Uday Joshi

About Uday Joshi

Experienced Associate Vice President with a demonstrated history of working in the hospital & health care industry. Skilled in Medicaid, Regulatory Analysis, Managed Care, Healthcare Management, and Leadership. Strong professional with a Master of Business Administration (MBA) focused in Health/Health Care Administration/Management and Finance from Boston University - School of Management.

Experience

1. Vice President Finance

   Healthfirst

   Jul 2013 — Present · Manhattan, NY, US

   Direct hands on experience with Medicaid, Medicare, MLTC, ACA & Govt Programs in all phases of managed care oversight including membership growth, manage medical expenses, strategy execution and business development- Responsible for risk adjustment, revenue maximization & encounter submissions for 1.5M members for PHSP, MLTC and Medicare products. Achieve and maintain the highest risk scores in plan service area which yields an incremental $25M in additional revenue in risk adjustment a month- Provide leadership and guidance to a team of over 20 accounting and managed care professionals whose ultimate responsibility is ownership for all activities for a $7B general ledger including year-end external audit, MAR audit, statutory (MMCOR), billing and all other regulatory reporting- Experience in CMS Bid processes with ownership on risk score accuracy and medical cost management through effective vendor and utilization management. Key stake holder in bottom line P&L results in Medicare products- Direct experience in implementing shared risk financial models and managing profitability with partners and stake holders. Expertise as a director of medical economics team and bridging the gap between the core corporate finance and analysis/actuarial teams- Experience in pricing, financial forecasting, medical cost trends, and savings initiatives. Keen understanding of all operational aspects of managed care including enrollment, claims, and medical management. Familiar with all aspects of managed care such as IBNR, APC/APG pricing methodologies, DRG repricing, and ACO surplus models- Prepare data driven presentations for hospital CEO’s and CMO’s to identify benchmarks, metrics and other areas for performance improvement. Create prospective models to assess financial performance and viability

Education

• Northeastern University

  Bachelor's Science, Cardiopulmonary Science

  1997 — 2000

• Questrom School of Business, Boston University

  Master of Business Administration (MBA), Health/Health Care Administration/Management and Finance

  2004 — 2006