in rather short order, they came up with an offer. Having gotten to know the principals and the company reasonably well, I accepted happily.
As the Vice President of Network Management, my role was somewhat state-specific with oversight of the NY delivery system, but with various enterprise functions as well such as provider sales/recruitment, vendor relationships, and more. MagnaCare had been a held property by several private equity funds for about a decade, but in January 2014, a new investor group led by Goldman Sachs replaced the previous equity folks and with that came the development of a parent company and many other changes. Among them was my ascension to Senior Vice President overseeing the entirety of the provider network, one that encompassed 100,000+ provider locations and 240+ hospitals. I invested into support and resources and built my team to 25 people, developed system tools to organize functions and processes, worked in great detail on a reporting package with the actuarial team, and developed a corporate discipline to establish a exceptional level of integrity amongst internal and external partners. As a senior leader on the executive team, we implemented new types of clients in the Exchange and FIDA arenas and helped to generate massive EBITDA margins.
Regrettably, the closure of Health Republic Insurance Company of New York, a large and important customer to MagnaCare, and a number of other concerns led to staffing changes of executive leadership and a re-organization of other individuals. I separated from the company in December of 2015 and have since taken on a number of clients as an independent consultant.