United Rheumatology is excited to announce two recent additions to its executive leadership team. Douglas Tardio has been an advisor and UR board member for over 4 years. Doug has helped shape many of the UR assets including the Guidelines and the Medical Policy Committee (MPC). He has an expansive career working for and with health plans. Most importantly, for more than 12 years Doug was the President, COO and then CEO of CareCore National. UR CEO Jon Glaudemans served on the Board of Directors of CareCore.
Doug grew this company from a regional radiology benefit management company in New York to the largest specialty benefit management company in the country. By 2014, CareCore was utilized by over 34 different health insurance companies including: UnitedHealthcare, Aetna, Cigna and many of the Blue Cross Plans covering over 50 million members across Commercial, Medicare Advantage and Managed Medicaid plans. Their program offerings expanded from Radiology to Cardiology, Radiation Therapy, Oncology, Musculoskeletal, Obstructive Sleep Apnea, Laboratory, and Post-Acute Care. At the time of investment by global growth equity firm, General Atlantic, the organization handled over 40,000 clinical reviews per day and managed capitated risk arrangements for over 6 million health plan members. There is no doubt Doug is incredibly well suited to help position UR as a strategic partner with health plans across the country. Doug will take on the roles of President, and Chief Strategy Officer.
Along the dramatic growth curve of Doug’s former organization, he had the opportunity to meet and secure the engagement of William Moore as the Chief Technology Officer for CareCore National. Bill or “WAM” as we know him, has an incredible background in information technology dating back to a first to market technology company founded while still in college. Along his career WAM has built a vast array of technology platforms from telecom in Central America, to the core ATM backbone for AT&T’s internet traffic.
While at CareCore, WAM was responsible for the development of the organization’s case management engine that collected and reported on over 8 billion pieces of healthcare data annually. Additionally, WAM filled the critical role of interfacing with each customer’s health plan’s technology department, coordinating the movement of millions of member’s eligibility data through claims payment while supporting technology systems handling 20,000 phone calls per day. William will take on the role of Chief Technology Officer at UR.
Both Doug and WAM had the opportunity to work with Shelley Weiner, MD at CareCore. Shelley has been invaluable to the organization as a consultant to the Medical Policy Committee, advising the group on the drafting of our copyrighted Pathways. Shelley was previously the Chief Medical Officer at CareCore.
Our goal at United Rheumatology has been to build it to a size and scale to enable us to engage with health plan payers collaboratively. We wanted to be able to replace individual practice frustration with FFS reimbursement with a strategic UR dialog around the total cost of care. Not surprisingly, this has been neither quick nor easy. We are thrilled that we have been able to assemble a leadership team with depth and the experience necessary to build the first of many United Rheumatology Care Management programs.