David Russell

About David Russell

I have worked in the Managed Care field for the last 20 years in multiple Network Management Department roles ranging from Provider Relations to Director of Network Contracting. I have lead contract negotiations with large health systems in Indiana and Ohio that create a high quality provider network for our customers. The relationships that I have built with the health systems allow for both organizations to develop a strong equity relationship to deliver high quality care for the customers in the State. I have also been involved in multiple Accountable Care Organizations (ACO) negotiations to provide value/quality based metrics for the health system. In my new role I will be responsible for seeking out new business opportunities for the organization and implementing a Direct to Employer contract strategy to help local employers manage their healthcare cost. Develop, coordinate and implement new quality programs that would fit with our ACO/Population Health program to improve the health and quality outcomes of the patients we have the privilege to serve.Specialties: Direct to Employer Agreements, BPCI-Advanced, Commercial (Employer and Individual), Medicare, Marketplace Exchange Plans, Medicaid Managed Care, Ancillary & Hospital Contracting, Physician Contracting, Contract Negotiation, Quality & HEDIS, Account Management, Business Development, Accountable Care Organizations

Experience

1. VP of Population Health and Business Development

   Marion Health

   Aug 2022 — Present · IN, US

   Lead Managed Care contract negotiations for the health system which includes hospitals, physician practices and urgent care facilities. Oversee and implement our direct to employer strategy with their self-funded benefit plan.Managed all the Value-Based agreements with Medicare Advantage, Commerical and Medicaid insurance plans.Improve our partnership with the different insurance payers to find solutions surrounding claims, provider enrollments, updated policies, and other programs impacting healthcare.Improved outreach to local employers to deliver onsite health screenings for their employees. Responsible for financial operations of the 18 physician practices ranging from annual budget, staff salaries. Physician compensation, GLA expenses and capital investments.