ABOUT John price

John Price has over 20 years of health plan and CMS managed care oversight experience. In addition to working for CMS for 8 years, he has worked for and with small, mid-sized, and the largest health plans in the country as well as Blues and non-Blues plans. He founded John Price Consulting, LLC to provide established Medicare Advantage, Prescription Drug Plans, and start-ups with best-in-class Medicare Advantage and PDP enrollment operations experience.

John speaks at a number of industry conferences each year on operations and compliance strategies.  He is a graduate of Penn State University, where he received his Bachelor of Science in Health Policy Administration.

John Price serves clients nationwide. Specific highlighted experience is noted at right. He resides with his family in suburban Philadelphia.

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• HIGHLIGHTED EXPERIENCE

  • 20 Years in Managed Healthcare
  • 8 Years Regulatory Oversight at CMS
  • Led and participated in over 30 Medicare Advantage/PDP audits during 8 years at CMS
  • Reduction of Enrollment Rejection Percentage to less than 1%
  • Enrollment Timeliness improvement from 65% to 100%
  • Managed Medicare Advantage Enrollment transaction processing Re-engineering efforts
  • MA/PDP Enrollment Vendor evaluation due diligence and professional recommendation
  • Enrollment Department Re-organization, including job description/responsibility division overhaul
  • Industry Best Practice implementation
  • Corrective Action Plan creation and execution

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