Lee Hyman

SUMMARYThrough 30 years of healthcare experience I have acquired a unique knowledge and skill set. Having operated and excelled at the intersection of Value Based Care on both the payer and provider side, Revenue Cycle Management, and Provider Audit I am able to engage issues and opportunities in a comprehensive and holistic manner and derive tangible and actionable solutions.NOTABLE ACCOMPLISHMENTSDeveloped and implemented a viable Value Based Care Risk Bearing model that could be utilized and managed by providers seeking to transition from FFS to VBC contracts.Manage and direct over $46 million in annual external medical spend for one of the fastest growing and most progressive value-based care, full-risk primary care practices in the country. Responsible for all medical cost spend and member case management for over 6,000 members in the Kentucky market.Responsible for the Operations and Finance of an exciting healthcare startup that has grown from an idea in 2017 to an organization presently valued at over $10 million. Responsibilities include managing a combine onshore and offshore staff of over 40 FTEs; negotiated all vendor and client contracts; developed and managed financial forecast models; oversaw all A/R and A/P services; and provided industry guidance and knowledge to the Founder and CEO.Took over a failed physician audit program with five employees and completely re-engineered and developed it into a successful division with over 40 Certified Professional Coders while adding major managed care clients including Blue Cross Blue Shield of Massachusetts.Led and managed the client relationship with Humana for over three years improving communication, coordination, reporting, and vendor performance resulting in over $500 million in direct recoveries and $250 million in cost avoidance in 2015.