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Work Background
WaystarFinancial Planning Analyst - Technical Services
Apr. 2024 - Jun. 2024Louisville, Kentucky, United States
VillageMDSenior Financial Analytics Analyst
Nov. 2022 - Dec. 2023■ Coordinate monthly payer-reporting for revenue, claims expense, capitated expense, and member months from many differentiated sources including: Anthem, Aetna, Blue Cross, Cigna, Devoted, Humana, United, Wellcare, and CMS
■ Manage more than $1 billion in annual revenue for Global Capitated, full-risk and Gainshare contracts to make sure our reporting and the payer's reporting is accurately reflected
■ Evaluate final settlement payments for accuracy between VillageMD and the different contracted insurance payers
■ Lead special projects such as evaluating Supplemental and Ancillary Capitated expenses to manage what we are paying for those services and utilized Snowflake SQL to create detailed, market-level reporting
FranServe, Inc.Sr. Finance Consultant (Finance & Operations)
Dec. 2020 - Nov. 2022Jeffersonville, Indiana, United StatesDetermine best investment options and strategies for clients by monitoring client data as well as future financial estimates. Establish financial reports and explain the significance of numbers to customers for seamless work flow. Provide exceptional assistance to individuals throughout United States by detecting franchise opportunities consistent with professional and financial objectives. Facilitate the funding of prospective franchisees' business operations by a variety of lenders. Meet unanticipated changes in financial conditions by sustaining positive ties with current customers and modifying advice and techniques. ■ Ensured continuous operational excellence by meeting overall regulatory requirements as well as keeping abreast on newest financial products and regulatory developments.
■ Enhanced organizational excellence by providing advice to customers based on circumstances, risk tolerance, and anticipated amount of future investment development.
HumanaSenior Market Finance Professional
Jan. 2018 - Jan. 2019■ Leveraged extensive financial expertise to steer all aspects of financial operations for the PA Medicare market
■ Orchestrated finances for approximately 30 provider groups comprised of risk and upside-only arrangements
■ Delivered finance-related data for quarterly Joint Operating Committee meetings with PA provider groups
■ Collaborated with seven Humana provider executives while also directing $100M+ in revenue and expenditures
AnthemFinancial Consultant Manager
Jan. 2014 - Jan. 2018■ Played a pivotal role in recouping $19M in savings by developing and utilizing Cost-of-Care initiatives
■ Secured $7M in payments from 50 separate hospitals by implementing an outpatient cost settlement process
■ Instituted reporting measures for inpatient, outpatient, physician, and pharmacy services paid for by Anthem
■ Completed vital projects that examined and accurately identified new methods for reducing medical expenses
■ Strove to boost capitated revenue and strengthen profitable operations according to state and plan guidelines
CoventryCares of KentuckySenior Financial Analyst
Jan. 2012 - Jan. 2013■ Handled the reconciliation and reporting of approximately $105M in monthly Medicaid revenue
■ Ensured that the revenue from Commonwealth of Kentucky for 267K members was accurately reported
■ Maximized the efficiency of the monthly revenue reporting process after migrating systems over to MS Access
■ Interfaced with 60 hospitals throughout Commonwealth of Kentucky to meet all contractual requirements
■ Brought in $5M in net dues by accurately calculating outpatient settlements and collecting the necessary dues
American Commercial LinesMarketing Manager
Jan. 2010 - Jan. 2010■ Immediately began adding value by negotiating the company’s most-lucrative one-time spot movement of coal
■ Generated $750K+ in revenue while working proactively with VP of Sales & Marketing, CFO, COO, and CEO
HumanaFinance Consultant
Jan. 2008 - Jan. 2012(Held this position from 2008 to 2010 and again from 2011 to 2012)
■ Recruited back to the company in 2011 for delivering major revenue improvements over the previous two years
■ Attentively tracked and accurately reported $77M in revenue improvements between 2009 and 2010
■ Participated on a special project team that analyzed the financial benefits of electronic medical records
■ Utilized an analytical mindset while serving on the special project team to generate $800K in extra revenue
■ Partnered with the internal team to expertly resolve claims issues, thereby creating $47M in additional revenue
■ Analyzed $1.5B in monthly Medicare and Medicaid payments while managing a $15M operating budget
UPSLong-Range Air Hub Planning Manager
Jan. 1988 - Jan. 2006■ Owned the P&L for $115M in operations, gaining a broad range of finance, accounting, and planning expertise
■ Made informed recommendations that enabled the approval of a $1.4B capital expenditure for the company
■ Earned recognition as a skilled finance professional, receiving a handpicked spot on the Special Project Team
■ Evaluated the operations of a Worldport air hub, and other UPS regional air hubs, to identify improvements
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