Kyle Lee
Springfield
Summary
Experienced Healthcare Finance Executive with over 30 years in reimbursement strategy and net revenue optimization within complex health systems. Delivered significant operational improvements and enhanced government reimbursement. Former Interim CEO with expertise in executive communication and operational leadership, advising on regulatory strategy and financial performance.
Overview
36
36
years of professional experience
Work History
Principal
MedTrack, Inc
Springfield
01.2008 - Current
- Provide strategic consultation on net revenue strategy, reimbursement optimization and regulatory positioning
- Review Medicare Bad Debt filings, identifying education, workflow and compliance opportunities
- Analyze provider-based Rural Health Clinics to optimize All-Inclusive Rate payment limits
- Compile and analyze Medicare DSH and S10 data
- Compile and analyze State Directed Payments for various programs
- Analyze service lines for strategic opportunities including market analyses, payor contract implications and pricing optimization
- Negotiate significant payors’ contractual agreements
- Lead cost report strategy, reopenings and regulatory positioning for complex health systems
- Improve ER Standby reimbursement
- Identify provider-based opportunities of clinical operations for PPS and CAH clients
- Evaluate physician practice structures in relation to revenue opportunities
- Review contractual models to assure accurate allowance calculations
- Presented strategic recommendations to Board members, senior management, and physicians on regulatory changes and mitigation plans
- Healthcare reimbursement and revenue consulting firm advising hospitals and health systems on operational strategies, productivity analysis, ER Physician tracking, revenue recognition analyses, cost analyses and healthcare compliance
Interim CEO
Stonewall Memorial Hospital District
Aspermont
01.2021 - 01.2022
- Improved financial performance of system by $1M in one year
- Analyzed service lines and improved through put, financial performance and patient satisfaction
- Analyzed payors’ contractual arrangements and negotiated contracts increasing reimbursement by an estimated $625k over a period of five years
- Recruited physicians and practitioners and modified physician compensation plans
- Navigated the strategic plan for the hospital, clinics and nursing home through the Public Health Emergency by developing and implementing strategies to appropriately guide efforts during the global healthcare crisis
- Rolled out the CMS Covid-19 vaccine mandate without losing any employees
- Oversaw management of Rural Health Clinics with emphasis on productivity and management within all inclusive rate payments
- Pursued grant opportunities which improved cash flow by $690K
- Developed and implemented system-wide Key Performance Indicators improving Board level visibility into financial and operational performance
- Worked with executive leadership team to conduct a Community Health Needs Assessment (CHNA) which identified the healthcare needs and concerns of the community
- Hospital District comprised of inpatient/outpatient Critical Access Hospital, three Rural Health Clinics and a Nursing Home
Regional director of Reimbursement
mercy / St. John’s Health system
Springfield
01.2004 - 01.2008
- Rebuilt in-house Reimbursement function, created Managed Care Finance division, oversaw payment assurance and contract performance analyses
- Evaluated and negotiated payors’ contractual arrangements, quantified financial impact and payor performance for all contractual negotiations
- Analyze service lines for strategic opportunities
- Oversaw all aspects of Charge Description Master and directed charge capture and reconciliation opportunities with clinical departments
- Served on various system committees including Compliance, Legislative and clinical service lines including Cardiology, Supply Chain, Seniors and Women & Children
- Managed Medicare profitability plan to stabilize and increase Medicare payments
- Identified opportunities and led initiatives for seven newly certified Critical Access Hospitals (CAH) which increased reimbursement $2.9M annually
- Directed analyses of provider based compliance and opportunities identifying $1.0M in potential reimbursement
- Managed identification, analyses and implementation of Rural Health Clinics
- Analyzed operations of inpatient Psychiatric unit and suggested changes which increased reimbursement by $1.2M
- Large fully integrated health system includes eleven urban and rural hospitals with DSH, distinct part units, Skilled Nursing Facilities, Critical Access Hospitals, approximately 28 Rural Health Clinics, Nursing Facility, home office reports, large physician practices and related insurance plan
Division director, Reimbursement
Norton Healthcare
Louisville
01.2001 - 01.2004
- Largest fully integrated system in Kentucky with annual net revenue of $850M; includes five urban and two rural hospitals of varying size and complexity, teaching programs, distinct part units, SNFs, rural health clinics, large physician practices and a home office.
director of Reimbursement
Hillcrest HealthCare system
Tulsa
01.1998 - 01.2001
- Largest fully integrated system in eastern Oklahoma; includes 14 urban and rural hospitals of varying size and complexity, teaching programs, Long Term Acute Care Hospital, organ acquisition programs, distinct part units, large physician practices and a home office.
Reimbursement Analyst, manager of governmental planning and reporting, director of reimbursement
Texas Health Resources
Dallas
01.1994 - 01.1998
- Fully integrated system included 14 hospitals resulting from the merger of Presbyterian Healthcare System and Harris Methodist Health Systems, providers included large, complex, teaching hospitals with PPS excluded units, a home office and smaller hospitals with rural health clinics.
senior auditor
Blue Cross and Blue Shield of Texas
Dallas
01.1990 - 01.1994
- Contracted by CMS as the fiscal intermediary / Medicare Administrative Contractor to audit hospitals for cost report compliance.
Education
master of health administration -
webster university
st. louis, mo04-2026
bachelor of business administration - accounting and business administration
eastern new mexico university
portales, nm12-1989
Skills
- Financial analysis
- Strategic planning
- Healthcare compliance
- Healthcare finance
- Revenue optimization
- Contract negotiation
- Data analytics
Affiliations
- Healthcare Financial Administration (HFMA)
- American Health Lawyers Association
- American College of Healthcare Executives (ACHE)
- Texas Association of Healthcare Financial Administration
- Texas Organization of Rural & Community Hospitals
Community Service
- Big Brothers & Sisters Past Board of Directors
- Eastern New Mexico University Foundation Board of Directors, Alumni Board of Directors
- Missouri State University Fraternity Sorority Life Advisor
Timeline
Interim CEO
Stonewall Memorial Hospital District
01.2021 - 01.2022
Principal
MedTrack, Inc
01.2008 - Current
Regional director of Reimbursement
mercy / St. John’s Health system
01.2004 - 01.2008
Division director, Reimbursement
Norton Healthcare
01.2001 - 01.2004
director of Reimbursement
Hillcrest HealthCare system
01.1998 - 01.2001
Reimbursement Analyst, manager of governmental planning and reporting, director of reimbursement
Texas Health Resources
01.1994 - 01.1998
senior auditor
Blue Cross and Blue Shield of Texas
01.1990 - 01.1994
master of health administration -
webster university
bachelor of business administration - accounting and business administration
eastern new mexico university