ANTHONY J. MUNGIN
20603 Fair Castle Drive| Cypress, Texas 77433 | email@example.com | 832-630-6487
PRESIDENT, CEO, COO, HEALTHCARE ADMINISTRATOR
Regulatory Compliance / Quality Assurance / Account Management / Administrative Operations
Highly Accomplished Management Executive qualified by MBA degree and over twelve years intensive experience in health care, managed care, capitation and fee-for-service environments within both public and private sectors; achievements reflect fiscal accountability, organizational leadership, and commitment to quality
Proven expertise in providing visionary leadership, strategic insight, and competitive plans during challenging economic periods. Track record of increasing revenues, improving quality and productivity, executing business strategy, and directing turnarounds and transitions in tough markets.
Well-honed ability to connect benefits and value of recommendations to stakeholders’ needs. Combine strategic and tactical financial expertise with strong foundation of general management, quality and process improvement, transaction structuring and negotiations, and proactive staff relations to maintain environment of positive accountability.
GENERAL MANAGER, 1/2014-Present
The Dental Team, PLLC, Dallas, Texas
Manages newly acquired dental practice; manages dental practice and support staff of 2 dentists and 3 support staff which include, office supervisors, and Manages dental practice and support staff of 1 dentists and 3 support staff which includes and dental assistants business assistants, hygienists and dental assistants. Successfully executed growth strategies resulting in revenue gains in excess of $150,000. Maximized practice revenues to area demographics.
? Transitioned patient services to new owner with full retention of patient base.
? Responsible for staff recruitment, retention, and career development.
? Successfully negotiated with 20 new insurance companies to create profitable managed care contracts.
? Executed cost containment initiatives increase net revenue growth by 20%.
? Standardize office management systems, reviewed production schedules, and implemented business imperatives to successfully meet/exceed business goals.
PRESIDENT AND CEO, 10/2009-Present
Managed Care Concepts, L.L.C, Houston, Texas
Spearheads growth opportunities on a national level; provides leadership and strategic direction to achieve company’s goals and objectives; accountability extends to financial statements, profit flow/cash flow analysis, and management of lines of credit.
? Won bids with City of Houston, Texas Department of Assistive and Rehabilitative Services (DARS), and Quality Imaging, Inc generating over 100k in new revenues within first few months of startup.
? Grew profitability from breakeven in the first year’s operating margins to over 15 percent in the second year.
VICE PRESIDENT OF GOVERNMENT PROGRAMS, 8/2008 – 10/2009
North America Dental Plan, Inc., Houston, Texas
Highly sought-after executive brought in to run government-funded program operations for start-up Dental Health Maintenance Organization providing Medicaid and Medicare benefits.
? Oversaw business development, customer services, claims, credentialing, and quality improvement functions.
? Key player in the submission of HMO licensing application, supporting documents, and policies and procedures, earning the praise of legal counsel for ability to deliver highly streamlined policies and procedures, quality improvement standards and practices that were in alignment with TDI' s licensing requirements.
VICE PRESIDENT OF OPERATIONS, 9/2007 – 8/2008
Dental Economics, LLC, Sugar Land, Texas
Promoted into position from Associate VP of Operations; oversaw public sector operations for busy dental insurance company providing benefits to health plan enrollees on a national level. Accountable for 12 accounts, 275,000 lives, $30 million in revenues, and management of 5 direct and 15 indirect reports. Spearheaded the development and customization of QI Program initiatives to encompass all markets (Louisiana, Illinois, Indiana, Missouri, Ohio and Texas).
? Added wraparound leased networks to improve marketability to diverse clients in support of marketing efforts yielding a 10 percent improvement in savings via increased in network penetration rates.
? Led dental plan through numerous pre-delegated and annual assessments resulting in scores in the 98th percentile, zero corrective actions, and minimal recommended changes.
? Steadily drove and sustained annual sales revenues from $1.M to $5M with the acquisition of major account with Preferred Health Network’s Louisiana Plan (35,000 lives).
? Slashed annual network access expenses by $360k through negotiation of the first per claims access fee with one of nations leading PPO networks (Dentemax).
? Instrumental in negotiating multi-year contracts with major accounts that included Wellcare ($3M), Superior ($14M), and Texas Health Springs ($18M).
? Added business development, plan pricing, and contract negotiation responsibilities, September 2007.
ASSOCIATE VICE PRESIDENT, OPERATIONS, 11/2003 – 9/2007
Dental Economics, LLC, Sugar Land, Texas
Accountable for member and provider call centers, claims, encounters, provider services, appeals and grievances, prior authorizations, enrollment and marketing.
? Oversaw implementation of all new accounts to include development of joint interface plans and facilitation of client meetings joint interface meetings.
? Strategically managed the proposal effort that ultimately won a $13 million Comprehensive Healthcare Program (Foster Care) contract over a field of approximately 15 responding firms.
? Secured statewide URA license in record-breaking six-month period in TX, one of the most stringent regulatory environment in the country.
PRINCIPAL, 2/2003 – 11/2003
Manage Care Concepts, Houston, Texas
Established operational systems and procedures, and provided executive leadership for managed care consulting firm serving HMOs, PPOs, IPAs, independent school districts, and state/federal agencies. Specialized in provider contracting and compensation design, contract negotiation, policy and plan development, operational assessment and RFP responses.
DIRECTOR, PUBLIC SECTOR PROGRAMS, 2/2002 – 2/2003
HealthVelocity, Ltd., Houston, Texas
Oversaw public sector program operations, managing fulltime staff of seven FTE in customer service, claims, credentialing and provider relations. Directly managed six key HMO client accounts with annual revenues in excess of $4.5 million. Accountable for quality improvement for a 5-county area encompassing 60,000 Medicaid members. Held oversight responsibility for the claims department, including claims analysis and adjudication, benefit coordination, claims data entry, claims inquiry and research, record retention and encounter data submission.
? $1.5 million in dental provider claims processed annually with error-free rate of 93%.
? Within first 90 days onboard, conducted intense comparison analysis and directed recoupment plan that restored $25,000 in duplicate claims payments erroneously paid to dental practices.
? Increased audit scores from 80% to 98% in the areas of credentialing, UM/QM, and claims on three consecutive audits, enabling continued contract renewal, rate increases, and expansion to new markets.
TEXAS HEALTH AND HUMAN SERVICES COMMISSION, AUSTIN, TEXAS 11/2000-1/2002
Provider Consultant (Health and Human Services Commission, 9/2001- 1/2002)
? Primary contact for contract interpretation, problem resolution, and physician education.
Interim Manager, Member and Provider services (TDH Bureau of Managed Care, 11/2000 - 9/2001)
Extensively involved in expansion of State of Texas Access Reform (STAR) Medicaid managed care program (700,000 members); direct Reports: 6 FTEs. Oversaw performance of highly technical, management, and administrative duties with considerable latitude for use of initiative and independent judgment.
? Perform specialized readiness review evaluation assessing MCO readiness to fulfill multimillion-dollar contracts.
? Appointed to taskforce charged with designing and implementing training strategies for Medicaid Managed Care rollout; coalition included representatives from five (5) Texas Medicaid HMOs (over 3,000 Medicaid providers trained on STAR Program participation).
? A part of an elite taskforce charged with implementing Diabetes Pilot Project for approximately 4,500 "at risk" Medicaid recipients in Bexar SDA.
EDUCATION & TRAINING
Master of Business Administration, Webster University, St. Louis, MO, 2000
Bachelor of Science, Business Administration, Wayland Baptist University, Plain View, TX 1997