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Richard Swift

Interim Chief Financial Officer

richard swift headshotSwift is the president of Medwise Partners, a company he founded in 1996. He has more than 30 years of health care experience working with health plans and providers throughout the country and has served for several years as the chief financial officer for a provider-owned health plan.

He has been involved in a broad range of financial and managed care projects including:

  • Numerous roles as interim CFO for multiple health care companies throughout the US. Companies ranged from having 20 to more than 200,000 members across a broad spectrum of for profit and nonprofit companies involved in commercial, Medicare and Medicaid products.
  • Played a key financial role in a health plan’s sale to a large national carrier.
  • Served as CEO for a provider-sponsored health plan as it a surrendered its insurance license.
  • Developed PPO and HMO products and networks for major health insurance companies.
  • Served as interim financial manager during a managed care turnaround initiative, with direct responsibility for underwriting, financial reporting, medical economics and billing and enrollment.
  • Served as interim underwriting director for a large regional HMO.
  • Managed and outsourced underwriting for numerous health plan clients.
  • Responsible for product development, analysis and pricing for Medicare + choice and Medicare demonstration products.
  • Managed regional underwriting for a large insurer.
  • Managed care operations in numerous markets including New York, New Jersey, Illinois, District of Columbia, Missouri, Louisiana and North Carolina.
  • Negotiated managed care contracts with hospitals, physicians and other health care providers.
  • Provided analysis of reinsurance options for numerous independent practice associations and capitated hospitals.
  • Developed and implemented reimbursement programs using resource-based relative value scale, capitation (including contact capitation), diagnosis related groups and a variety of risk-sharing programs.
  • Reviewed provider’s contracts with managed care companies to identify payment discrepancies and lost revenues.
  • Developed a number of risk-sharing arrangements that were used between a major medical school and regional health plan.
  • Developed medical expense monitoring programs for numerous health plans and insurers to identify and manage their medical cost structure and expense trends.
  • Managed the underwriting and risk assessment process for several local and national health plans.
  • Developed monitoring and incentive plans for a managed Medicaid plan.

Before becoming a consultant, Swift was the CFO at several provider-owned HMOs and was the regional CFO for a national managed care company. Prior to that, he was responsible for the development and negotiation of managed care reimbursement programs in several markets.

Swift received a bachelor’s degree from Mercer University and an MBA in health care administration from the University of Miami in Florida.

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