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John Hurd

John Hurd

Senior Proposal Manager at Everise

McKinney, Texas

Ambitious, team-oriented management professional with 20+ years managing and overseeing dynamic work environments and implementing best practice processes and programs to maximize staff productivity. Adept at assessing plans, devising solutions and streamlining operations to improve bottom-line profitability, while supporting the development and launch of corporate sustainability programs. Adept at designing and implementing customer-specific technical solutions, proposals, and business operations to achieve defined program and corporate goals. Talented at researching and evaluating industry/corporate data; defining project scope, conducting whiteboard sessions, and drafting proposals to win new accounts. Expert presenter; adept at forging strategic partnerships and advising leadership on deploying strong communication initiatives.

SPECIALTIES

•Pre-Sales Strategic Information Consulting
•Project Management Methodologies
•Medicaid / Medicare Regulatory Compliance
•Claims Analysis / Adjudication
•Healthcare Experience
•Service Level Guidelines and Policies
•Medical Coding
•Operations Management
•Standard Operating Procedures (SOP)
•Claims Billing

Key Professional Highlights:

•Devised and created strategic solutions and service offerings to drive value across the health plan value chain (Mailroom Operations, Scanning & OCR, Document Repository, and Workflow Management; Marketplace; TeleHealth; Member Care Management; Provider Data Management; Claims; Membership Management & Billing; EDW & Analytics; Product Data Management; and Contact Management)

•Facilitated Payment Integrity Solutions working with recognized and strategic partners to provide proven fraud detection software and decision support tools for Fraud, Waste, and Abuse (FWA) scoring using workflow automation and dashboards to proactively detect and investigate fraudulent claims

•Applied analytic tool sets for medical claims review/investigation, medical coding, data mining/analysis, investigative analysis, case tracking/investigation and audit results

•Developed and delivered 100+ healthcare payer BPO solutions / cost models for contracts valued from $2M to $1B


Experience:

  • Proposal Manager (CAP GEMINI ERNST & YOUNG)
  • Senior Proposal Manager (Everise)
  • Documentation Specialist/Team Lead (CAP GEMINI ERNST & YOUNG)
  • Senior Proposal Manager - Healthcare Payer Services (Perot Systems Corporation)
  • BPO Solution Architect - Healthcare Payer Services (DELL SERVICES (formerly Perot Systems))
  • Global Practice Lead - Provider Data Management Solutions (NTT DATA Services (formerly Dell Services))
  • Program Manager - BPaaS Solutions (DELL SERVICES (formerly Perot Systems))

Skills:

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