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Work Background
CareDeliversBusiness Development and Operations Lead
Jan. 2023New York City Metropolitan AreaUnder contract through NS2 Consulting Group, LLC, providing advisory services related to business and operations development for CareDelivers, a Public Benefit Company supporting the value-based clinical and financial success of safety-net healthcare practices
NS2 Consulting Group, LLCChief Executive Officer
Oct. 2018Phoenix, AZConsulting services for start-up organizations and physician practices/groups with focus on value based care improvement, payor contracting, go-to-market and target audience development. A client focused approach to value based care initiatives that blends clinical, financial and organizational impact. Collaboration and partnership are the keys...your goals and objectives coupled with NS2 insights.
Evolent HealthAssociate Director, Risk Adjustment
Apr. 2017 - Jun. 2018Phoenix, Arizona AreaDevelopment and deployed Medicare Advantage risk adjustment activities in a multi-payor, managed care environment affiliated with a large cross functional health system. Led vendor relationships, contract development, value-based initiatives and central staff/leadership.
CignaRegional Admin, Independent Practice Network Ops / Sr Project Specialist, Value-Based-Care Programs
Feb. 2013 - Apr. 2017Phoenix, Arizona AreaExecutive responsible for deployment of a Medicare Advantage Physician Engagement model with a primary focus on cost containment, resource/service support, practice data interpretation and value-based-care (VBC)services associated with select provider groups and networks. Established relationships with providers and groups to educate and orient them to a risk sharing model. Program involved over 500 primary care providers and 25K beneficiaries enrolled in two distinct Medicare Advantage plans. Develops targeted provider outreach plans that focus on clinical and financial metrics and indicators. Supports VBC project development and implementation in the commercial space for hospitals and specialty providers.
Arizona Priority CareAssociate Executive Director
Aug. 2012 - Feb. 2013Chandler AZOperational executive engaged for start-up efforts in a regional, Medicare Shared Savings Program accountable care organization. Areas of initial focus included, provider development and beneficiairy awareness programs. Primary interface with corporate support team and CMS on data and process problem resolution
OptumRegional Manager, Market Consultation - Network Programs
Mar. 2008 - Dec. 2012Phoenix, Arizona AreaResponsible for developing and deploying Medicare Risk Adjustment (RA) business and provider educational plans with a focus on initiative management, performance optimization, value-based-care and cost containment. Reviewed programs and projects for compliance with regulatory guidance and protocols. Developed and built on-going relationships with provider and management partners to anticipate / respond to changes in market conditions and to formulate effective business and clinical development strategies. Continually monitored trend levels, risks and opportunities to achieve established business and metric targets.
ConcentraNational Director, Strategic Accounts
Jan. 2006 - Dec. 2008Phoenix AZOversaw Federal Government accounts, built and maintained contract executive relationships. Identified and captured government business by leveraging existing contacts and contracts and by developing and implementing effective marketing and business development strategies. Served as a TRICARE and Veteran’s Administration liaison across internal business units. Developed network design strategies to maximize impact on core business areas. Utilized knowledge, skills, and experience to assist with contract acquisition, implementation, and compliance monitoring.
TRICARE Regional Office - WestChief Operating Officer
Jan. 2003 - Dec. 2006San Diego CAOperational executive tasked with integrated health plan development, implementation, business planning, and contract compliance monitoring for 2.4M DoD beneficiaries over a 21 state area. Directed optimization efforts for in-house, purchased and network services at 126 medical facilities via five year, $10B commercial support contract. Primary interface between health plan management and intermediate organizational levels. Led execution of comprehensive performance and customer service based contract incentive program valued at $4.7M annually. Directed multi-site, cross functional regional office staff of 60.
Tricare Heartland Regional OfficeDeputy Director - Director of Operations
Jan. 2001 - Dec. 2003Dayton, Ohio AreaDirected planning, development and operation of the military integrated healthcare system covering seven states. Ensured policy deployment to optimize care for 650K covered lives, in such areas as QA, network development and referral/access procedures. Oversaw all field activities related to $6.4B, TRICARE managed care support contract and implementation of Medicare Demonstration Programs. Collaborated with tri-service facility executives, via Board of Directors, on joint disaster preparedness and clinical processes improvement. Directed and integrated activities of 35-person staff.
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