Paragon Health Consulting guides insurance companies, especially Medicaid MCOs new to the commercial insurance business, through Exchange implementation, whether initial offering of Qualified Health Plans or expansion into new states. Services include production schedules and staffing requirements, budget development, outsourced vendor selection, competitor analysis, product design and pricing strategies, provider network development and Member acquisition and retention programs. Paragon emphasizes knowledge management and staff development, to rapidly enhance client staff capabilities to assure a successful implementation.
Richard was previously the Vice President - Business Development, Celtic Insurance, the commercial insurance subsidiary of Centene Corporation (NYSE: CNC). As Vice President of Business Development, Richard was responsible for Centene’s Exchange-based planning and business development including Exchange policy liaison with HHS / CMS / CCIIO, state governments and industry organizations (NAIC, AHIP, MHPA), business planning and product development, provider contracting strategies, and Member acquisition / retention strategies and sales execution through a host of sales and marketing channels.
Celtic Insurance, through its Massachusetts subsidiary CeltiCare of Massachusetts, was the only national insurer with experience on the Massachusetts Exchange (the Massachusetts Health Connector Authority). Richard has conducted extensive analysis of the impact of MA health care reform on individual coverage (and associated gaps in coverage) and Employer Sponsored Insurance (ESI) trends, providing unique insights on the impact of ACA nationally.
Prior to joining Celtic, Richard advised a number of insurers on development of strategic plans in response to ACA. He was a Partner at the Boston law firm of Hutchins & Wheeler (now Nixon
Peabody) where he specialized in health care finance, reimbursement systems, corporate development and provider contracting and cost management / revenue maximization for health systems and insurers. Richard founded and was President and CEO of EdTech Networks, Inc., a multi-media communication platform with an integrated loyalty marketing program that served K-12 schools. Richard has transitioned his deep knowledge of law, health care finance and successful direct-to-consumer marketing and sales strategies to increase market share on the Exchanges.
Richard is a graduate of Harvard College, and Boston University School of Law.