Patricia Mosier Hughes
CEO @Essential Healthcare Solutions, Llc
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WORK HISTORY
CEO @Essential Healthcare Solutions, Llc
Accomplished Healthcare Executive with entrepreneurial leadership style that thrives in dynamically challenging environments requiring focused decision with a strong emphasis on providing innovative strategic planning for business growth within the healthcare industry; vast experience with large regional and national provider network development expansions leading large teams, providing network strategy including access analysis, identification of key stakeholders, contract language, reimbursement methodologies, contract negotiations for all provider types including hospital, and behavioral health; In-depth knowledge of health systems; provider and facility credentialing; start-ups and program development for both providers and facilities; billing and revenue cycle management; practice management system implementation; government contract proposal and submission; awarded a three year government subcontract supporting military personnel and families on military installations providing direct behavioral health support in more than 13 states for the MFLC program; provided clinical and non-clinical staffing support for federal, state and commercial contracts. Over 27 years experience operating and managing healthcare programs with a strong emphasis on building specialty provider networks, capture solutioning, medical recruiting and training, disaster rapid response services, case management, correctional health and behavioral health program development and support. Extensive experience leading large staffing project teams; Awarded a state multiyear government prime healthcare staffing contract providing direct care services for intellectually disabled residents; Awarded a prime state wide contract providing healthcare recruiting services for state owned hospitals and behavioral health facilities
SKILLS
ABOUT PATRICIA MOSIER HUGHES
Performance-driven accomplished healthcare executive offering 28+ years’ comprehensive achievements with experience in diverse settings. Developed performance-based solutions promoting industry leadership while earning an exceptional reputation. Recognized for innovative business development initiatives and management techniques yielding enhanced business practices, increased productivity and net profits; expertise in strategic and financial planning, and insurance payer contract negotiations. Vast experience in developing provider and payer solutions for network development and value-based reimbursement. Established track record of successful strategic and tactical leadership in all aspects of managed care from both a provider and payer perspective. Demonstrated success in negotiating and implementing favorable contractual agreements. Lead all aspects of provider network strategy and project management for large regional and national provider network development projects for all lines of business including Medicare Advantage, Medicaid, Commercial, ERISA, Workmen\'s Comp, VA, LTSS, Behavioral Health, Vision and Delegated Vendors. Extensive knowledge in contract language negotiation (Paralegal), hospital, facility and provider contracting, and market analyses. Expanded experience in program development and government contracting including RFI & RFP submissions. Behavioral health subject matter expert including licensure, Joint Commission Accreditation, facility start-ups, program development, revenue cycle management and business development. Government Subcontractor for an RFP that was recognized in 2018 as being within the competitive range of the most highly rated proposals for a behavioral health military global program, providing 4 major programmatic solutions within the RFP. The RFP was one of three awarded the government contract for a 10-year optional period to support the MFLC Program.
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