Cultivation of Expertise

Entry into managed care

While working on his undergrad studies in information systems, he approached a temporary agency for possible work that would align with his future career aspirations. He was quickly placed on a temporary assignment to perform data entry, a skill that apparently was in high demand at the moment. His first assignment, which turned out to be his only one from the agency, was with a Fortune 500 managed care organization. His charge was straightforward: enter data from financial reports into a desktop database and generate new reports. However, he soon questioned the efficiency of the process. His curiosity led him to investigate the original data source, revealing that the data already existed in a file format. Within the first week, he had streamlined the process, reducing a forty-hour process into a task that was less than five hours per week. This efficiency did not go unnoticed – the company moved quickly to hire him directly, full-time, effectively ending the temporary role he was brought in to fill. You could say this was his first foray into process improvement, a skill that would become a cornerstone of his career. 

Learning the ropes of managed care

His initial education, and new-found interest, in managed care began at that same managed care organization. Initially, performing in the newly formed role that had been created for him, finance analyst, he provided basic utilization, financial, and provider reimbursement reporting.

That was followed with a new role which arose when the Market Director of Information Systems abruptly left the organization. Although he didn't receive the title, he did inherited the responsibilities, which marked a significant jump in the path along the learning curve. This new position was a blend of both business and data analysis. His charge was to provide business support and ad hoc reporting to address the gap in needs not met by standard corporate reports. His approach was hands-on: he collaborated closely with various department staff to understand their specific reporting needs. This process was enlightening in two major ways. First, it offered him an in-depth understanding of each department's function, as well as the underlying data that each department used and generated. Second, it enabled him to deliver precise, timely reports, that provided the actual information that the business users needed for their desired outcomes, which was often very different than the information they originally asked for.

The company's systems were robust, and he navigated to extract and analyze data. This immersion in data and departmental functions was a masterclass in managed care. This set the tone for him to begin understand and learn about the nuances of benefits structures, enrollment, authorization rules, provider reimbursement arrangements, and claims adjudication – the building blocks of managed care. More importantly, he learned the value of developing a relationship with each department within the organization, helping them overcome the obstacles of the silo-like boundaries that often exist between functions.

Supporting a broad array of critical managed care initiatives

After his transformative journey at the company, he would move on to work with various organizations, both large and small, stretching across the country. His career path, initially rooted in Information Technology, gradually shifted towards business and operational roles. His involvement in project management, leading diverse teams, and spearheading critical initiatives marked significant milestones. He managed the configuration claims administration system, orchestrated system upgrades and migration, led market expansions and new product launches , developed and executed plans for venturing into new states, to included associated application and regulatory compliance, and oversaw various integrations associated with acquisitions and merger.

This rich tapestry of experiences paved the way for the inception of Gentry Consulting.