Scott Johnson
Rochester Hills,MI
Summary
Innovative and strategic administrator and business developer with key areas of operations management in managed care and value-based contracts include $400,000,000 MSSP ACO, over $3,000,000 in MA risk agreements, 2000+ physicians and 500+ ancillary in PHO/PO contracts. Key areas of leadership include oversight of value-based contracting including MSSP ACO management, CIN strategies, physician organization/hospital partnerships, and population health management and alternative payment model development and has captured market growth opportunities with over $30 million in new revenue, and $20 million in savings opportunities.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Director, Provider Contracting
Blue Cross Blue Shield of Michigan
08.2022 - Current
- To expand at risk contracting for Medicare Advantage networks, lead provider negotiations and facilitating cross-functional development of contract implementation
- Asked by senior leadership to provide oversight for 10+ existing narrow networks into one consolidated portfolio and build a 3-year management plan
- Narrow networks are both local and national networks that are set quality/cost targets
- Assigned by senior leadership to take on project oversight for emerging care models for emergency and hospital services at home.
Director, Provider Network Management
Health Alliance Plan
10.2019 - 08.2022
- Provide strategic planning and direction of key operations related to network development for physician/hospital contracting, value-based contracts, and provider services within the southeast Michigan market, leading team efforts in identifying network opportunities for reducing cost of care, HEDIS and Medicare Star improvements, cost containment, and member satisfaction
- Portfolio oversight represents 500+ ancillary, physician organization and group contracts that make up $650,000,000 in commercial business $700,000,000 in Medicare Advantage business.
- Major daily activities include building effective and accountable relationships with HAP PO, PHO, hospital, and ancillary networks to drive performance for members, providers and HAP
Strategy Consultant
Independent Consulting
06.2019 - 10.2019
- Partnered with healthcare entities startups and physician organizations, to provide individualized population health management strategies and value-based contract and implementation support.
- Managed multiple projects concurrently, ensuring timely delivery and high-quality results.
Vice President of Operations
McLaren Health Care / McLaren Physician Partners
09.2017 - 05.2019
- Development and oversight for population health management initiatives for existing and new contracts on behalf of over 2000 providers and 9 hospitals with P&L responsibilities for both ACO and Population Health Services Organization of 52 FTEs
- Key areas of oversight include operations management for a $400,000,000 MSSP ACO and Value-Based Contracts over $250,000,000 BCBSM
- Responsible for building and maintaining relationships inside and outside of the organization for success in managed care.
Vice President, Operations and Market Solutions (Nov 2016 – Sep 2017)
Ascension Health Care
02.2013 - 09.2017
- Duties progressed from director to vice president over a 5-year period
- Accountable for design and execution of population health strategies, including IT and analytics and clinical workflow integration
- Responsible for regional physician performance improvement teams to connect physician leaders with field staff in review of physician engagement and estimated $30 million in pay for performance opportunities across payer market portfolio, and integration with practice transformation and other value-based initiatives involving 2000+ physicians and 5 hospitals.
- Developed new revenue streams by identifying growth opportunities and forging strategic partnerships with key industry players.
- Enhanced company profitability by implementing strategic business plans and optimizing operational processes.
Senior Health Care Analyst Supervisor (Oct 2011 - Jan 2013)
Blue Cross Blue Shield of Michigan
07.2009 - 01.2013
- Consultative work with physician organizations and assisted in the implementation of BCBSM quality initiatives and population health infrastructure in the flagship Patient Centered Medical Home (PCMH) program, auditing and consulting, as well as performance reviews in BCBSM initiatives
- Increased efficiency by streamlining data analysis processes and implementing automation tools.
- Developed comprehensive training materials for new analysts, improving onboarding efficiency.
Education
Executive Masters Business Administration - School of Business Administration
Oakland University
Rochester Hills, MI01.2022
Masters - Public Health
Michigan State University
East Lansing, MI01.2015
Bachelor of Arts - Economics
Michigan State University
East Lansing, MI01.2004
Skills
- Strategic Planning
- Verbal and written communication
- People Management
- Operations Management
- Project Management
- Business Planning
- Negotiation
- Contract and Vendor Management
- Business Development
- Contract Negotiation
- Employee Development
- Revenue Growth
Certification
- Fellow of the American College of Healthcare Executives (FACHE), 2022
- HFMA, Certified Healthcare Financial Professional (CHFP), 2023
- HFMA, Certified Specialist Managed Care (CSMC), 2021
- Villanova University, Lean Six Sigma-certificate, 2015
- Villanova University, Six Sigma Green Belt-certificate, 2015
Affiliations
- Fellow, American College of Healthcare Executives (ACHE)
- Healthcare Financial Management Association (HFMA)
Timeline
Director, Provider Contracting
Blue Cross Blue Shield of Michigan
08.2022 - Current
Director, Provider Network Management
Health Alliance Plan
10.2019 - 08.2022
Strategy Consultant
Independent Consulting
06.2019 - 10.2019
Vice President of Operations
McLaren Health Care / McLaren Physician Partners
09.2017 - 05.2019
Vice President, Operations and Market Solutions (Nov 2016 – Sep 2017)
Ascension Health Care
02.2013 - 09.2017
Senior Health Care Analyst Supervisor (Oct 2011 - Jan 2013)
Blue Cross Blue Shield of Michigan
07.2009 - 01.2013
Executive Masters Business Administration - School of Business Administration
Oakland University
Masters - Public Health
Michigan State University
Bachelor of Arts - Economics
Michigan State University