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Work Background
MSS Consulting LLC (Healthcare)Founder & Principal | Healthcare Consulting
Jan. 2021Chicago, Illinois, United StatesFractional CFO and strategic advisor with operator experience supporting provider-sponsored health plans, behavioral health systems, and value-based healthcare organizations. Deliver financial leadership during executive transitions, M&A integration, regulatory change, and performance turnarounds. Current Projects:
✅Providing healthcare financial consulting services including value-based solutions, risk arrangements, Medicare risk adjustment, Medicare bid process and cost management to a risk-bearing physician entity
✅Serving as a financial strategic advisor to a health tech, pre-seed start-up
✅Serving as a pre-seed CFO for a health tech/SaaS company working in the concierge medicine and diabetes space Other Selected Client Engagements:
✅Chief Financial Officer (Limited-Duration Engagement) — Confidential Health Plan | 2023-2024
- Led finance, risk adjustment, and product teams for $250M Medicare Advantage plan.
- Implemented zero-based budgeting and renegotiated provider risk contracts.
- Delivered $720K in operational savings via analytics and AI-driven tech enhancements. ✅Interim CFO — Mind Springs Health / West Springs Hospital
Remote / Grand Junction, CO | 2023
- Managed finance and revenue cycle for $60M behavioral health network.
- Delivered $3M in cost improvements and improved A/R collections by 14.6%.
- Secured $2.7M in long-term financing to stabilize operations. ✅Interim Market Finance Lead — Resources Global Professionals (RGP)
Remote / Portland, OR | 2021–2022
- Supported integration of MA/MSSP lives post-acquisition.
- Built financial models to assess clinic productivity and identify M&A opportunities.
- Transitioned 15,000+ members to a risk-based payment model. https://www.mssconsulting.org/
NextLevel HealthChief Financial Officer
Jan. 2019 - Dec. 2020Greater Chicago AreaManaged Accounting, FP&A, Informatics, Actuary with 3 direct reports and 10 indirect reports
• Directed risk adjustment strategy by targeting missing HCCs and improving PCP utilization
• Worked with private equity and investment bankers for outside financing opportunities
• Managed 10 Value Based programs rewarding physician groups for quality and financial/utilization performance
Select Transaction Experience:
• $6.8MM premium improvement: demonstrated administrative and risk adjustment inadequacies to State agencies
• $3.3MM medical expense savings: implemented claims audit program for inpatient (DRG) services My role at NextLevel Health concluded following the company’s acquisition (asset sale). I was proud to help lead financial strategy and regulatory compliance during a critical transition period.
Health Plan of San Mateo (HPSM)Chief Financial Officer
Jan. 2017 - Dec. 2018San Francisco Bay AreaManaged Claims, Accounting (payroll, 401K, A/P, G/L), FP&A, Facilities, and Contract Admin departments with 5 direct reports and 60 indirect reports. P&L responsibilities for 140,000 members (~$1 billion)
• Developed policies and procedures to strengthen financial audits
• Created 3-year financial plans based on new product offerings • Created cross functional Cost Committee to identify opportunities for financial and operational improvements Selected Transaction Experience:
• $16.5 MM Health Homes “go/no-go” evaluation – Responsibilities included creation of a three-year model for complex membership care, estimating provider capitation rates, and initial cash outlays • $4 MM Contract Audit – Responsibilities included identifying outlier trends in provider contracting rates, and system configuration versus prior years events. Revamped specialist enhanced fee schedule • $15 MM Evaluation of Care Management Program - Responsibilities included scenario projections, running sensitivity analysis to show changes in risk adjustment, utilization and direct/indirect overhead to gauge break-even point and short-term investment needs
AetnaSr. Director/Chief Financial Officer (Illinois Medicaid Duals)
Jan. 2015 - Dec. 2016Greater Chicago Area• Managed P&L of $1.5 billion in annual revenue (180,000 members) • Prepared monthly close presentations for senior leadership on a monthly/quarterly/annual basis • Led financial rate setting activities and in coordination with corporate and State actuaries
• Engaged five medical groups in Value Based Solutions (VBS) risk arrangements to improve quality metrics and utilization management Selected Transaction Experience:
• $60 MM EBITDA turnaround plan – Responsibilities included identifying operational and financial opportunities, appointing business owners to implement tactics and measure results against expectations. Initiatives included member retention, fee schedule configuration issues, reduction in readmissions and ER admissions, and identifying inpatient short-stays
• $45 MM cost accounting reallocation – Responsibilities included reallocation of 500 FTEs into product P&Ls based on variable and fixed costing methodologies
Molina HealthcareVP Finance and Analytics
Jan. 2013 - Dec. 2015Greater Chicago Area• Managed health plan functional departments including Reporting and Analysis, Project Management, Risk Adjustment and Facilities • Provided local plan support for provider report card/performance monitoring activities with regard to quality, pay for performance (P4P) and medical costs
• Managed relationship with state department of insurance and other regulators for all financial matters
• Represented the finance function by participating on committees, task forces, work groups, and multidisciplinary teams
• Led cross-functional medical cost trend committee
HumanaRegional Finance Director (GA/NC/SC)
Jan. 2009 - Dec. 2013Atlanta, GA• Managed P&L statements of $2 billion for both medical and administrative expenses • Directed the preparation, analytics and strategy for the annual Medicare bid sessions and five-year projection models
• Coached and mentored three financial analysts
• Lead cost and utilization analysis through weekly financial trend meetings to identify areas of cost savings
• Managed capitation and various financial risk arrangements for engaged provider groups
• Provided reporting metrics and opportunities for revenue improvement for Medical Service Organizations (MSOs) and other risk providers
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