VP or Director or Manager
Content
DENYSE A. NEWBERY 1025 Narrows Point Dr Birmingham, Alabama 35242 205.991.9143 205.999.8520 e-mail: [email protected]
SUMMARY Healthcare professional with 25+ years experience. Recognized strengths in gene ral management/administration, training/team building, sales/marketing and custo mer service. A results-oriented change agent who learns quickly, develops close working relationships, and leads with good sense, good will, and good character . Expertise is broad in scope and includes the following skills: * * * * Strategic Planning * Payer and Provider Contracting Product Development * Physician and Hospital Relations Budget Planning * Community Relations Operations Management
PROFESSIONAL EXPERIENCE DENYSE NEWBERY CONSULTING, LLC, Birmingham, Alabama 20 06-Present Privately owned and operated consulting company developed to assist the health c are industry with strategic planning, marketing and operational issues. Team Lead Consulting project for the Department of Defense, TRICARE Military Health Plan, through United Military and Veterans Services to contract hospital, physician and ancillary providers in Alabama and Mississippi. Team Lead for Alabama and Mississippi with oversight of five consultants. Responsible for hospital contracting for Alabama and Missis sippi, numbering 100 facilities. Owner/President Consulting project for HealthSouth Corporation Responsible for the review of contractual language and reimbursement methodologi es for all payer contracts for the Diagnostic Division in order to input into IDX s ystem. Responsible for the inventory of all legal documents and the creation of a Mast er Legal Document in order to meet Compliance regulations. Compiled a hard copy f or each Surgery Center and created /updated automated system. Responsible for performing Compliance review for all Medical Director/Program D irector/Ancillary Contracts for all Rehabilitation hospitals. Performed Monthly Audits for Rehabi litation facilities to ascertain Compliance status.
OAKSTONE PUBLISHING, LLC .; Birmingham, Alabama 2005-2006 Publisher of Medical CME audio, video and written materials Group Product Director Responsible for new product development efforts including Board Review Programs , Challenger Audio Program and Distinguished Author Series with Johns Hopkins.
HEALTHSPRING OF ALABAMA, INC., Birmingham, Alabama 2002 - 2004 Privately owned managed care company with locations in four states. Vice-President/Commercial Marketing Responsible for product development and Sales/Account Service function. * Supervision of twelve staff members * Development of marketing projections/budget * Development of new products for employer groups and individuals * Responsible for Public Relations /Advertising/Print Collaterals * Conducted due diligence in the provider community to determine network expans ion DENYSE NEWBERY CONSULTING, LLC, Birmingham, Alabama 1999 - 2002 Privately owned and operated consulting company developed to assist the health c are industry with strategic planning, marketing, and operational issues. Owner/President Consulting projects for Tenet Healthcare Corporation, Eastern Health System, Hea lth Partners of Alabama, Health Strategies, Inc., Noland Health Services, Greyst one Internal Medicine, and Collateral Benefits. * Successfully completed the divestiture of Health Advantage Plans, Inc. for its owners. * Performed all customer service, provider relations, and claims research functi ons in the Health Advantage Plans, Inc. divestiture as well as all administratio n functions. * Developed a TPA business plan for Health Strategies, Inc. Completed a marketin g analysis for Health Partners of Alabama. * Completed provider/payer contracts for Noland Health Services. * Conducted operational assessment and implemented necessary changes for Greysto ne Internal Medicine to create a more efficient environment and reduce Accounts Receivables * Recruited specialists for a Vision Program for Collateral Benefits
TENET HEALTHCARE CORPORATION AND EASTERN HEALTH SYSTEM, Birmingham, Alabama 1993 - 1999 A for-profit Managed Care company owned by two provider systems. Annual revenue s exceeded $30 million.
Health Advantage Plans, Inc. Senior Vice-President of Operations Responsible for day-to-day operations including functional areas of Marketing, C laims, Information Systems, Office Support Staff, Member Services, Finance, Medi cal Management and Facilities. (sixty employees) * The Plan's membership increased from 5,000 to 20,000 in a two-year period. * Integrated the HMO, TPA, and Medicare business lines and staff from three sepa rate companies. * Supervised the Information System conversion to Amisys. * Coordinated the renovation of the office building including the telephone syst em, furnishings, equipment, and relocation of staff.
Group Administrators, Inc. Chief Operating Officer Responsible for the operational functions of Third Party Administrator. (Twentytwo employees) * Directed the Information System post-conversion for Amisys. * Restructured the staff and functions to achieve better performance. * Established relationships with reinsurance companies and brokers. * Developed claims processing procedures so "clean claims" were adjudicated with in 15 workdays. * Developed policy and procedure manual and implemented policies and procedures with staff. * Initiated extensive training program. * Stabilized client base. Brookwood Development, Inc. Director of Sales and Marketing Responsible for sales/marketing strategy, product design, and communication plan for a joint venture MSO among Medical Center East, Brookwood Medical Center, an d Lloyd Noland Hospital. * Negotiated third party payer contracts for institutions. * Secured fifty new accounts for the Occupational Health Program at Brookwood Me dical Center. * Developed products and pricing strategies in conjunction with Towers/Perrin fo r Managed Care Division
HEALTH PARTNERS OF ALABAMA, Birmingham, Alabama 1991 - 1993 A for-profit Managed Care company owned by the Baptist Health System. Annual re venues exceeded $50 million. Director of Marketing/Consultant Responsible as a Consultant and Director for strategic planning, product develop ment, advertising, sales, client services, and network development. * Supervised 20 staff positions. * Coordinated provider network expansion into Montgomery and Mobile. * Plan membership increased from 32,000 to 50,000 members over an eighteen-month period. * Initiated and implemented a name change campaign. Membership retention was 98% . * Coordinated the Medicare Advantage application process
UNIVERSITY HOSPITAL DEPARTMENT OF STRATEGIC PLANNING AND MARKETING DEVELOPMENT, Birmingham, Alabama 1990 - 1992 A 900 bed teaching hospital serving local, regional, national, and international markets. Consultant/Marketing Specialist Responsible for the development of an Occupational Medicine Program, contract ne gotiations, and various insurance related programs. * Developed Occupational Health business plan for UAB employees. * Negotiated direct contracts between UAB and employers, TPAs, and insurance pay ers. * Developed and operationalized the marketing of a Center of Excellence Program for transplant services.
DENYSE NEWBERY CONSULTING, INC., Birmingham, Alabama 1984 - 1990 A privately owned consulting company developed to assist physicians, insurance c ompanies, and hospitals. Annual revenues exceeded $350,000. Owner/President Consulting assignments included feasibility studies for HMO and PPO development, technical assistance in the marketing and management areas of health plans, tra ining programs for sales representatives, development of hospital/physician join t ventures negotiation and implementation of insurance products, review of feder al applications for HMO and CMS designation. Clients included: Partners National Health Plans Maxicare Aetna General Medical Associates CIGNA Anderson Memorial Hospital Department of HHS Blue Cross/Blue Shield of New Jersey Sun Health RIGHA
EDUCATION Nazareth College of Rochester, Rochester, New York Major: Speech Pathology and Audiology Graduate Studies Nazareth College of Rochester, Rochester, New York Major: Speech Pathology and Audiology B.S. Degree
COMMUNITY INVOLVEMENT Guest Lecturer University of Alabama Masters of Public Health Program, 1995 - 20 04
Guest Lecturer GHAA Annual Meetings, 1980 - 1984
SUMMARY Healthcare professional with 25+ years experience. Recognized strengths in gene ral management/administration, training/team building, sales/marketing and custo mer service. A results-oriented change agent who learns quickly, develops close working relationships, and leads with good sense, good will, and good character . Expertise is broad in scope and includes the following skills: * * * * Strategic Planning * Payer and Provider Contracting Product Development * Physician and Hospital Relations Budget Planning * Community Relations Operations Management
PROFESSIONAL EXPERIENCE DENYSE NEWBERY CONSULTING, LLC, Birmingham, Alabama 20 06-Present Privately owned and operated consulting company developed to assist the health c are industry with strategic planning, marketing and operational issues. Team Lead Consulting project for the Department of Defense, TRICARE Military Health Plan, through United Military and Veterans Services to contract hospital, physician and ancillary providers in Alabama and Mississippi. Team Lead for Alabama and Mississippi with oversight of five consultants. Responsible for hospital contracting for Alabama and Missis sippi, numbering 100 facilities. Owner/President Consulting project for HealthSouth Corporation Responsible for the review of contractual language and reimbursement methodologi es for all payer contracts for the Diagnostic Division in order to input into IDX s ystem. Responsible for the inventory of all legal documents and the creation of a Mast er Legal Document in order to meet Compliance regulations. Compiled a hard copy f or each Surgery Center and created /updated automated system. Responsible for performing Compliance review for all Medical Director/Program D irector/Ancillary Contracts for all Rehabilitation hospitals. Performed Monthly Audits for Rehabi litation facilities to ascertain Compliance status.
OAKSTONE PUBLISHING, LLC .; Birmingham, Alabama 2005-2006 Publisher of Medical CME audio, video and written materials Group Product Director Responsible for new product development efforts including Board Review Programs , Challenger Audio Program and Distinguished Author Series with Johns Hopkins.
HEALTHSPRING OF ALABAMA, INC., Birmingham, Alabama 2002 - 2004 Privately owned managed care company with locations in four states. Vice-President/Commercial Marketing Responsible for product development and Sales/Account Service function. * Supervision of twelve staff members * Development of marketing projections/budget * Development of new products for employer groups and individuals * Responsible for Public Relations /Advertising/Print Collaterals * Conducted due diligence in the provider community to determine network expans ion DENYSE NEWBERY CONSULTING, LLC, Birmingham, Alabama 1999 - 2002 Privately owned and operated consulting company developed to assist the health c are industry with strategic planning, marketing, and operational issues. Owner/President Consulting projects for Tenet Healthcare Corporation, Eastern Health System, Hea lth Partners of Alabama, Health Strategies, Inc., Noland Health Services, Greyst one Internal Medicine, and Collateral Benefits. * Successfully completed the divestiture of Health Advantage Plans, Inc. for its owners. * Performed all customer service, provider relations, and claims research functi ons in the Health Advantage Plans, Inc. divestiture as well as all administratio n functions. * Developed a TPA business plan for Health Strategies, Inc. Completed a marketin g analysis for Health Partners of Alabama. * Completed provider/payer contracts for Noland Health Services. * Conducted operational assessment and implemented necessary changes for Greysto ne Internal Medicine to create a more efficient environment and reduce Accounts Receivables * Recruited specialists for a Vision Program for Collateral Benefits
TENET HEALTHCARE CORPORATION AND EASTERN HEALTH SYSTEM, Birmingham, Alabama 1993 - 1999 A for-profit Managed Care company owned by two provider systems. Annual revenue s exceeded $30 million.
Health Advantage Plans, Inc. Senior Vice-President of Operations Responsible for day-to-day operations including functional areas of Marketing, C laims, Information Systems, Office Support Staff, Member Services, Finance, Medi cal Management and Facilities. (sixty employees) * The Plan's membership increased from 5,000 to 20,000 in a two-year period. * Integrated the HMO, TPA, and Medicare business lines and staff from three sepa rate companies. * Supervised the Information System conversion to Amisys. * Coordinated the renovation of the office building including the telephone syst em, furnishings, equipment, and relocation of staff.
Group Administrators, Inc. Chief Operating Officer Responsible for the operational functions of Third Party Administrator. (Twentytwo employees) * Directed the Information System post-conversion for Amisys. * Restructured the staff and functions to achieve better performance. * Established relationships with reinsurance companies and brokers. * Developed claims processing procedures so "clean claims" were adjudicated with in 15 workdays. * Developed policy and procedure manual and implemented policies and procedures with staff. * Initiated extensive training program. * Stabilized client base. Brookwood Development, Inc. Director of Sales and Marketing Responsible for sales/marketing strategy, product design, and communication plan for a joint venture MSO among Medical Center East, Brookwood Medical Center, an d Lloyd Noland Hospital. * Negotiated third party payer contracts for institutions. * Secured fifty new accounts for the Occupational Health Program at Brookwood Me dical Center. * Developed products and pricing strategies in conjunction with Towers/Perrin fo r Managed Care Division
HEALTH PARTNERS OF ALABAMA, Birmingham, Alabama 1991 - 1993 A for-profit Managed Care company owned by the Baptist Health System. Annual re venues exceeded $50 million. Director of Marketing/Consultant Responsible as a Consultant and Director for strategic planning, product develop ment, advertising, sales, client services, and network development. * Supervised 20 staff positions. * Coordinated provider network expansion into Montgomery and Mobile. * Plan membership increased from 32,000 to 50,000 members over an eighteen-month period. * Initiated and implemented a name change campaign. Membership retention was 98% . * Coordinated the Medicare Advantage application process
UNIVERSITY HOSPITAL DEPARTMENT OF STRATEGIC PLANNING AND MARKETING DEVELOPMENT, Birmingham, Alabama 1990 - 1992 A 900 bed teaching hospital serving local, regional, national, and international markets. Consultant/Marketing Specialist Responsible for the development of an Occupational Medicine Program, contract ne gotiations, and various insurance related programs. * Developed Occupational Health business plan for UAB employees. * Negotiated direct contracts between UAB and employers, TPAs, and insurance pay ers. * Developed and operationalized the marketing of a Center of Excellence Program for transplant services.
DENYSE NEWBERY CONSULTING, INC., Birmingham, Alabama 1984 - 1990 A privately owned consulting company developed to assist physicians, insurance c ompanies, and hospitals. Annual revenues exceeded $350,000. Owner/President Consulting assignments included feasibility studies for HMO and PPO development, technical assistance in the marketing and management areas of health plans, tra ining programs for sales representatives, development of hospital/physician join t ventures negotiation and implementation of insurance products, review of feder al applications for HMO and CMS designation. Clients included: Partners National Health Plans Maxicare Aetna General Medical Associates CIGNA Anderson Memorial Hospital Department of HHS Blue Cross/Blue Shield of New Jersey Sun Health RIGHA
EDUCATION Nazareth College of Rochester, Rochester, New York Major: Speech Pathology and Audiology Graduate Studies Nazareth College of Rochester, Rochester, New York Major: Speech Pathology and Audiology B.S. Degree
COMMUNITY INVOLVEMENT Guest Lecturer University of Alabama Masters of Public Health Program, 1995 - 20 04
Guest Lecturer GHAA Annual Meetings, 1980 - 1984
