DONALD F. HENDRIAN JR

• Provided executive leadership for Skilled Nursing Facility (SNF) network strategy across multiple states and all UHC lines of business (Medicare Advantage, Medicaid, Commercial), aligning with enterprise affordability, quality, and access goals
• Directed SNF network development and optimization to meet CMS and state-specific network adequacy requirements, driving measurable improvements in clinical outcomes and member experience
• Led strategic contract negotiations with SNF providers, delivering network affordability through value-based reimbursement models, aligned incentives, and provider engagement
• Championed cross-market initiatives to scale network performance strategies in partnership with UHC Clinical, Network, Sales, and Regulatory teams, as well as Optum post-acute leadership
• Collaborated closely with national M&R, E&I and C&S leaders to ensure regional network performance, compliance, and provider relations aligned with enterprise-wide strategy
• Served as the market-facing executive in enterprise affordability forums, integrating local insights with national strategy to drive sustainable cost-of-care outcomes
• Mentored SNF network teams across multiple regions, fostering a results-driven, collaborative, and accountable leadership culture
• Supported UHC growth strategy through provider network readiness for new product expansion, market entries, and Stars performance optimization
• Leveraged analytics to assess network performance, identify gaps, and drive reimbursement innovation, including pay-for-performance and total cost-of-care models
• Strengthened UHC's position in the post-acute space by developing strategic provider partnerships that enhanced access, continuity of care, and clinical integration
• Translated enterprise goals into market-level operational plans with clear KPIs, delivering improved affordability, access, and service predictability
• Acted as executive liaison between SNF providers and UHC leadership, ensuring mutual alignment on priorities, expectations, and performance metrics
• Demonstrated deep understanding of managed care, value-based contracting, and the evolving post-acute care landscape across diverse geographies
• Advocated for enterprise alignment by driving connectivity between regional execution and corporate strategy, contributing to UHC’s broader market leadership

REIMBURSEMENT/ACCOUNTING

• Supported budgeting forecast and planning, actual vs. plan analysis and month-end close process.
• Focused on business improvement initiatives and led and directed projects.
• Worked with management to provide decision support analysis.
• Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
• Identified improvement changes regarding key processes for internal controls and accounting procedures.
• Validated existing accounting management and reporting systems to assess quality and conformance, identify problems and implement corrective actions.
• Prepared internal and regulatory financial reports, balance sheets and income statements.
• Established and checked coding procedures, monitored reports and updated internal files.
• Developed strategic plans for day-to-day financial operations.
• Guided and trained less experienced financial analysts.
• Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
• Improved overall financial reporting by streamlining control processes and reporting structures.
• Responsible for maintaining knowledge in all aspects of Medicare contracting and reimbursement.
• Cost Report – preparation / submission / audits / amendments Medicare, Medicaid, Blue Cross, Champus.
• Disproportionate Share / 340b.
• Connex Correspondence with NGS / MAC.
• S-10 audits.
• Wage Index preparation / submission.
• Assists in accumulation and development of reports in Excel / statistics that are used in preparation of third party cost analyses in Excel.
• Medicare Bad Debt.
• Collection of statistical and financial data needed for preparing annual / quarterly / monthly reports in Excel.
• Hindsight / Freeze / Contractual analysis in Excel.

REPORTING

• Provides reports and analysis for C-Suite and department managers.
• Through development of a keen understanding of hospital operations, performs variety of complex studies to analyze, evaluate and present findings regarding existing and proposed programs and services.
• Documents cost savings and revenue findings.
• Assists in obtaining, evaluating and presenting data necessary for critical decision making through analysis, service design or market research.
• Reviews and monitors Medicare regulations to keep abreast of trends in governmental reimbursement.
• Develops and maintains understanding of trends in non-governmental reimbursement to ensure financial viability of the hospital.
• Collaborates and coordinates with DMH's Chief Medical Officer and Chief Nursing Officer in all quality, safety and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) improvement activities with a focus on improving patient outcomes and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) results, while utilizing clinical (ICD-10, CPT, UB Codes, DRGs) performance improvement benchmarking software systems.
• Develop and implement clinical (ICD-10, CPT, UB Codes, DRGs) benchmarking systems to produce key performance metrics pertaining to and contributing to improving quality, safety and performance outcomes.
• Oversees and manages all market planning data bases to monitor and report hospital and ambulatory care market share and outmigration, including market share penetration in primary and secondary markets.
• Provide analyses, reports and recommendations to support future System's market growth initiatives.
• Develops productivity reporting systems for system-wide, including Decatur Memorial's Medical Group.
• Relies on experience and judgment to plan and accomplish goals and is capable of independence in the performance of a variety of complicated tasks.
• Consults with management to determine unique requirements for information retrieval from systems.
• Leads and mentors others in the hospital to assist in development of knowledge of hospital operations and department's contribution toward success of the hospital.
• Establishes and maintains a group of key individuals to help facilitate training and software testing.
• Trains end users on software functionality.
• Produces and manages Board and Executive organizational dashboard metric reporting.
• Leverage best practices and leading industry benchmarks across the System.
• Manages data collection, analyses, and reporting of all organizational performance dashboard metric reports, including Executive and Operational dashboards.
• Assists and supports “EPIC” Clinical Data Base Manager and Resource Manager in data gathering, analyses and reporting.
• Identifies trends and opportunities for improvement, based upon in-depth analyses.
• Works with various data base systems and “EPIC” system to gather and analyze data in order to develop key priority reports as requested.
• Provides daily, weekly and monthly organizational performance reports as requested.
• Provides AD-HOC reports for C-Suite and department managers.
• Provides assistance to hospital administration and departments to identify and implement new business opportunities.
• Assists in obtaining, evaluating, and presenting data needed for decision analysis, service design or market research.
• Evaluates major capital projects to determine their value in effective utilization of resources.
• Trains and provides support on use of system and interpretation of output data.
• Assists in preparation and/or presentation of special projects to the Board of Directors, senior management and other applicable parties.
• Recommends appropriate organizational actions and strategies to respond to projected economic trends and regulatory changes.
• Maintains positive internal and interpersonal communications at all times, and mentors direct reports.
• Keeps abreast of national, regional, state and industry trends and plans accordingly.
• Works collaboratively with management team members sharing data and report findings and recommendations.
• Develops and produces and productivity reports.
• Compute quarterly WRVU reports to determine if providers will achieve a bonus based upon computed productivity compensated salary.
• Chargemaster in building new charge codes and maintaining as codes delete/change/added.

PAYOR CONTRACTING/REVENUE CYCLE

• Provides Payor Contract analyses, modeling and forecasting done in Excel to support all contract negotiations.
• Makes recommendations for consideration in contract negotiations.
• Negotiates reimbursement and language of payor contracts.
• Effectively collaborates with team members and consultants while performing duties and assignments.
• Produces managed care analyses and reports in Excel that are well-understood at all levels of the organization.
• Uploads all Payor Contracts rates, terms and conditions into Payor Contract Management System.
• Analyzes and reconciles reimbursement in Excel to determine if and providers are being reimbursed in accordance with Payor contract terms and conditions.
• Identifies opportunities for improvement in revenue cycle.
• Effectively interacts with Payor representatives when performing managed care contracting analyses in Excel.
• Produces managed care performance reports, including denial management and stop-loss reports in Excel.
• Manages Payor Contract data bases and keep all data systems up to date.
• Oversee decision support system and Managed Care Contract documentation.
• Maintains managed care contract files and work papers in an organized manner.
• Develops and maintains reports that provide utilization and financial results in Excel for managed care contracts in force.
• Develop, implement and manage staff resources to provide timely manage care reimbursement modeling and forecasting in Excel to support Contracting negotiations.
• Responsible for development, coordination and analysis of managed care contracts.
• Works closely with Payor Contracting team to ensure timely notification of changes to payors and to ensure all contracts are appropriately identified, negotiated, implemented, audited and renegotiated in a timely manner.
• Manages planning process for contract renewals and negotiations including assessment of historical performance and issues as well as identification of payor specific issues.
• Collaborates with Business Office staff to ensure proper payment / reimbursement and pre-authorization and denial management processes are in place.
• Addresses operational issues and reviews contracts and terms in order to facilitate implementation.
• Responsible for identifying managed care opportunities in the marketplace.
• Establishes productive personal relationships with payor reps.
• Ensure timely notification of changes to payors and to ensure all contracts are appropriately identified, negotiated, implemented, audited and renegotiated in a timely manner.
• Manages planning process for contract renewals and negotiations including assessment of historical performance and issues as well as identification of payor specific issues.

COST ACCOUNTING

• Maintains and updates Cost accounting.
• Ensures that Cost accounting is updated so that only the most current information is used.
• Maintains cost accounting to accurately reflect the cost of doing business on both macro and micro basis.
• Prepares financial analysis in Excel for strategic and operational initiatives.
• Works effectively with Operations, Strategy, and Financial team members in development of business plans.
• Works collaboratively and effectively with members of administrative team and other clinical leaders, while performing business plan efforts.
• Possesses excellent analytical skills and high quality presentation skills.
• Transfers data into information.
• Assists in budget process – computing units, revenue ($1 billion), expenses for individual departments.

FINANCIAL ANALYTICS/DECISION SUPPORT

• Perform decision support system updates and refreshes, as well as provide technical, analytic, and reporting guidance and solutions to users working with decision support, “EPIC”, and other software.
• Lead analysis, evaluation and create documentation of user, business, and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) needs and requirements.
• Manage implementation of new or enhanced decision support software and reports.
• Research, evaluate and ensure that “EPIC” EMR is properly integrated with decision support products and data contained within are accurate.
• Research and evaluate decision support products and make recommendations for improvement based on user, business, and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) needs and goals.
• Establish and provide routine trainings on “EPIC” and decision support products.
• Recommends organizational best practices by providing documentation on well-documented principles, standards, and system architectural diagrams.
• Participates in architecture review of all critical decision support system designs and provides technical guidance in selection and implementation processes.
• Independently performs and documents feasibility analyses, up to and including the most complex and advanced, on current and potential future projects.
• Provides reporting, analytics, financial and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) modeling and forecasting in excel for support of user, business, and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) needs and goals.
• Provides response development and documentation connected to data / information collection efforts.
• Manage system functionality, data, user access, and documentation.
• Possess strong healthcare financial and “EPIC” clinical (ICD-10, CPT, UB Codes, DRGs) systems data processing, analytic and reporting experience.
• Consults with project, report, and analytics owners to determine data requirements and documents them for reference and future use.
• Provides routine and ad-hoc reports, analytics, and dashboard / scorecard updates as needed, as well as speak to and presents results.
• Develop and modify as necessary new and existing trainings and supporting documentation and materials.

INFORMATION TECHNOLOGY/SYSTEMS MAINTENANCE

• Maintains and updates system databases.
• Ensures that all data bases are updated so that only the most current information is used.
• Ensures data integrity between systems by keeping control tables up to date, monitoring daily summary reports and taking corrective action when systems do not balance.
• Manages production activities.
• Resolves crisis issues.
• Takes steps to ensure pure data is protected through backup and archive routines.
• Manages and coordinates installation, testing and use of software related to systems.
• Maintains expert knowledge of systems and interfaces.
• Diagnose, troubleshoot and document decision support systems issues and then work with vendors to resolve.
• Manages and coordinates installation, testing and use of all software modules (i.e., Horizon Performance Manager, Pathways Contract Management, CodeCorrect, VitalWare) used for analysis.
• Maintains expert knowledge of Horizon Performance Manager System's databases and its interface to “EPIC” clinical / STAR financial system.
• Manages policy and procedure development for Decision Support system users.
• Resolves crises issues in relation to production activities and system downs and/or data corruption.
• Takes steps to ensure pure data that is protected through backup and archive routines.
• Ensures data integrity between "EPIC", HBO STAR, Trendstar and Horizon Performance Manager systems by keeping control tables up to date, monitoring daily summary reports and taking corrective action when systems do not balance.
• Supports sound accounting methods and procedures plus develops and installs decision support systems to maximize administrative and managerial control.

• Preparation of corporate Federal income tax return and multiple State returns of a large manufacturing corporation (over 34 companies), perform consolidation of these companies into one parent company.
• Preparation of international accounting packages, perform account reconciliations and analysis, provide journal entries
• Collaborated with legal, finance and compliance departments to structure solutions to complex and multi-faceted challenges.
• Communicated with external customers and taxing jurisdictions to clarify tax notices and resolve other inquiries.
• Maintained database of federal and state tax laws and regulations to promote uniform policy and procedural compliance.
• Communicated complex tax issues and terminology with others by explaining in easily-understood terms.
• Researched tax issues and stayed current on all federal and state tax laws.
• Calculated estimated and tax liabilities and issued payment instructions to facilitate timely corporate tax payments.
• Analyzed tax issues and made recommendations for remediation to management.
• Prepared all federal and state income tax paperwork for extensions and returns.
• Prepared and reviewed federal and state tax returns to comply with corporate submission requirements.
• Completed IRS and State audits and investigations to check provided information.
• Recommended financial solutions in relation to tax implications.
• Produced briefs, located records and organized documentation to support court cases.

• In-charge on audit teams, performed all planning, budgeting, client discussions, fieldwork, reviewing, wrap-up.
• Audit reports (prepared and issued over 30 reports), financial statement preparation, management opportunity letters, staff evaluations, follow-up, researched GAAP accounting and regulatory accounting questions that arose during the course of the audit.
• Manufacturing, Small Business, Pension/Benefit Plans, Financial Institutions.
• Government Audits (State of Illinois for OAG (was in charge for the State Treasurer audit for 3 years, Department of Financial Institutions/Unclaimed Property, Bureau of the Budget, special assignment for Department of Rehabilitation Services).
• County, City, Universities audits.
• Identified control gaps in processes, procedures and systems through in-depth research and assessment and suggested methods for improvement.
• Preparation of tax returns (Federal and State).
• Corporations (C,S, & Ptp) - single entity, consolidated, allocation and apportionment.
• Manufacturing, Small Business, Financial Institutions, Partnerships, Individual, Pension Reporting (5500's)
• Accounting Services
• Fixed asset rollforwards, provided spreadsheet assistance, research, cash management.
• Training.
• Prepared working papers, reports and supporting documentation for audit findings.
• Interviewed business owners, explained audit scope and conducted exit interviews of audit findings.
• Determined financial and operational audit areas, providing most economical and efficient use of audit resources.
• Identified management control weaknesses and provided value added suggestions for remediation.
• Completed audit papers by thoroughly documenting audit tests and findings.
• Identified audit risks, prepared budgets and coordinated with management and audit team in preparing related reports.
• Upheld strict confidentiality protocols with client details and tax return information.
• Evaluated design and operating effectiveness of audit areas.
• Created final certification reports for businesses and mitigated annual audit risks.
• Enhanced audit controls by improving planning and testing processes.
• Maintained up-to-date knowledge of tax codes, legislation and tax programs.
• Used accounting software to issue tax returns and prepare consolidated reports.
• Facilitated financial and operational audits, working with internal and external managers to communicate recommendations or issues surrounding audits.
• Computed taxes owed by applying prescribed rates, laws and regulations.
• Provided journal entries and performed accounting on accrual basis.