Managed Care and Healthcare Business Development
Miami Marlins, L.P. is a professional baseball franchise of Major League Baseball. Based out of Marlins Park in Miami, Florida.
Registered Nurse by training, graduating from Howard University in Washington, D.C. with a BS in Nursing and a BS in Microbiology in 1992. After working as a clinical emergency department nurse and diabetic educator for several years, he entered the managed health care market and began applying the traditional nursing process of assessment, diagnosis, planning, implementation and evaluation to the administrative and case management components of health care. Mr. King has more than ten years experience in the managed care industry specializing in government programs including Medicare Advantage and Florida Medicaid. Mr. King has overseen the operations of MCOs through the transition from Medicare +Choice to Medicare Advantage and the introduction of the Prescription Drug (Part D) plan and Special Needs Plan structure; he has participated with the Centers for Medicare and Medicaid Services (CMS), the National Committee for Quality Assurance (NCQA) and the Florida Agency for Health Care Administration (AHCA) for the development and oversight of government program policy. Mr. King specializes in the management of the Medicare Risk Adjustment payment methodology for Medicare Advantage Plans and also has successfully managed three NCQA, one URAC, two AAAHC and one JCAHO accreditations. In addition to the strong clinical background, Mr. King has a keen sense for business development and operations. Mr. King currently serves as Vice President of Clinical Operations and Business Development for Independent Living Systems in Miami, Florida. He oversees the company's MSO operations, the Post-Acute Support Systems (PASS™) care transition program and the SNP & Community Living Care Management Program. Specialties: Managed Care Consulting - Compliance, Medical Management Programs, Quality Management Programs; Special Needs Plan - Benefit Design, Care Management Models; Care Transition - Program development & implementation.