Richard Flores was placed as the director of managed care contracting for UNITE HERE HEALTH, a mission-driven Taft-Hartley Trust Fund. The Fund's health plan serves more than 220,000 union workers and their families in the hospitality, food service, and gaming industries through national, multi-state benefit plans. In this role, Rich works with senior leadership and regional directors of healthcare delivery to develop strategic planning efforts for benefit plan design and performance. He oversees the team responsible for day-to-day contractual relationships with vendors and providers, and has oversight of the service provider resolution process of the Fund. Rich also serves as a contract subject matter expert, translating performance analyses into policy and benefits recommendations.
Rich comes to UNITE HERE HEALTH from WellCare Health Plans in Chicago, where he served as the vice president of field network management. With oversight of the provider network function for a four-state region – including network contracting, credentialing, provider relations, and provider operations – Rich delivered on the development of a high-quality, high-performance provider network to improve the efficiency and quality of the organization's cost structure through innovative value-based purchasing strategies and care management approaches, contributing to the sustainable, profitable growth of the health plan.
Previously, Rich served as the vice president of network development and contracting for Centene's IlliniCare Health plan; as the chief operating officer of UnitedHealthcare's Mississippi Health Plan and as the vice president of marketing and business development for Global Home Health in Chicago. Additionally he served as a regional vice president with Multiplan's Private Healthcare Systems, Inc. and as the vice president of network development for UNICARE Health Plans of the Midwest. Earlier in his career, Rich served in site leadership managed care roles for two Chicago-area hospitals, and spent 21 years as a network development manager for BCBS's HMO Illinois.
Rich is originally from Chicago, and holds a bachelor's degree in business administration and a master's degree in healthcare administration from DePaul University.
QLK's Patti Hall, Managing Partner of the Life Sciences Practice led the search.