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Larry Griffin
Hospital Plan Administrator
Summary
Highly accomplished Hospital Plan Administrator with 10+ years of experience in managing comprehensive health insurance plans for over 10,000 members. Proven expertise in regulatory compliance, benefit utilization optimization, and healthcare provider collaboration. Led teams in developing and implementing cost-effective care management programs, resulting in a 15% reduction in hospital readmissions. Demonstrated success in negotiating contracts with healthcare providers to secure competitive rates and ensure access to quality healthcare services. Possess a deep understanding of healthcare revenue cycle management, patient financial assistance, and claims processing. Committed to leveraging data-driven insights to improve plan performance and drive value for members.
Education
Master of Health Administration
July 2019
Skills
- Healthcare Revenue Cycle Management
- Hospital Plan Development
- Medicare and Medicaid Reimbursement
- Risk Adjustment and Coding
- Patient Financial Assistance
- Claims Processing and Adjudication
Work Experience
Hospital Plan Administrator
- Developed and implemented a wellness program for plan members, promoting preventive care and chronic disease management.
- Managed plan finances, including premium collection, claims processing, and investment strategy.
- Conducted actuarial analysis to assess plan performance, identify cost drivers, and make datadriven recommendations.
- Coordinated with state and federal regulators to ensure compliance with health insurance laws and regulations.
Hospital Plan Administrator
- Managed a comprehensive health insurance plan for 10,000+ members, ensuring regulatory compliance and optimizing benefit utilization.
- Collaborated with healthcare providers to develop and implement costeffective care management programs, reducing hospital readmissions by 15%.
- Led a team of health benefits specialists in providing personalized support to plan members, improving customer satisfaction ratings by 20%.
- Negotiated contracts with hospitals, clinics, and pharmacies, securing competitive rates and ensuring access to quality healthcare services.
Accomplishments
- Developed and implemented a strategic plan that led to a 5% increase in patient satisfaction and a 3% reduction in operating expenses.
- Negotiated and secured a 5% increase in reimbursement rates from commercial payers, resulting in an additional $2 million in revenue.
- Led a team that successfully implemented a new electronic health records (EHR) system, reducing manual processes by 20% and improving patient care coordination.
- Developed and implemented a quality improvement program that reduced hospitalacquired infections by 10%.
- Trained and mentored a team of 10 hospital plan administrators, resulting in increased productivity and improved employee morale.
Awards
- Hospital Administrator Excellence Award
- Health Plan Leadership Award
- National Association of Health Plan Administrators (NAHPA) Award
Certificates
- Certified Professional in Healthcare Revenue Cycle Management (CPHRM)
- Certified Healthcare Revenue Cycle Analyst (CHRA)
- Certified Medical Reimbursement Specialist (CMRS)
- Certified Professional Medical Auditor (CPMA)
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How To Write Resume For Hospital Plan Administrator
- Highlight your experience in managing large-scale health insurance plans and ensuring regulatory compliance.
- Quantify your accomplishments with data-driven metrics whenever possible to demonstrate the impact of your work.
- Emphasize your collaborative approach to working with healthcare providers and plan members.
- Showcase your problem-solving and negotiation skills, especially in the context of healthcare cost management.
- Demonstrate your understanding of healthcare trends, emerging technologies, and industry best practices.
Essential Experience Highlights for a Strong Hospital Plan Administrator Resume
- Managed a comprehensive health insurance plan for 10,000+ members, ensuring regulatory compliance and optimizing benefit utilization.
- Collaborated with healthcare providers to develop and implement cost-effective care management programs, reducing hospital readmissions by 15%.
- Led a team of health benefits specialists in providing personalized support to plan members, improving customer satisfaction ratings by 20%.
- Negotiated contracts with hospitals, clinics, and pharmacies, securing competitive rates and ensuring access to quality healthcare services.
- Developed and implemented a wellness program for plan members, promoting preventive care and chronic disease management.
- Managed plan finances, including premium collection, claims processing, and investment strategy.
- Conducted actuarial analysis to assess plan performance, identify cost drivers, and make data-driven recommendations.
Frequently Asked Questions (FAQ’s) For Hospital Plan Administrator
What are the key responsibilities of a Hospital Plan Administrator?
Hospital Plan Administrators are responsible for managing the day-to-day operations of health insurance plans, including member enrollment, benefit design, claims processing, and provider network management.
What are the educational requirements for becoming a Hospital Plan Administrator?
Most Hospital Plan Administrators hold a bachelor’s or master’s degree in health administration, public health, business, or a related field.
What are the career advancement opportunities for Hospital Plan Administrators?
With experience, Hospital Plan Administrators can advance to roles such as Health Insurance Director, Vice President of Operations, or Chief Executive Officer.
What are the key skills and qualities of a successful Hospital Plan Administrator?
Successful Hospital Plan Administrators possess strong analytical, problem-solving, and communication skills. They also have a deep understanding of the healthcare industry and are committed to providing quality healthcare services to members.
What is the average salary for a Hospital Plan Administrator?
According to the U.S. Bureau of Labor Statistics, the median annual salary for Health Insurance Claims Examiners, which includes Hospital Plan Administrators, is around $61,000.
What is the job outlook for Hospital Plan Administrators?
The job outlook for Hospital Plan Administrators is expected to grow faster than average in the coming years due to the increasing demand for healthcare services and the aging population.