Kristina Green - Leadership Development Consultant & Trainer, Cardigan Careers

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Work Background

Cardigan Careers, LLCPrincipal Leadership Development Consultant

Oct. 2022Los Angeles Metropolitan Area

Kristina M Green, LLCCareer Strategist Coach & Founder

Oct. 2022United States

HCIT ConsultingExecutive VP, Client Services Delivery

Oct. 2022United States• One of two leaders reporting to the Chief Executive Officer charged with overseeing the seamless execution of client relations and project execution. • Implemented foundational best practices, tools, and organizational frameworks for process and project management for adoption and delivery of contracted scope of services. • Provided strategic thought leadership with the CEO for operational strategy, business development, and scalability. • Contracted as a project management consultant for overseeing the IT implementation of a Care Management system solution for a national nephrology healthcare start-up. • Aided in the timely submission of a multi-million-dollar Request For Proposals (RFP) for a national nephrology healthcare start-up. • Oversaw a $1M project budget for a case management department implementation for a health system with 2,000+ employees and 9-figure annual revenue.

L.A. Care Health PlanDirector, Commercial & Group Product Management (Promoted)

Apr. 2020 - Oct. 2022Los Angeles Metropolitan Area• One of two leaders reporting to the Executive Director of Commercial & Group Products facilitating the annual Quality Health Plan (QHP) re-contracting to maintain the Commercial On-Exchange lines of business. • Oversaw a team of 5 specialists to facilitate the annual application process to maintain the 8-figure annual revenue generated from On-Exchange membership. • Facilitated successful annual QHP re-contracting within 12 months of transitioning into the role. • Implemented a re-contracting project strategy to balance a team of 5 resources and optimize efficiencies and results contributing to a number one price position on the California Exchange, two years in a row.

L.A. Care Health PlanExecutive Advisor, Enterprise Business Architecture

Apr. 2018 - Apr. 2020Greater Los Angeles Area• One of ten direct reports to the Chief Operating Officer to advise on enterprise business priorities and implement global enterprise architecture capabilities to balance and reprioritize the IT portfolio projects. • Certified Enterprise Architect (TOGAF) with 4+ years of experience in adopting and implementing business architecture methodologies for evaluating and reprioritizing business and IT-related enterprise portfolio projects for a local health plan with an 11-figure annual revenue. • Annually evaluated and restructured 3-4 dozen enterprise priority programs to align with organizational strategic goals and multi-year, 9-figure IT implementation budget. • Laid the foundation for business architecture capability within the organization to aid in the portfolio management and prioritization of a 9-figure IT budget for enhancement projects. • Facilitate the adoption of business architecture methodologies for all future business and IT-related projects. • Collaborated with senior leaders, representing 12 critical enterprise teams, on developing and prioritizing a multi-year enterprise-wide roadmap.

Conifer Health SolutionsManager, Quality Programs

Jan. 2017 - Mar. 2018Encino• One of five direct reports to the Chief Operating Officer tasked with developing and overseeing client implementation of quality programs to improve patient care and quality outcomes. • Facilitated and achieved honorable recognition by America’s Physician Groups (APG) for all 7 Independent Physician Associations (IPA) groups submitted for such distinction leading to further awards and recognition within the healthcare industry. • Spearheaded and acquired $250,000 grant funding for 5 contracted physician groups to aid in a network-wide encounter submission improvement project. • Developed the strategy for allocating and implementing encounter improvement programs across 5 client physician groups to aid in the improved outcomes in quality of patient care. • Developed the client implementation strategy for improving patient care reimbursement models for 2 client physician groups.

HealthCare PartnersManager, Reg HCC Programs / Regional Project Manager

May. 2010 - Jan. 2017Chatsworth, CA• One of three direct reports to the Regional Vice President, tasked with developing and implementing the regional risk adjustment strategy. • Developed and facilitated the strategy and implementation plan for leveraging a team of 10 to optimize regional field operations that increased revenue reimbursement by 30% in 12 months. • Provided thought leadership to regional colleagues for implementation strategies to improve patient care and accurate reimbursement. • Developed and implemented physician compliance and education programs to manage regional membership. • Oversaw a 9-figure department budget for managing regional program initiatives.

WellPoint, IncProject Manager

Feb. 2002 - Dec. 2009Woodland Hills, CA• Led the ongoing accreditation cycle to maintain and pursue accreditation with National Committee for Quality Assurance (NCQA) and Utilization Review Accreditation Commission (URAC), as follows: o Led national cross-functional teams in preparation for accreditation audits. o Developed and maintained accreditation strategy. o Drafted the gap analysis for all program documentation and organizational operating procedures for alignment with accreditation standards. o Implemented an oversight committee and work group structures to support alignment with accreditation standards. o Implemented legal and compliance review cycle. o Developed and trained staff (200+) nationwide on NCQA & URAC accreditation standards and audit preparations. o Developed and maintained the execution and archival strategy of program documentation. • Representative for all Quality accreditation presentations and inquiries. • Chaired the WellPoint (URAC) Case Management & Health Call Center Work Group and Leadership teams. • Oversight of regulatory program compliance activities, as follows: o Identified high litigation risk patient cases and business practices and work with legal to proactively address gaps in program delivery o Reviewed Federal and State Regulatory Alerts against company policies and protocols to ensure compliance. o Developed and implement strategies for updating staff and program-related materials to maintain company compliance with regulations o Identified and implemented program changes necessary to ensure compliance with applicable P&Ps, accreditation standards and regulatory alerts Accomplishments / Results: • Achieved “Excellent Accreditation” National Committee for Quality Assurance (NCQA) ratings for Disease Management and Nurse Advice Line for all five-subsidiary national “Blue Cross Blue Shield” plans • Achieved “Full Accreditation” (URAC) for Case Management and Health Call Center programs for subsidiary Health Management Corporation.