Craig L. Lyon

Craig Lyon brings to Gorman Health Group clients more than 35 years of experience in health care management and consulting.  His experience includes a wide variety of health care organizations including health plans, hospitals, medical groups, Independent Practice Associations (IPAs), Medical Service Organizations (MSOs) and other related entities. His network and contracting experience includes work with commercial and Medicare health plans, hospitals and physician owned managed care entities.

Since joining GHG, Craig’s work has focused on the development of CMS-compliant provider networks for Medicare Advantage plans. His efforts in support of new and existing health plans to expand have lead to numerous successful CMS applications approvals for HMOs, PPOs, PFFS and Special Needs Plans. Services include the development of Medicare compliant provider contracts, managing provider contracting and credentialing campaigns, reimbursement strategy, provider database development and management, Health Service Delivery table creation and assistance with other network related CMS application materials.

Craig has a developed a large team of network consultants with extensive experience with payors, MSOs, large multi-specialty groups. The team has experience in physician group practice management including compensation strategies, billing and AR, facilities, systems and electronic medical records. Under Craig’s direction, the team has also directed the development of managed care programs in group practice environments, including payor negotiation and contracting (risk and non-risk), primary and specialty panel development and selection, contract development, rate setting, selection of third-party administrators and operations.

Prior to his role at GHG, Craig held senior management positions with organizations such as Sutter Health Hospital System, Memorial-Herman Hospital, Sutter Medical Foundation, Sacramento Sierra Medical Group, Sutter North Medical Group, and The Pace Group.