Director, Healthcare Transformation
A highly effective healthcare manager with more than 25 years of experience working with providers and insurers, Michael Grodus, director of healthcare transformation at Medical Advantage, provides management services and performance improvement guidance for its client, Professional Medical Corporation. Under Mr. Grodus’s leadership, Professional Medical Corporation has earned tens of millions in value-based reimbursement for providers and the ACO is among the top in the nation for quality and cost savings. An expert in provider network development, reimbursement methods and contracting, as well as financial administration of physician organizations, hospitals and managed care entities, Mr. Grodus skillfully guides physician organizations toward more cost-effective care and reimbursement strategies that lead to value-based healthcare delivery.
Prior to joining Medical Advantage, he was vice president of healthcare network strategy for the Capital District Physician Health Plan in Albany, New York, where he was responsible for provider network strategy and development, service area expansion, reimbursement and cost savings, as well as negotiating and contracting with a provider network of more than 70 hospitals, 14,000 physicians and ancillary providers. Mr. Grodus has also served as director of network development and contracting for Priority Health and previously held a similar position with M-Care. He also was controller and subsequently chief financial officer of Oakland Physician Network Services, where he established and maintained the financial services department. He also held management positions at the Detroit Medical Center for seven years, serving as director of finance for Children’s Hospital of Michigan and as manager of finance for DMC Coordinated Health Care, the DMC’s managed care contracting entity, and three affiliated independent physician associations.
Mr. Grodus received a bachelor of science degree in administration from the University of Michigan-Dearborn and a master’s in business administration from Wayne State University.