Ryan Paul is an accomplished leader experienced in federally qualified health center (FQHC)/rural health clinic (RHC) contracting, value-based contract management, negotiations, regulatory compliance, vendor relationships, request for proposal (RFP) development, strategic planning, project management, process improvements, financial modeling, and budgeting. From structure and strategy to operations, he helps organizations improve their profitability and performance.
Prior to joining HMA, Ryan was director of provider contracting and servicing at Highmark Wholecare (formerly Gateway Health Plan). In this role, he created value for the organization by contracting with health system, hospital, and FQHC/RHC providers to control costs, improve quality, secure appropriate access to services, and create a better member experience. He set and executed Medicaid and Medicare contracting strategies to achieve and maintain a competitive position for the organization’s products. He was responsible for integrating provider contracting strategies with clinical management, marketing/advertising, product development, and consumerism strategies and created innovative reimbursement models to meet strategic goals.
During his tenure at HM Health Solutions (now enGen), he served as a senior consultant for Medicare – Clinical & Government Programs. In this role, Ryan excelled at establishing processes and utilizing technology to support large-scale, complex customer engagements. He collaborated closely with the product, infrastructure, and security teams to configure solutions that delivered significant value to clients. As a delivery lead for a portfolio of client enterprise transformational product offerings, he designed and owned project artifacts to ensure timely milestones, high-quality deliverables, and adherence to budgetary constraints. He also provided invaluable leadership to engagement work streams and nurtured the professional development of early career professionals.
Ryan was a senior project manager in the Division of Financial Analysis at the Pennsylvania Department of Human Services, Medicaid Bureau of Fiscal Management. He led development of a project management office and oversaw a team negotiating rate reconciliations with healthcare centers. He also ensured compliance with a state-wide hospital assessment program and collaborated on legal appeal cases. His expertise and leadership contributed to the success of various cross-functional projects within the bureau.
Ryan Paul has a Master of Business Administration with a concentration in health care administration from Saint Francis University and a Bachelor of Science in psychology with a health science concentration from Pennsylvania State University.
In his free time, Ryan likes to run, read, and engage in outdoor activities including fishing and hiking.