Mark D. Bevelander

Director, Provider Network Management @Blue Cross & Blue Shield of Rhode Island

Providence, RI, US
MOBILE NUMBERS
+91 *********19

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WORK HISTORY

Sep 2021 — Present

Director, Provider Network Management @Blue Cross & Blue Shield of Rhode Island

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EDUCATION

N/A

Johnson & Wales University

Bachelor of Business Administration (BBA), Business, Management, Marketing, and Related Support Services

SKILLS

Customer ServiceNegotiationProcess ImprovementOperations ManagementHealthcare Information TechnologyMedicareNetwork DevelopmentManagementTeam BuildingProgram ManagementEmployee BenefitsHipaaHmoContract NegotiationProvider RelationsContract ManagementStrategic PlanningVendor ManagementProject ManagementHealth PolicyAccount ManagementChange ManagementClaimMedical Expense Trend AnalysisMedicare Part DHealthcareRfpHealthcare IndustryPilot Program DevelopmentInsuranceAnalysisMedicaidHealthcare ManagementCross-Functional Team LeadershipWorking with PhysiciansHealth InsuranceManaged CarePpoLeadershipBudgets

ABOUT MARK D. BEVELANDER

Over 30 years health insurance provider network management experience with a focus on negotiating, maintaining and managing complex healthcare provider contracts that include alternative payment models where applicable. Trend Management Experience: Identify areas of opportunities for trend rightsizing and quality improvement. Implemented effective programs to address trends where appropriate in collaboration with network providers. National Contracting Experience: Active member of the Blue Cross Blue Shield Association CareSourcing Workgroup which contacts nationally for participating Blue Plans. Medical and Payment Policy Development and Maintenance: Ensure medical and payment policies meet all regulatory and business requirements as well as the expectations of internal and external stakeholders. Leading Teams: Associate and manager development experience that ensures all associates and managers learn, develop and thrive. So often it is the navigation of relationships, need to react quickly to internal and external stakeholders that define the effectiveness of an associate or manager.

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Mark D. Bevelander — Director, Provider Network Management at Blue Cross & Blue Shield of Rhode Island in Providence, RI, US | Unifers