Randy has over 30 years of operational experience in developing and working with insurance companies, physician organizations and health care delivery systems specifically in the areas of commercial and Medicare managed care risk products. These business models have all dealt directly with agreements that were modeled under the assumption of financial risk or a percentage of premium contract.
Prior to working with PANS, Randy was the President and CEO of HealthSpring of Illinois, a Medicare Advantage Prescription Drug (MAPD) plan, operational throughout Chicago, Illinois. During the first eight years of operation, Randy guided the organization through all phases of development, sales and operation, helping it grow to be the second largest MAPD in Chicago. Approximately twenty (20%) of the overall HealthSpring membership was considered to be dual eligible, and the Illinois plan was a recognized leader in reducing unnecessary admissions and re-admissions while improving the overall quality of care as measured by STARs.
In addition to having worked with other multi-line health plans (Blue Cross, Blue Shield, Sanus/New York Life), Randy has considerable senior level experience working with physician-governed organizations (PhyCor, NAMM, WellMed), where he provided executive leadership in all areas related to operational and delegated responsibility, including utilization/quality oversight, overall network operations and organizational fiscal integrity.