Mike Opich, MA
Senior  Consultant

Mike has over fifteen years experience in health care.  Mike has held executive positions in provider network development, contract negotiation, and reimbursement systems development in Medicare and commercial plan settings.  Mike’s background combines his extensive experience in network management and operations with experience developing and supporting information technology solutions for payors and providers.

Mike served as Chief Operating Officer of a large physician hospital organization in Scottsdale, AZ.  Mike was responsible for health plan contracting strategy, physician and hospital system reimbursement and incentive programs, claims operations and all information technology. 

Mike also has held several positions at major health plans in the Southwest marketplace where he worked in Medicare and commercial network development, provider contracting, utilization and quality analysis, and HEDIS and compliance reporting.  

Mike worked for a leading health care software development firm responsible for developing and enhancing software to manage provider data, contract information and administer Medicare and commercial reimbursement methodologies.  Mike also directed the firm’s product support department, responsible for customer relationship management and identifying and resolving software anomalies.

Mike served as the Arizona Regional President for a national physician billing and information technology company.   Mike’s operations background and knowledge of Medicare and other reimbursement programs proved very effective in maximizing provider reimbursement while reducing administrative cost through streamlined operations.

Mike founded and ran a document imaging company which employed proprietary technology and software to capture health care information from claim forms and automate data entry through scanning and optical character recognition.

Mike holds a Master’s degree from Michigan State University in Econometrics and a Master’s Degree from the University of Detroit in Economics.

CMS Publishes Final 2009 MA Capitation Rates and Part D Payment Policies; CMS Will Conduct Plan Level Audits and Not Make Coding Intensity Adjustments for 2009, 04.10.08
Other SNP Sponsors Could Follow In QMed's Wake, Consultant Says; Medicare Advantage News, 11.15.07
The Medicare Outlook: Keys to Success in the New Senior Market, Munich Re America HealthCare Newsletter, 11.01.07
 
Protecting Beneficiaries: Improving & Monitoring Medicare Marketing Practices - AHIP, 05.07
Hard Sell Cited as Insurers Push Plans to Elderly, New York Times, 05.07.07
Advantage Plan's Risk- Wall Street Journal, 04.22.07
Power Shift in Congress Revives Health Debate - New York Times, 01.02.07
 

Home || Contact || Site Map || GHG Webmail || Copyright © 1996-2006 Gorman Health Group, LLC