Senior managed care executive and consultant. Significant background in network development, provider contracting and health plan operations. Experienced in working with C-Level Managers.

John Hays has more than 30 years of experience in health plan management, health plan consulting and network development. It includes senior management assignments in health maintenance organizations, health systems and consulting firms where he successfully started up plans in Ohio, West Virginia and Georgia and executed the turnaround and subsequent sale of a plan in the southeast U. S.

Most recently, John has completed several network development projects for Medicare Advantage plans, Medicaid plans critical care organizations and, most recently, a cooperative health plan formed to offer coverage on a state health insurance exchange His contracting work has helped plans meet CMS and ACA network compliance standards, maintain their existing territories and expand geographically. Services include provider network analysis, reimbursement strategy, contracting and Health Service Delivery table creation. John’s assignments have taken him to most areas of the U.S.

Work Terms

hourly, weekly, monthly, based on task or project completion, Hourly rate varies depending on complexity of work and can be discounted for longer term projects.