Robert J. Dondes
Consultant

Bob Dondes’ managed care experience has included positions with multiple health plans – both publicly-traded and academic medical center-owned -- in Washington, D.C., Maryland, New York, Maine, Ohio, Kentucky, Tennessee and Arkansas. These include:

• HealthWise of America (a United Healthcare corporation), where he held three concurrent executive leadership roles:
  • Vice President - where he had line responsibility for all operations in support of its five HMOs and oversight of 270 FTEs and a $30 million cost center;
  • CEO of Potomac Medical Services Corporation, a $50 million HealthWise subsidiary responsible for strategic business development and management consulting; and
  • COO of Chesapeake Health Plan, an 80,000 member HMO providing services to commercial, Medicare, and Medicaid members in the greater Maryland, Northern Virginia region;
• CEO of Toledo Health Plan, a 20,000 member HMO owned by the Medical College of Ohio and subsequently sold, under Bob’s leadership, to Promedica; and
• several management positions over a period of years at The Wellcare Management Group, involving the start-up of three HMOs and the ongoing operations of two others.

The Tompkins Group’s clients benefit from Bob’s experience in:

• developing, implementing, and managing the operations of managed care organizations, involving enrollment and eligibility management, claims processing, financial and clinical reporting, internal audit, provider and patient relations, and state and federal regulations compliance;
• interim management of organizations in both start-up and close-down / transition to new ownership modes, including obtaining HMO licenses, NCQA accreditation, and Certificate of Need development ;
• HMO product development, including point-of-service (POS), Medicare, and Medicaid risk products;
• evaluating, negotiating, and managing provider-HMO contracts: primary care and specialty capitation, global risk contracting, hospital case rates, DRGs, and other prospective payment terms;
• MCO information system implementation (AMISYS);
• HMO sales and marketing, particularly to FEHBP and State employee benefits programs.

Bob received his academic education from the graduate school of the State University of New York, the University of Michigan Medical School, and the University of Michigan.