JOSEPH H.

HARVEY
14703 Canopy Drive
Tampa, Florida 33626
678-463-3582
SUMMARY
Excellent background and track record of success in the area of managed care con
tract negotiations in commercial and Medicare markets as demonstrated by twenty
four years of experience in key positions including sixteen years with market le
aders including UnitedHealthcare of Georgia, Inc., Wellpoint Health Networks, In
c., and Anthem Health Systems, Inc.
Extensive, comprehensive and growth-oriented experience in high level negotiatio
ns and management of Network Management staff including coaching and developing
staff and effectively managing performance.
People-oriented individual with well-developed communication skills, natural lea
dership abilities and a dedication to meeting and exceeding goals.
EDUCATION
M.B.A., - Capital University, Columbus, Ohio
B.S., Administrative Sciences - The Ohio State University, Columbus, Ohio
H.I.A., Health Insurance Associate, Indianapolis, Indiana
PROFESSIONAL EXPERIENCE
MANAGED CARE ASSOCIATES, LLC 2009- Present
President 2009-Present
* Negotiate managed care contracts on behalf of payors and health care provider
s to maximize the financial impact of the arrangement under review and work to i
ncorporate language which will be beneficial for the party represented during co
ntract negotiations.
* Conduct managed care contract review and analysis to assure that the elements
contained in the document under review are acceptable to the client and that th
e client has access to the expertise necessary to understand the agreement and t
o make educated decisions on the key issues contained in the agreement under rev
iew.
* Conduct fee schedule and rate analysis to assure that each fee schedule and/o
r rates under review achieves the goals and targets for reimbursement that meet
the expectations of the payor or health care provider represented during the rev
iew.
WELLCARE HEALH PLANS, INC. 2006-2008
Director Network Development 2007-2008
* Responsible for creation of Network Development strategy and implementation o
f network expansion activities in a start up operation for the state of Texas fo
r a Medicare HMO for three regions including Houston, San Antonio and Dallas/For
t Worth market areas.
* Responsible for hiring, training and oversight of fifteen Network Development
and Provider Relations positions in three office locations including Houston, D
allas/Fort Worth and San Antonio and responsible for providing the leadership to
achieve market specific goals to meet network adequacy standards.
* Directly involved in complex hospital, Independent Practice Association (IPA)
and large physician group negotiations which were critical to the success of th
e state wide expansion efforts.
WELLCARE HEALH PLANS, INC. 2006-2008
Director, Enterprise Network Contracting and Risk Management 2006-2007
* Collaborated with the legal department to develop a suite of provider contrac
t standard templates which met acceptable standards to be used by Network Develo
pment and Provider Relations in health plans throughout the country to accomplis
h operational efficiencies, standardization and mitigation of financial risk.
* Developed an audit process to identify non standard terms in contracts and a
process to identify contracts that met established performance criteria and thos
e that were in need of remediation.
UNITEDHEALTHCARE OF GEORGIA, INC. 2002 - 2006
Director of Network Management 2002-2006
* Accountable for management of key contracting professionals and provider rela
tions positions whose performance ranked in the top five performing Health Plans
within a large national organization.
* Actively lead complex negotiations with key hospitals and hospital systems, P
hysician Hospital Organizations (PHO's), Independent Practice Associations (IPA'
s), and large medical groups.
* Managed a team of Network Development professionals, developed a successful g
rowth strategy and implemented an expansion plan to complete a service area expa
nsion which created a strategic advantage in new market areas throughout the Sta
te of Georgia.
HUMANA, INC. 2001 - 2002
Director, Provider Contracting 2001-2002
* Created and implemented a strategic plan to convert a tightly-managed, limite
d access Health Maintenance Organization (HMO) for commercial and Medicare lines
of business into a wide access HMO that provided excellent geographic availabil
ity of health care providers in a market demanding more choices for health care
services.
* Managed twelve Network Management and Provider Relations staff and recruited
talented professionals into key positions.
KEY PARTNERS, INC. 1998 - 2000
Director of Network Development 1998-2000
* Successfully created and implemented a strategic plan for a start-up operatio
n for the largest Third Party Administrator in the Southeast region of the Unite
d States.
* Negotiated contracts with seventeen hospitals and physician groups representi
ng over three thousand physicians during an eighteen month time period and succe
ssfully achieved market competitive rates for a start-up Network.
HERITAGE SOUTHWEST MEDICAL GROUP, P.A. 1997-1998
Director, Network Development 1997-1998
* Managed Network Operations, Network Development and Provider Relations for th
e second largest IPA in the Dallas/Fort Worth marketplace which included fourtee
n full time staff positions.
* Successfully led, motivated and managed network staff who negotiated market c
ompetitive rates for commercial and Medicare HMO business.
UNICARE LIFE AND HEALTH INSURANCE COMPANY
(An affiliate of WELLPOINT HEALTH NETWORKS, INC.) 1995-1997
Regional Vice President of Network Development 1996-1997
 * Received promotion and given the responsibility for establishing the Georgia
Region as a start-up operation which included hiring, training and directing a t
eam of twelve Network Management staff.
* Responsible for oversight of day-to-day operations of the HMO and PPO network
s and successfully managed performance to competitive price points in an expansi
on market.
UNICARE LIFE AND HEALTH INSURANCE COMPANY
(An affiliate of WELLPOINT HEALTH NETWORKS, INC.) 1995-1997
Regional Director of Network Development 1995-1996
* Responsible for establishing three Texas Regions as start-up operations which
included hiring, training and directing a team of eighteen Network Management s
taff.
* Established Policies and Procedures, processes, and created strategies to dev
elop successful HMO and PPO networks which were excellent by industry standards
in the North Texas market.
ANTHEM HEALTH SYSTEMS, INC. 1986-1995
Director of Network Development and Provider Relations 1993-1995
* Received promotion and given the responsibility to manage the network develop
ment and provider relations activities for the south-central region, which encom
passed a nine state area including Texas.
* Successfully expanded the operation from three offices to five offices which
included offices in Dallas, Houston, San Antonio, Austin and El Paso, Texas and
expanded the staff from fifteen positions to twenty five positions to accommodat
e a significant increase in existing business.
Coordinator of Network Development 1991-1993
Health Care Management Consultant 1986-1991