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Ed Holme is a Senior Consultant with PivotHealth Consulting, LLC, a physician practice management company based in Brentwood, Tennessee.
Holme has more than 30 years of experience in executive management in both medical groups and health plans at the local, regional and national level. He has a wide range of skill sets to assist our clients, including strategic planning, project management, health plan contracting, turn-around management, senior level operations, government compliance, provider relations, forecasting-budget preparation, work flow engineering and profit/loss performance management.
RELEVANT EXPERIENCE
Served as the Chief Administrative Officer (CAO) for a System-owned Health Plan in Reno, Nev., which became the most respected plan in the state of Nevada. Revenue increased by 60% and Membership grew 50% annually for three years. Reconstructed market approach to cooperation rather than competition with agents and brokers, greatly improved the claims payment and turn around process, upgraded information systems, restructured the management team to fit the culture of success. Successfully marketed prepaid Medicare in market and garnered over 40% of the eligible population.
Designed and implemented an appointment system for 34 clinics, 350 physicians and 1,200 ancillary personnel which became the national model for his firm. It was implemented on budget and in roughly half the time which had been anticipated.
Oversaw all provider relationships and bottom line responsibility for the Southern California region of a nationally-known managed care company, where he was able to double the market penetration in San Diego with a growth of 250% in three years. A 300% rate of growth for the Medicare network products in Orange County also occurred in that 3-year period.
Developed medical management systems and training for Saudi Arabian nationals to take over hospital and clinical management duties for Arabian-American oil firm.
EDUCATION
B.S., University of Santa Clara
M.B.A., University of Santa Clara
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