Brian Burns

About Brian Burns

Brian Burns is a seasoned managed care senior executive with over 33 years of Payer experience. He currently leverages that expertise as an Independent Consultant in the healthcare Payer and Provider space through his company, Burns Consulting Group. In the past two years his clients have included specialty pharmacy, managed care companies, healthcare software firms, outpatient laboratories, and several global NYC management firms, to name a few. From January 2020 to March 2021 Brian was the external consultant overseeing Executive Vice President duties at Blue Cross Blue Shield of Louisiana while a national search was conducted for a permanent replacement. In that role, Brian oversaw clinical pharmacy, the provider network and medical management/clinical solutions. In total, Brian has over 33 years of experience in the Payer healthcare space serving as a Senior Vice President at Blue Cross Blue Shield of Kansas City for 18 years. In that capacity, Brian was an expert overseeing provider network management and reimbursement strategies incorporating many collaborative value based care contracts with network health systems and physicians. He also oversaw clinical pharmacy including being the lead negotiator with the pharmacy benefit managers. He also had executive oversight of medical management where the Chief Medical Officer, medical directors, and nurse case managers reported up to him. In that division he oversaw all utilization management, case management, NCQA and URAC accreditation, credentialing and all health and wellness programs. Brian\'s engagements often include developing go-to-market strategies with senior executives and helping to implement them.

Experience

1. Chief Executive Officer

   Burns Consulting Group

   Dec 2017 — Present · Houston, TX, US

Education

• University of Houston

  Bachelor of Arts - BA, Economics

  1981 — 1985