Alex Yarijanian MSHCA

• Streamlined processes by conducting thorough operational audits and implementing best practices.
• Optimized resource allocation for operational excellence and improved service delivery.
• Cultivated high-performing teams by fostering a culture of continuous learning and professional development.
• Built strong relationships with key stakeholders by facilitating regular communication and collaboration.

• Value-Based Care & Payer Contracting Negotiations, Mahmee, Led the expansion of maternity care services focusing on value-based payment models
• Directed the expansion of services, resulting in an 86% increase in provider network size within two years
• Spearheaded value-based contracting strategies, leading to a $58 million cost reduction for a major Medicaid Plan
• Negotiated and directed the implementation of Health Net’s first-of-its-kind maternity provider group risk agreement.

• Spearheaded healthcare infrastructure development with a focus on integrating nonmedical services into mainstream healthcare
• Orchestrated the development of a provider network encompassing over 1200 healthcare providers across multiple states
• Managed a $1.5 billion diversified care portfolio, emphasizing strategic growth and innovation in healthcare services
• Worked with California MCOs to negotiate, contract, and implement innovative solutions for vulnerable populations
• Collaborated closely with physicians, hospitals, and healthcare providers to develop a comprehensive provider network
• Awarded two Best in Class Awards from Health Net and ComPsych for exceptional contributions to healthcare
• Launched tele-prehab (physical therapy) provider networks, covering over 10 million lives in the California market
• Developed a provider network delivering approximately 114% Return on Investment (ROI) to upstream payer partners in a risk-based model
• Expanded coverage across 49 States and DC, evolving Carenodes into a central hub for healthcare business operational support for payers and providers nationwide.

• Led payer relations and contracting contributing to an expansion of managed care access to neurodegenerative diseases care
• Managed payer relations and contracting strategies with a network of 50+ providers specializing in cognitive health services.

• Directed operational modernization, breaking revenue records and substantially improving payer reimbursements at this behavioral health group
• Increased provider network efficiency by implementing digital health initiatives, leading to a 25% reduction in administrative costs
• Led initiatives in provider network activities, resulting in a 40% growth in provider engagement and satisfaction scores.

• Network & Contracting Negotiations, Led contract negotiations and network management for Humana's commercial and Medicare Advantage products, achieving significant improvements in network adequacy and compliance
• Demonstrated expertise in Medicare and commercial health plans, enhancing provider network adequacy and compliance
• Implemented efficiencies improving network accuracy by 54%
• Negotiated mutually viable deals from risk/value-based to hospitals and downstream
• Contributed to a net increase of 11% in year-over-year consumer satisfaction
• Managed global risk contracts; operationalizing various delegated functions
• Designed and contracted networks for greater competitive position across markets
• Led a team, accomplishing measurable improvements within in a highly matrix organization.

• Managed the CMS Bundled Payment Care Initiative (BPCI) for 14 Hospitals and 50+ post-acute care providers (Home Health Agencies, Skilled Nursing Facilitates)
• Effective network strategies deployed to address post-acute spent resulting in shared savings
• Developed and helped execute network strategy in partnership with hospital leadership teams, using performance data to help drive executive decision making and team integration to facilitate downstream implementation of the decisions made.

• Directed ambulatory care contracting and compliance across 28 clinics in CA and TX
• Achieved a 380% increase in market share through effective IPA contracting strategies
• Implemented quality-based programs, reducing readmissions and enhancing risk revenue
• Realized $2.1M savings by enhancing DHCS, CMS, and contractual compliance efforts
• Secured $1.75 million in Medicare-based incentives, focusing on value-based and pay-for-performance models
• Improved average Risk Adjustment Factor (RAF) by 1 point across 2,000 MA lives
• Initiated a cost-containment pilot with a regional MSO, saving $25,000 per member per month for the top 1% of Medicaid utilizers
• Successfully enrolled over 100,000 Californians into the Covered CA
• Executed audits to identify and address operational misalignment from contracts
• Coached a team of 450 staff on managed care utilizing enterprise communication skills
• Increased average patient encounters from 1.4 to 2.9 per year for 5,000+ assigned lives
• Enhanced HEDIS scores on 50% of metrics for ~13,000 patients, triggering Pay for Performance (P4P) payouts.

GPA: 4.0

Summa Cum Laude, GPA: 4.0