FCHP Company
Industry: Health insurance company
DescriptionFounded in 1977, Fallon Health is a Worcester, Massachusetts-based provider of health insurance and health care services. In partnership with Weinberg Campus, Fallon Health also operates Fallon Health Weinberg, a health insurance company based in Amherst, New York. CEO: Richard P. Burke Headquarters: Worcester, MA Chief compliance officer: James Gentile Chief medical officer: Carolyn Langer SVPs: James Gentile, Carolyn Langer, Jill Lebow, David Przesiek, Emily West Subsidiaries: Fallon Total Care Inc., Fallon Health & Life Assurance
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FCHP Employees
Fchp March 2008 - Present
Skills
Microsoft Excel, Microsoft Office, Property & Casualty..., Project Management, Insurance, Risk Management, Customer Service, Account Management, Call Centers, Strategic Planning, Process Improvement, Analysis, Change Management, Training, Team Building, Banking, Access, Financial Analysis, Data Analysis, Leadership, Business Analysis
Education
Porter and chester Institute Worcester campus 2013 — 2015
Associate of Science (A.S.), Computer Networking and Technology
Assumption College 2009 — 2011
Associate's degree, Medical Billing and Coding, Credit
FCHP 2011 - 2012
Fidelity Investments January 2004 - October 2010
Fidelity September 1999 - January 2010
Autologic Information International December 1997 - September 1999
The Palmer Group January 1997 - November 1997
Skills
Unix
Education
Bard College
Bachelor of Arts, Physics
University of Massachusetts Boston
Computer Science
Neighborhood Health Plan June 2015 - Present
Neighborhood Health Plan June 2014 - June 2015
UnitedHealth Group May 2012 - May 2014
FCHP November 2008 - May 2012
AIM Healthcare Services, Inc. June 2004 - July 2007
Skills
Medicare, Process Improvement, Health Insurance, HIPAA, Insurance, Healthcare, Data Analysis, Project Management, Access, Hospitals, Healthcare Management, Analysis, Medicaid, Claim, Healthcare Information..., Managed Care, Testing, Healthcare Consulting, Healthcare Industry, Contract Management, Quality Improvement, Auditing, Quality Assurance
Education
Anna Maria College 2010 — 2011
Master of Public Administration (M.P.A.), Hospital and Health Care Facilities Administration/Management
St. Vincent Hospital at WMC July 2008 - Present
Fallon Community Health Plan 2005 - 2008
FCHP 2005 - 2008
Athol Memorial Hospital 2000 - 2005
St. Vincent Hospital 1996 - 2000
Skills
Human Resources, Employee Relations, Recruiting, Applicant Tracking..., Healthcare, Leadership, Nursing, Hospitals, HIPAA, Healthcare Management, Process Improvement, Healthcare Information..., Clinical Research, Policy, EMR, New Hire Orientations, Acute Care, Job Fairs, BLS, Benefits Administration, Personnel Management, College Recruiting, Meditech, Managed Care
Education
Worcester State University 1994 — 1996
Business Administration
Johnson & Wales University 1992 — 1994
Business Administration
Assumption College
Gossett Consulting Services November 2007 - Present
HTMS 2007 - Present
Security Health Plan June 2010 - August 2011
FCHP October 2007 - May 2010
Network Health Plan January 1997 - November 2007
Skills
Business Analysis, Process Improvement, SDLC, Business Process..., Visio, Healthcare Information..., Requirements Analysis, Management, HIPAA, Software Documentation
Education
St. Cloud State University 1992 — 1996
Bachelor of Science, Management
Fallon Community Health Plan September 1987 - Present
FCHP February 1982 - 1987
Skills
Insurance, Employee Benefits, Account Management, Health Care Reform, Medicare, Disability Insurance, Underwriting, Customer Service, Medicaid, Healthcare, Sales, New Business Development, Sales Presentations, Strategic Planning, Direct Sales
Education
Bridgewater State College 1978 — 1980
Social Work
Quinsigamond Community College 1976 — 1978
Fallon Community Health Plan 1998 - Present
fchp October 1998 - July 2015
Skills
Advertising, Healthcare, Newsletters, Copywriting, Marketing Communications, Social Media, Medicare, Process Improvement, Marketing, Direct Mail, Managed Care, Employee Benefits, Creative Concept Design, Health Insurance, Adobe Creative Suite, Insurance
Education
Anna Maria College 1982 — 1986
bfa, art
Fallon Community Health Plan July 2011 - September 2015
Fallon Community Health Plan 2008 - July 2011
FCHP 2004 - 2008
Education
College of the Holy Cross
Bachelor’s Degree, Cum Laude
FCHP May 2005 - Present
United Healthcare September 1997 - May 2005
Consolidated Group February 1991 - October 1997
Skills
Health Insurance, Health Savings Accounts, Insurance, Access, Account Management, Employee Benefits, Medicare, Managed Care, Underwriting, Healthcare, Customer Service, Disability Insurance, Health Care Reform, Brokers, Provider Relations, Long-term Care, Life Insurance
Education
Nichols College
MBA, Business Management
Assumption College 1984 — 1988
FCHP January 1991 - Present
Skills
Formulary design and..., Pharmacy benefit design, Medication utilization..., Drug trend analysis, Medication marketing..., Rebate contracting and..., Pharmacy benefit..., Medicare pharmacy..., Medicaid pharmacy..., Pharmacy legislative..., Pharmacy cost of care..., Medication therapy...
Education
Massachusetts College of Pharmacy and Health Sciences 1976 — 1980
RPh, pharmacy
none January 2011 - Present
RIS the paper house 2002 - 2003
FCHP 1999 - 2000
LaVigne Inc. 1990 - 1999
Education
Anna Maria College 2009 — 2011
MEd, Elementary Education
Framingham State University
FCHP 2001 - Present
Jewish Healthcare Rehab 1998 - 2001
Skills
Clinical Research, Medical Coding, Microsoft Office, Insurance, Claim, Customer Service, Healthcare, Medicare, Managed Care, Medicaid
Education
Clark University 1981 — 1983
MHA
Seattle University 1977 — 1981
BSN, Cum Laude honors
DST Health Solutions July 2013 - Present
American Medical Association June 2011 - January 2013
Molina Medicaid Solutions (formerly a division of Unisys Corporation) April 2010 - October 2010
Molina Medicaid Solutions (formerly a division of Unisys Corporation) 2010 - October 2010
Molina Medicaid Solutions (formerly a division of Unisys Corporation) 2010 - August 2010
Fallon Community Health Plan October 2008 - January 2010
FCHP 2008 - January 2010
VTR 2008 - 2009
BCBSMT May 2008 - August 2008
HMSA 2006 - 2008
Skills
Agile Methodologies, BizTalk, Business Analysis, Business Intelligence, Business Requirements, Change Management, Claim, EDI, Employee Benefits, HIPAA, Healthcare, Healthcare Information..., ICD-10, IT Strategy, Integration, Medicaid, Medicare, Microsoft SQL Server, Process Improvement, QNXT, Quality Assurance, Requirements Analysis, Requirements Gathering, SDLC, SQL, SharePoint, Systems Analysis, Testing, Vendor Management, Visio
Education
Stephen F. Austin State University 1976 — 1981
BA, Sociology, Criminal Justice
McKesson Health Solutions February 2014 - Present
Fidelity Investments November 2011 - February 2014
Fidelity Investments July 2010 - November 2011
Fidelity Investments 2009 - 2010
Public Sector Partners February 2007 - October 2009
University of Massachusetts Medical School 2004 - 2007
UMass Medical School 2004 - 2007
FCHP 1999 - 2003
ExecuTrain of Worcester and RI 1996 - 1999
Fallon Clinic 1993 - 1996
Skills
SDLC, Requirements Analysis, Business Requirements, Business Analysis, SQL, Software Project..., Business Process..., Java, Databases, Systems Analysis, Database Design, Microsoft SQL Server, Visio, Software Documentation, Visual Basic, Oracle, Analysis, Software Development, Project Management, Web Services, Requirements Gathering, Testing, Process Improvement, Agile Methodologies, Business Objects, Quality Assurance, Program Management
Education
The University of South Dakota 1988 — 1990
BS, Criminal Justice, communications
Evolent Health December 2014 - Present
Evolent Health May 2013 - Present
FCHP June 2008 - May 2013
WellPoint 2001 - 2008
Skills
Managed Care, Health Policy, Hospitals, Healthcare Management, Healthcare, Medicine, Medicare, Disease Management, Utilization Management, Leadership, Medicaid, Healthcare Industry, Health Insurance, Quality Improvement, Healthcare Information..., Network Development, Provider Relations, Internal Medicine, Pharmacy Benefit..., Physician Relations, Public Health, Healthcare Consulting, Clinical Research, Physicians, HIPAA, Informatics, Medical Education, Health Care Reform, EMR, HMO, EHR
Education
The University of Connecticut Health Center 1985 — 1989
MD, Medicine
The University of Connecticut Health Center 1985 — 1989
MD, Medicine
Rensselaer Polytechnic Institute 1978 — 1979
M.Eng. Env. Eng, Environmental Engineering
Rensselaer Polytechnic Institute 1974 — 1979
BS Bio; M Eng
Rensselaer Polytechnic Institute 1974 — 1978
B.S., Biology
FCHP Application DeveloperFallon Community Health Plan
Education
Bangalore University 1997 — 2001
BE, Computer Science
Worcester Polytechnic Institute
Fallon Community Health Plan September 2003 - Present
FCHP 2003 - Present
Skills
Motivational..., Computers, Case Managment, Health Insurance, Certified Case Manager, Customer Service, Utilization Management
Education
College of Our Lady of the Elms 1980 — 1982
BSN
Fitchburg State College 1976 — 1980
MBHP June 2002 - Present
MBHP June 2002 - Present
FCHP (Fallon Community Health Plan) June 1988 - June 2002
FCHP 1988 - 2002
Becker College September 1994 - June 2000
Skills
Disease Management, Clinical Research, Medicare Part D, Medicare, Health Policy, Healthcare Information..., HIPAA, Patient Safety, Treatment, Psychiatry, Patient Education, Quality Improvement, Medicine, Psychotherapy, Mental Health, Utilization Management, Pharmacy Benefit..., Managed Care, Pharmacy, Behavioral Health, Program Development
Education
Massachusetts College of Pharmacy and Health Sciences 1968 — 1973
BS Pharmacy, Pharmacy
Massachusetts College of Pharmacy and Health Sciences 1968 — 1973
Pharmacy
Worad Inc August 2014 - Present
FCHP November 2010 - November 2013
Federal Heath Sign Co. October 2005 - August 2007
Skills
Program Management, Software Documentation, Business Process, Project Management, Project Planning, Budgets, Account Management, Manufacturing, Customer Service, Data Analysis, Analysis, Business Process..., Lean Manufacturing, Lean Management, Lean Operations, Lean Thinking, LEED Projects
Education
Worcester State College
Bachelor's, Business Administration
Mountview
Quinsigamond Community College
Associate of Arts (AA), General Studies
FCHP June 2008 - Present
eClinicalWorks August 2004 - June 2008
Data General 1981 - 1987
Skills
EHR, Healthcare, HIPAA, Software Implementation, Visio, Software Documentation, Project Management, Process Improvement, Business Analysis, Healthcare Information..., Team Building, Troubleshooting, Informatics, Health Insurance, Data Analysis, Customer Service
Education
Assumption College
Bachelor's, Liberal Science
Fallon Community Health Plan February 1984 - Present
FCHP 1984 - Present
Fallon Community Health Plan (FCHP) 1984 - 2014
Reliant Medical Group February 1984 - February 2003
Skills
Certified Professional..., Cetified Medical..., HIPAA, Managed Care, Healthcare Information..., Medicare, Insurance, Provider Relations, Health Insurance, Healthcare, Process Improvement, Business Analysis, Analysis, Microsoft Office
Education
Quinsigamond Community College 1974 — 1975
David Hale Fanning Trade 1968 — 1972
HealthDrive Corporation August 2015 - Present
Southboro Medical Group April 2014 - May 2015
Reliant Medical Group November 2012 - February 2014
FCHP August 2009 - November 2012
Small Business Insurance Agency March 2005 - October 2009
Skills
Insurance, Employee Benefits, Health Insurance, Customer Service, Microsoft Office, Microsoft Excel, Outlook, Training, Access, HIPAA
Education
Salter College-West Boylston 2005 — 2007
Certification, Legal Assistant/Paralegal, 3.9
Salter College-West Boylston 2005 — 2007
Certificate, Legal Assistant/Paralegal, 3.9
fallonhealth August 1999 - Present
FCHP 1999 - Present
Skills
Process Improvement, Health Insurance, Management, Insurance, Managed Care, Strategic Planning, Sales Operations, Account Management, Employee Benefits
Education
Becker College
Bachelor’s Degree, Bachelor of Science in Business Administration, Management Concentration
fchp
Skills
Nursing, Healthcare, Disease Management, Healthcare Management, Case Management, Hospitals, Managed Care, Customer Service, Healthcare Information..., Clinical Research, Home Care, Medicare, Mental Health, Utilization Management, HIPAA, Medicaid
Education
St Joseph School of Nursing 1995 — 1998
Registered Nursing/Registered Nurse
Bridgewater State University 1987 — 1990
Bachelor of Science (BS), Special Education and Teaching
Elm Street Congregational Church February 2000 - Present
Elm Street Congregational Church February 2000 - Present
Brookfield Congregational Church March 2005 - October 2010
FCHP March 1994 - May 1999
Skills
Organized Multi-tasker, Professional attitude, Microsoft Office..., Dependable Team Player
Education
Rob Roy Academy-Worcester 1977 — 1978
Cosmotology, Cosmotologist
Quinsigamond Community Collage
Accounting
Southbridge High
GED
FCHP August 2007 - Present
Gentiva Health Services March 2005 - June 2007
apple Valley Nursing home January 2000 - July 2005
Skills
Healthcare, Hospitals, Nursing, Healthcare Management, Clinical Research, Healthcare Information..., BLS, EMR, Patient Safety, Critical Care, ACLS, Inpatient, Medicine, Pediatrics, Cpr Certified, Public Health, Treatment, HIPAA, Acute Care, Medical Terminology
Education
Mount Wachusett Community College
Associate's degree, Registered Nursing/Registered Nurse
University of Massachusetts, Amherst
Bachelor of Science (BS), Registered Nursing/Registered Nurse