Richard Wildzunas is an accomplished healthcare executive with over thirty-five year’s experience. His record of success includes twenty years as a senior executive in a Medical Center of 695 beds, development of one of the largest managed care organizations in New York City including the entire metropolitan area extending entirely throughout the States of New York and New Jersey; besides having a separate consulting business for thirty years, and in recent years consultant to two start-up healthcare information technology companies primarily involved in re-selling Electronic Medical Record technology..
He also developed as a consultant the first comprehensive Orthopedic Medical Center in the state of New Jersey and two Ambulatory Surgery Centers. Consultant Director to multi-specialty and single specialty IPA’s, medical practices and medical plans, he was also involved in the operations of the largest multi-specialty Group Practice in the Northeast. Mr. Wildzunas has served as Chairman, Co-Chairman and Board Member on healthcare committees for the state of New Jersey and various state healthcare associations, including non-profit state organizations; in addition to serving on the Board of Directors for the US Army Federal Credit Union which included Chairman of the Finance Committee instituting first home mortgages for servicemen
Accomplishments
- Physician/hospital operations, new business development, corporate legal/regulatory affairs and compliance, and the ability to think out-of-the-box in relationship to understanding and meeting the complexity and challenges facing healthcare today:
- Responsible for the operations and all regulatory and legal affairs, managed care contracting, physician department directors, hospital-based physician service groups, clinical departments, Utilization Management/Quality Assurance departments, and Risk/Safety Management;
- Developed operations of Medical Records and Quality Assurance/Utilization Review departments regarding compliance with reimbursement regulations and to maximize revenues;
- Directed facility through several successful JCAHO accreditation surveys and assumed 18-month responsibility as coordinator of Medial Affairs at request of Medical Executive Committee;
- Hospital direct line responsibility of all regulatory and legal affairs, human resources, physician department directors/contracting and licensure/accreditation;
- Directed hospital operational efficiencies with positive net revenue and continued JACHO Accreditation (most financially;
- Physician recruitment/contracting for 25 years, directly for a hospital and directly for physicians;
- As Executive Officer, increased a managed care’s annual net revenues from $23 million to $67 million in 3 years, propelling the organization from #5 in the market to #1 position for several years;
- Developed and implemented HMO and PPO licenses in New York State, and personally negotiated a $2.95 million start-up capitalization for the HMO which was the first HMO in the New York State to be capitalized at under $5 million;
- Expanded an Insurance Company’s into 17 additional states, and grew a private company’s sharp/needle disposable business from 23 hospitals to over 100 hospitals;
- Developed two 18,000 sq. feet ambulatory surgery centers with a focus on orthopedics,
- Developed in the State of New Jersey the first comprehensive orthopedic medical center in a new state-of-the art building covering 55,000 sq. ft.
- Identified and formulated business opportunities and partnerships with physicians, hospitals, and healthcare systems on behalf of Cathedral Health System in Newark, NJ for the development of a comprehensive Spine program;
- Developed screening criteria and long-term objectives with physician groups in establishing partnerships for formation of free-standing ambulatory surgical centers;
- Received “Entrepreneur of the Year” award from Senator D’Amato in New York State;
- Achieved ranking by Crain’s New York Business as largest managed care organization in New York metropolitan area;
- Developed and implemented corporate business relationships, corporate contracting, and insured product lines in the States of New York, New Jersey, Connecticut and Pennsylvania;
- Developed and implemented three licenses including an HMO license in record time of less than six months in the State of New York;
- Negotiated capitalization of HMO with New York State Department of Insurance officials, becoming 1st HMO to start up with less than $5 million ($2.95 million). License enabled development of point-of-service programs in partnership with various insurance companies and self-insured labor trust funds;
- Developed and implemented first licenses for a PPO in New York State for Auto No-Fault and Worker’s Compensation, gaining support of several insurance companies due to cost effectiveness and extensive provider and service baseline;
- Chief Executive Officer for corporate network development, positioned company as largest Managed Care Organization in the New York metropolitan area;
- Partnering with country’s largest electrical trade union (35,000 employees), developed and received grant from Robert Wood Johnson Foundation for $374,000 to implement a Worker’s Compensation project providing 24-hour medical coverage in conjunction with separate legislation approved by the State of New York.
- Leveraged grant further by developing and implementing Worker’s Compensation Alternative Dispute Resolution program, operating under separate state legislation;
- Gained recognition and support of payers throughout New York State and New Jersey, with large volume of plan participants from Connecticut, Pennsylvania and Ohio due to established licenses, associated cost effectiveness, and provider base line;
- Provided consultant services for physician practices, insurance companies, hospitals and health-related companies and appeared on live cable network as a Healthcare Executive;
- Developed hospital managed care network in New Jersey to support development and expansion of a PPO into the state;
- Developed and served as Consultant Executive Director for a single-specialty IPA, multi-specialty IPA, and multi-specialty surgical group practice;
- Responsible for all Hospital regulatory and legal affairs, managed care contracting, physician department directors, hospital-based physician service groups, clinical service departments, Utilization Management/Quality Assurance departments, and Risk/Safety Management;
- Developed Hospital operations of Medical Records and Quality Assurance/Utilization Review departments regarding compliance with reimbursement regulations and to maximize revenues following participation as a beta test site for Medicare DRG’s.
- Directed Hospital through several successful JCAHO accreditation surveys and assumed 18-month responsibility as coordinator of Medial Affairs at request of Medical Executive Committee;
- Developed two six (6) room 18,000 square feet ambulatory surgical centers (Syndicated physician ownership to over 100 physicians) and purchased a 6 ½-acre building site and developed a 3-story, 55,000 sq. ft. medical arts building;
- Renegotiated fee schedules and contracts the State of New Jersey for 250 physicians;
- Developed and implemented first licenses for PPO in New York State for Auto No-Fault and Worker’s Compensation, gaining support of several insurance companies due to cost effectiveness and extensive provider and service baseline;
- Executive in charge for corporate network development, positioned a PPO/HMO as the largest MCO in New York City metropolitan area. Partnering with country’s largest electrical trade union (35,000 employees);
- Developed application and received grant from Robert Wood Johnson Foundation for $374,000 to implement Worker’s Compensation demonstration project providing 24-hour medical coverage.