Boyd Woolsey

Boyd Woolsey

Senior Provider Contracting Executive at Regence BlueCross BlueShield of Utah

Location
Greater Salt Lake City Area
Industry
Hospital & Health Care

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Boyd Woolsey's Overview

Current
Past
  • Director, Managed Care at Johnson & Johnson
  • Group Operations Manager at Intermountain Healthcare
  • Business Development Director at Intermountain Home Care
  • Account Executive, Payer Contracting at HCA
  • Patient Account Services Director at HCA
Education
Connections

500+ connections

Boyd Woolsey's Summary

A skilled and dynamic leader with over 25 years guiding physicians, health care professionals, technicians and administrative staff in hospital, clinic, home health, and durable medical equipment settings. Extensive skill in contracting and cross-functional project partnering, strategic development with tactical execution resulting in solid solutions.

Specialties: Seasoned leadership skills emphasizing collaboration, mentoring, compassion, effective planning coupled with the ability to be flexible and adaptable. A veteran in account management in negotiating and resolving complex and sensitive issues with tact and persuasiveness to executives and staff at all levels of an organization

Boyd Woolsey's Experience

Senior Provider Contracting Executive, Network Management

Regence BlueCross BlueShield of Utah

Nonprofit; 1001-5000 employees; Health, Wellness and Fitness industry

August 2013Present (1 year 2 months) Salt Lake City

Develop contracting relationships with physicians, physician groups, hospitals and ancillary providers to facilitate contracting strategies, coordination of analytical support, negotiation and effective administration.
• Strong understanding of managed care and accountable health system models and relationship to contracting strategy and reimbursement methodology
• Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers
• Demonstrated competency related to varying payment methodologies and value base contracting. (such as Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per
Diem, Per Case, Med Advantage)
• Proficient in contract negotiations with hospital systems, large medical groups
• Analyze financial, quality, and utilization data to develop contracting strategies
• Organize and manage a portfolio of contracts
• Ability to effectively manage conflict and ambiguity
• Proficient in building relationships and negotiating successfully with large and complex
market-leading institutional and professional providers
• Independently and effectively communicate with high level executives internally and externally

Contracting & Provider Relations Manager

University of Utah Hospitals and Clinics

Nonprofit; 5001-10,000 employees; Hospital & Health Care industry

August 2012August 2013 (1 year 1 month) Greater Salt Lake City Area

Responsible for provider operations and functions including network contracting, provider relations and credentialing activities. Planned, organized, directed interactions with external customers, human resource and financial management.
• Assisted in the evaluation of provider network and implemented strategic plans to achieve company targets through aggressive primary care, specialty, hospital and ancillary provider contracting and management
• Maintained relationships with DME suppliers and traditional health care providers to enhance network to achieve desired coverage, pricing and budget targets
• Assisted in the analysis of claims trend and market data to derive positive contract arrangements
• Delivered direct, complete and actionable feedback to foster continuous learning

Lt Col, Medical Service Corps

United States Air Force

Government Agency; 10,001+ employees; Defense & Space industry

November 1989October 2012 (23 years)

Provided leadership and oversight for all patient administration functions in military treatment facilities and clinics. Coordinated medical care for active duty, dependents and retirees. Administrative oversight of Business Office, Ambulatory Care, OB/GYN, Medical and Surgery Wards, Orthopedics, Lab, Radiology, Pharmacy, Medical Records, Physician Services and Optometry
- As Executive Officer, directed the administrative affairs of up to 43 Physicians (Family Practice, Internal Medicine, Pediatrics, General Surgery, Cardiology, Gastroenterology, Endocrinology, OB/GYN, Emergency Medicine, Occupational Medicine, and Radiology
- Served as medical liaison to the Kingdom of Morocco for African Lion Health Civil Affairs to coordinate primary care clinics in several villages throughout the country
- Directed all affairs in regards to contracting, collections, and coordination of benefits
- Facilitated credentialing, compliance/quality improvement; call schedule, hospital privileges, coding, malpractice and professional societies to maintain licenses and professional affiliations
-Oversaw physician staff grievance process and arbitrated issues related to unionized employees to interpret and apply provisions of employment contract conditions
-Served as primary public affairs contact to provide medical capacity to the community in the event of natural or man-made emergencies and/or disasters

Director, Managed Markets

Johnson & Johnson

Public Company; 10,001+ employees; JNJ; Hospital & Health Care industry

December 2011August 2012 (9 months) Nationwide

Responsible for managing account teams to promote company products to payers and ensure favorable access, coverage and reimbursement. Developed positive payer relationships with key opinion leaders and executives to establish targeted initiatives in promoting and building a holistic approach to diabetes.

* Analyzed contract requirements, terms and conditions to ensure compliance with appropriate laws, regulations, and corporate policies resulting in broader coverage and timely reimbursement
* Directed payer opportunities and trends resulting in positive growth and significant attainment of territory goals and objectives .
* Developed strategic initiatives and led tactical implementation with team resulting in broader opportunities for growth and influence with health care professionals

Director, Managed Care

Johnson & Johnson

Public Company; 10,001+ employees; JNJ; Hospital & Health Care industry

September 2004December 2011 (7 years 4 months) Nationwide

Provided market intelligence, education on benefit designs and reimbursement trends to develop activities to solidify brand value to managed markets customers. Led all contract reviews, solicitations, proposals and bids for team of 5
* Analyzed significant or unique contract requirements, special provisions, terms and conditions resulting in compliance with appropriate laws, regulations, and policies
* Provided contractual guidance to company and business team members resulting in well informed and prepared employees
* Analyzed new laws, regulations and contract trends for positive impact on area goals and objectives resulting in focused and strategic touch points
* Developed strategic initiatives and lead tactical implementation with team resulting in double digit growth for 5 years

Group Operations Manager

Intermountain Healthcare

Nonprofit; 10,001+ employees; Hospital & Health Care industry

May 2001September 2004 (3 years 5 months) Greater Salt Lake City Area

Directed operations for 16 primary care and specialty locations, with 43 providers, 3 pharmacies, 12 direct reports, and 100 in-direct reports. Developed and monitored $30 million budget. Performed in-depth operation and capital budgeting forecasting for strategic planning, physician recruitment and RVU productivity, business improvement initiatives, and community relations resulting in positive growth and increased employee tenure

Business Development Director

Intermountain Home Care

Nonprofit; 10,001+ employees; Hospital & Health Care industry

May 1996May 2001 (5 years 1 month) Greater Salt Lake City Area

Planned, organized and led system wide directives for the administration of policies and strategies concerning contracting, marketing, customer service, managed care and business development.

Developed and implemented comprehensive contract and negotiation strategy for pharmaceuticals and durable medical equipment resulting in the first ever broad based focused approach in providing comprehensive services to home based patients

Account Executive, Payer Contracting

HCA

Public Company; 10,001+ employees; HCA; Hospital & Health Care industry

September 1995May 1996 (9 months) Greater Salt Lake City Area

Refined relationships with payer groups through managed care contract negotiations and
development of business development strategies.
• Nurtured productive contracting relationships with HMO’s, PPO’s, and government payers
• Analyzed Utah House and Senate Bills dealing with healthcare resulting in implementation of
recommended course of action with lobbyists, committee members, and hospital administrators

Patient Account Services Director

HCA

Public Company; 10,001+ employees; HCA; Hospital & Health Care industry

February 1994September 1995 (1 year 8 months) Price, Castleview Hospital

Directed AR with a staff of 23 in admitting, billing, and cash posting for a rural hospital.
• Improved accounts receivable days from 63 to 45 and bad debt from 3.5% to 1.0%
• Reduced $270,000 in budgeted costs and increased recovery profitability by 67%

Boyd Woolsey's Skills & Expertise

  1. Healthcare
  2. Managed Care
  3. Hospitals
  4. Leadership
  5. Cross-functional Team Leadership
  6. Strategic Planning
  7. Management
  8. Strategy
  9. Medicine
  10. Healthcare Management
  11. Analysis
  12. Team Building
  13. Physician Relations
  14. Budgets
  15. Human Resources
  16. Contract Negotiation
  17. Medical Coding
  18. Business Development
  19. Sales Operations
  20. Medical Records

Boyd Woolsey's Education

University of Colorado at Denver

Master of Science, Health Administration

The curriculum is accredited by the Commission on Accreditation of Healthcare Management Education (CAHME). The MBA and MS in Health Administration are the only accredited health administration programs in the Rocky Mountain region.
Coursework focuses on teaching analytic decision making processes used by both top-level
executives and managers in administering units within health care organizations

University of Phoenix

Bachelor of Science, Business Adminstration

Community College of the Air Force

Air Command and Staff

The curriculum develops higher order of thinking by challenging students to think critically and exercise a combination of analytical and practical tools required as leaders charged with the nation's defense. ACSC graduates are well educated in the profession of arms with emphasis on the use of air and space power in joint campaign planning and the operational art of war. The ACSC curriculum:

*Facilitates the air and space minded thinking of students
*Develops and enhances abilities for higher-level command and staff responsibilities
*Enhances abilities to think critically about operational air & space concepts in a dynamic
international environment
*Broadens students' understanding of the nature of conflict and current and future threats to the United States and its allies, and
*Develops and enhances students' abilities to plan and execute the joint campaign planning process and air and space operations to support the joint force commander

Community College of the Air Force

Squadron Officer School

SOS helps officers grow professionally. While at SOS, officers step out of their specialties and broaden their focus on essential leadership competencies as well as Officership, Leadership, Problemsolving, Core Values, and the Air Force as an institution in the profession of arms. Students strengthen their Officership and Leadership techniques and apply what they learn in classroom discussions and field exercises. SOS not only provides students with an opportunity to see how their leadership skills influence team success, but also to experience Followership in support of other student leaders.

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