Frank Stevens applies more than thirty-four years of senior leadership and operations experience to advise clients and counsel regarding financial and operational improvement, strategy, mergers and acquisitions, feasibility analysis, turnaround and insolvency matters, forensic investigations, regulatory compliance, labor and human resource issues, third-party administration, reinsurance, managed-care litigation, and workers compensation matters.
Mr. Stevens’ experience includes the turnaround of five financially troubled health maintenance organizations, development of a national preferred provider organization network serving three hundred payers/insurance/self-funded employers/managed-care clients in forty-one states, and introduction and implementation of managed-care networks and utilization management in the South African insurance environment.
Mr. Stevens is experienced in managed-care contracting, provider credentialing, reimbursement rate setting, claims processing and benefit administration, provider fraud and abuse detection, and provider profiling based on billing practices and quality outcomes. His experience also includes the areas of benefits development, utilization management, and quality assurance policy and procedures.
Mr. Stevens is an experienced operating executive, having performed the role of turnaround chief executive officer/chief risk officer for three companies. He has also coached several other boards of directors and management teams in the development and implementation of successful turnaround plans.
Mr. Stevens consults with hospitals and academic medical centers regarding financial, operational, compliance, and strategic issues including financial modeling of mergers and acquisitions and capital projects.
Mr. Stevens has served as a trustee for both commercial and personal trusts and conducted forensic investigations of trustees on behalf of clients. He has conducted investigations for trustees of fiduciaries and their actions and created trusts and installed trustees to administer trusts. He has been appointed conservator of two organizations, a responsible person in the bankruptcy court, and a monitor in a state regulatory action. He has also conducted investigations for state conservators and special examiners in the bankruptcy court.
Mr. Stevens has been retained by the California State attorney general to conduct investigations and provided advisory services to the Department of Justice regarding antitrust issues.
Mr. Stevens also consults with his life science clients regarding Foreign Corrupt Practices Act, eDiscovery, special investigations, litigation consulting, royalty-trademark-patent issues, and financial modeling of proposed business opportunities.
Education
Nova Southeastern University
MBA, 1983
Ohio University
BGS, 1974
Case Work
Health Plan Monitoring and Corrective Action Plans
State departments of insurance and departments of managed healthcare have retained BRG experts to serve as interim officers and monitors for financially troubled managed health plans.
Health Plan Medical Loss Ratios
Health plans and regulators have retained BRG experts on engagements that involved assessing health plans’ medical loss ratios (MLR; medical expenses divided by premium revenue).
Health Plan Bankruptcy Matters
Bankruptcy courts have appointed BRG experts as conservator, special monitor, and trustee for managed healthcare plans undergoing liquidation or reorganization.
