HealthCare Coverage Policy, Implementation & Analytics Insights
Saint Petersburg, Florida
CIGNA Healthcare
National Medical Director for Coverage Policy
WAH Florida, Main Office in CT
JBKessel Consultation Services
Consultant
Tampa/St. Petersburg, Florida Area
CIGNA Healthcare
Director of Operations for Behavioral Health Gievances and Post Service Clinical Review
January 2009 to May 2011
WAH: team of 26 in multiple sites across the country
Magellan Health Services
Medical Director & VP Clinical Services
2000 to 2005
CIGNA Healthcare
Lead Medical Director and National Medical Director of Outpatient Behavioral Health
2005 to 2009
Tampa/St. Petersburg, Florida Area
Magellan Behavioral Health
Vice President Medical Services, Eastern Pennsylvania
May 1996 to November 2004
Greater Philadelphia Area
Oversee development of medical, prevention, pharmacy and reimbursement policy for Cigna Healthcare, as well as clinical coding; ensure implemenation of coverage policy; oversee identifiecation of codes on prior authorization. Team of 32 across the United States. Interface with Product, Sales, Service and Clinical Operations, PBM, Finance Oversee development of medical, prevention, pharmacy and reimbursement policy for Cigna Healthcare, as well as clinical coding; ensure implemenation of coverage policy; oversee identifiecation of codes on prior authorization. Team of 32 across the United States. Interface with Product, Sales, Service and Clinical Operations, PBM, Finance
📖 Summary
National Medical Director for Coverage Policy @ CIGNA Healthcare Oversee development of medical, prevention, pharmacy and reimbursement policy for Cigna Healthcare, as well as clinical coding; ensure implemenation of coverage policy; oversee identifiecation of codes on prior authorization. Team of 32 across the United States. Interface with Product, Sales, Service and Clinical Operations, PBM, Finance WAH Florida, Main Office in CTConsultant @ JBKessel Consultation Services Forensic consultative services. Specialty in capital offenses. Past work in civil and other forensic services. Work in pharm industry in program development. Tampa/St. Petersburg, Florida AreaDirector of Operations for Behavioral Health Gievances and Post Service Clinical Review @ CIGNA Healthcare Oversee behavioral health denial, grievance and post service review program. Team of 26. Cigna Behavioral Health Outpatient Medical Director From January 2009 to May 2011 (2 years 5 months) WAH: team of 26 in multiple sites across the countryMedical Director & VP Clinical Services @ Magellan Health Services VP Clinical Services and Medical Director. Eastern Pennsylvania Region. Commercial Business. 3.2 M covered lives. Responsible for team of 12 FTE MDs, 87 clinical and non clinical staff. Liaison to Health Plan. Chair of Quality, Medical lead for two successful NCQA BH accreditations. From 2000 to 2005 (5 years) Lead Medical Director and National Medical Director of Outpatient Behavioral Health @ CIGNA Healthcare Manage UM in CBH Eastern Region (Chesapeake and Tampa sites, 4 MDs). Responsible for UM, Quality across sites. From 2007 through 2009, assumed role fo Medical Director for National Outpatient and Case mnagement Programs for Cigna Behavioral Health. During those years, also served as Medical resource to Program Development team, workign on CM, LMP, UM and QIA programs. earned Green Belt Certificatio in Six Sigma. From 2005 to 2009 (4 years) Tampa/St. Petersburg, Florida AreaVice President Medical Services, Eastern Pennsylvania @ Magellan Behavioral Health VP Medical Services Magellan behavioral Health, Led behavioral health clinical organization managing the behavioral health program for multiple commercial employers, 3.2 million members, across three Northeastern states. Responsibilities include UM, QI, Clinical content oversight and budget management, New Tech, BH P&T input, and Health plan medical liaison functions. Oversaw team of 92 clinicians: medical doctors, nurses, social workers, and support staff From May 1996 to November 2004 (8 years 7 months) Greater Philadelphia Area
What company does Julie Kessel work for?
Julie Kessel works for CIGNA Healthcare
What is Julie Kessel's role at CIGNA Healthcare?
Julie Kessel is National Medical Director for Coverage Policy
What industry does Julie Kessel work in?
Julie Kessel works in the Hospital & Health Care industry.
Who are Julie Kessel's colleagues?
Julie Kessel's colleagues are Ashley Sheble, Erynn Szewczyk, Jennifer PMP, Daniel Tavelli, Maria D'Addario, John Mattern, Patrina (Kelly) Dixon, Carrie Larson, Sid Priya, and Matt Ferguson
Extraversion (E), Intuition (N), Feeling (F), Judging (J)
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