Amanda Anstett
Parker,CO
Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Associate Director, Quality Field Organization- Optum Insights- QFO
Optum
11.2022 - Current
- Establish effective strategies and implement efficient processes to attain a performance level of 4+ Stars for CMS quality health plan ratings for 12 contracts, 250,000 members lives for Medicare Advantage Contracts within UnitedHealthcare,
- Oversee and track the performance of a field team consisting of 50 employees operating in five different States.
- Develop and deploy market level business plans focused on CMS Risk Adjustment, Clinical Quality, HEDIS, and Stars Part C and Part D initiatives
- Drive initiative development and execution in a heavily matrixed management structure
- Optimize business opportunities and brand strength across all initiatives
- Ensure local market strategy execution success while balancing competing business priorities
- Deliver performance reporting and updates to senior leadership, including Health Plan CEO(s), CMO, National and Market leads
- Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy
- Develop and track strategic provider targets focused on improving quality outcomes
- Guide and support employees in reaching organizational goals and enhancing their career growth.
- Improved overall team efficiency by streamlining project management processes and implementing new collaboration tools.
- Enhanced employee performance through targeted training programs and regular feedback sessions, resulting in higher productivity levels.
- Revamped internal communication channels to foster greater transparency between departments and improve overall organizational cohesion.
- Managed and directed teams comprised of up to 50 individuals, overseeing daily operations, training initiatives, and performance improvement strategies.
Sr. Manager, Clinical Quality- Optum Insights- QFO
Optum
03.2022 - 11.2022
- Accountable for leading multi-disciplinary team of direct reports (practice performance managers, Medicare consultants, RN’s) for three state region (CO/MT/WY)
- Responsible for ensuring that the team achieves performance metrics, performance guarantees, and quality standards to obtain a 4+ CMS health plan Star rating.
- Develop and implement team strategies for effectively managing new account relationships in expansion markets such as Montana and Wyoming.
- Engage in collaborative efforts with cross-functional teams to develop practice-specific strategies aimed at enhancing Medicare Stars ratings and ensuring accurate coding and documentation by healthcare providers.
- Provide guidance and support to employees to enable them to meet business goals and enhance their professional growth.
- Create collaborative work groups to facilitate process improvement and problem-solving efforts across matrixed teams within the organization.
- Successfully led a team to achieve over 80% of UHC Medicare Advantage members in 4-star contracts for the designated markets.
- Led change management initiatives to drive organizational transformation without compromising employee morale or productivity levels.
Associate Director - OptumCare CO
Optum
09.2020 - 03.2022
- Responsible for business launch and growth of affiliate provider group network for Colorado arm of OptumCare, exceeding contract procurement by 20%
- Co- Developer of Colorado provider engagement playbook for OptumCare IPA
- Experienced collaborator with inter-disciplinary teams to create and deploy reporting packages, resources and tools to support risk delegated membership in affiliate practices
- Responsible for development of incentive packages for contracted affiliate provider groups to support quality and risk performance for delegated membership and contracted groups
- Experienced and collaborative individual with a proven ability to thrive in diverse work environments and cross-functional teams developing efficient workflows and processes to drive strategy for CMS quality metrics and process improvement workflows to address gaps in care.
- Lead strategy development to support increased adoption of Optum provider data platforms for contracted physician groups
- Drive processes and improvement initiatives that directly impact revenue, clinical performance, affordability, NPS, HEDIS/STAR measures and Quality Metrics
- Experienced in deploying technological solutions for improvement of access, quality, service and affordability into provider offices
- Responsible for creation of operational guidelines and protocols for network managers to enhance the performance of value-based care.
- Led team of 4 Account Management professionals in special projects and daily operations.
- Spearheaded the contracting strategy for risk contracts with key IPA provider groups.
- Enhanced employee performance through targeted training programs and regular feedback sessions, resulting in higher productivity levels.
- Implemented data-driven decision-making strategies, leading to more informed business choices and positive outcomes.
- Mentored junior staff members, providing guidance on professional development opportunities and career progression paths within the company.
- Experienced in utilizing advanced analytics tools to identify trends in CMS quality compliance rates & provider performance behavior, informing future product development plans.
Provider Engagement Executive- Colorado
Humana
04.2018 - 09.2020
- Territory management oversight of CO/AZ
- Effectively managed relationships and enhanced performance for ten value-based contracts across CO, including shared savings, downside risk, and full risk agreements, improving cost savings ratios by 5-10%
- Responsible for ensuring financial and clinical success in meeting contractual targets for cost and quality in value-based care.
- Provide guidance, support, and training to Provider Engagement Professionals across 2 markets in order to enhance their skills and professionalism.
- Implementation leader responsible for overseeing and guiding the market engagement team in their adoption of the new company provider engagement reporting platform.
- Act as a strategic partner in negotiating and terminating contracts with provider groups through network collaboration.
- Consultant providing strategic guidance and expertise to the leadership team on improving and optimizing network performance and capacity.
- Accountable for development and execution of strategies by provider engagement team using data analysis of key performance indicators (KPIs) in contracts, HEDIS performance, cost drivers, and documentation improvement strategies.
- Delivery of performance reporting to the senior leadership team at the executive level.
- Conducted educational seminars and events throughout Colorado to inform contracted physicians about Humana services.
Lead Provider Engagement Professional- Colorado
Humana
04.2015 - 04.2018
- In charge of overseeing and managing a portfolio of 150+ primary care physician (PCP) practices. Including maintaining strong relationships with stakeholders, ensuring accountability for performance under value-based contracts, and growth and retention of membership base.
- Responsible for conducting data analysis on performance trends and cost drivers within PCP offices.
- Business unit lead responsible for organizing and implementing educational events to increase brand recognition.
- Promoted to the Lead Provider Engagement role in June of 2017 due to exceptional performance.
- Appointed as a co-leader for the operations team to guide the implementation of a strategic reorientation in our approach towards engaging with providers.
- Responsible for overseeing and coordinating market activities, as well as collaborating with various teams and resources, to enhance the performance of PCP groups in relation to population health metrics. This includes managing quality, coding, health services, and network team initiatives.
- Successfully facilitated the transition of 80% target groups from a STARS quality incentive program to a downside risk sharing model along the value-based care continuum.
Practice Operations Director- Multi-Specialty Practice
Concentra
09.2009 - 03.2015
- Responsible for overseeing the operations and financial growth of a high-volume clinic, which served more than 175 patients daily.
- Responsible for ensuring compliance and engagement of employed and contracted physicians with company directives.
- Responsible for overseeing the financial management, operational efficiency, and maintaining accountability of a clinic that generates annual revenues exceeding $5 million.
- Elevated center to be #1 in nation in Customer service and patient satisfaction amongst 300+ owned clinics nationwide
- Responsible for providing performance reports to executive-level leadership, demonstrating overall organizational performance.
- In charge of expanding three service lines, Urgent Care, Physical Therapy, and Occupational Medicine.
- Responsible for overseeing employee coaching, development, training, recruitment, termination, and performance improvement efforts.
- Successfully maintained a high employee retention rate surpassing the national average.
Education
Bachelor of Science - Health Care Administration
Metropolitan State College of Denver
Denver, CO05.2006
Skills
- Medical Group Operations
- Business Development/ Acumen
- Strategic Planning
- Value Based Care
- Quality & Risk Management
- Payor Strategies & Management
- Operations Management
- Data & Financial Analytics
- HEDIS/CAHPS/HOS Experienced
- Team Leadership/Development
- Change Management
- Process Improvement
- Project Management
- Performance Management
- Cross-functional Collaboration
- Industry knowledge
Certification
Lean Six Sigma- Yellow Belt
Timeline
Associate Director, Quality Field Organization- Optum Insights- QFO
Optum
11.2022 - Current
Sr. Manager, Clinical Quality- Optum Insights- QFO
Optum
03.2022 - 11.2022
Associate Director - OptumCare CO
Optum
09.2020 - 03.2022
Provider Engagement Executive- Colorado
Humana
04.2018 - 09.2020
Lead Provider Engagement Professional- Colorado
Humana
04.2015 - 04.2018
Practice Operations Director- Multi-Specialty Practice
Concentra
09.2009 - 03.2015
Bachelor of Science - Health Care Administration
Metropolitan State College of Denver