Amy Burnside
Wesley Chapel,FL
Summary
Accomplished healthcare business operations professional with 16 years of experience in building relationships, leading people, and implementing new business in healthcare including managed care, state health plan operations organizations, and large hospital organizations. Experience includes oversight of business operations, stakeholder relationship building, staff development, KPI and quality improvement metrics management, and increasing patient/customer satisfaction. Skillsets include an emphasis on people leadership, executive relationship building, conflict management and resolution, and project management oversight for health plan implementations.
Overview
17
17
years of professional experience
Work History
Director of Clinical Initiatives & Strategy
Optum, WellMed, UnitedHealth Group
04.2022 - Current
- Lead Optimal Care & Value Based Care Initiatives
- Implement specialty referral optimization steerage best practices for the Florida market.
- Collaborate with National Team on presenting new initiatives to senior and medical leadership team. This includes coordinating implementation with IT, EHR and Care Management team for successful implementation
- Meet monthly with HealthCare Economics team and key Senior stakeholders to present current metrics
- Responsible for analyzing and completing monthly Quad Aim propeller for CMO of Florida market. Data includes Quality & Risk, Patient Experience, Human Capital, Talent Acquisition, Cost of Care, VBC metrics.
- Present and conclude annual physician bonus to compliance and quality committee, review quarterly with finance and medical directors for appropriate clinician and APC bonus payout
- Deep Dive and recommend programs for Florida market, such as Supportive Care program
- Develop post-acute care network by analyzing skilled nursing facilities for all of Florida market based on metrics quality, and geographic location to physician clinics for members
- Lead quarterly JOCs (Joint Operating Committee) with partnered skilled nursing facilities to review opportunities and metrics; STARS, average length of stay and readmission rates
- Align post-acute care network with hospitalist program to improve transition of care for patients
- Lead and implement 2023/24 Major Business Objective for Care & Value affordability pillar
Manager of Project Implementation/Program Manager
Centene Corporation
09.2019 - 03.2022
- Lead a team of professional project managers responsible for standing up large MCOs, from new health plans, business implementations, expansions, and migrations for 500k plus members
- Collaborate with internal teams throughout project life cycle for all operational areas to include IT, Call Center, Enrollment, Customer service
- Managed Health Benefit Ratio program for Sunshine Health Plan to include goals, risks, barriers, savings and KPIs and report to Centene CEO and Health Plan CEO
- Work directly with CMO on Clinical Outcomes Unit to oversee initiatives from L-gate status L0-L4
- Submit AOP (Annual Operating Plan) analysis to include estimates of yearly savings
Site Manager III
BayCare Medical Group
12.2014 - 08.2019
- Direct operations of 3 Pediatric practices to include 8 Pediatricians
- · Lead a team of 30 team members to include front and back-office staff
- Manage finances and budget kept physicians apprised of operation statement
- Annual team evaluations, coaching and counseling of team members
- Complete payroll for 30 team members in Kronos payroll system
- Responsible for successful acquisition transition of private physician office and team to BayCare Medical group
Regional Practice Administrator
Florida Hospital Physician Group
04.2013 - 12.2014
- Lead day to day operations of multiple physician practices for assigned region to include specialty and primary care offices
- Implementation of standard operating procedure(s) to improve access, finances, and patient flow
- Research, prepare and present monthly financial and operation reports to executive hospital leadership to include CFO & CEO
Practice Manager of Operations
Arnold Palmer Children's Hospital
05.2007 - 04.2013
- Lead multi-physician practice to include 11 Anesthesiologist and 14 Nurse Anesthetist (CRNA’s)
- Lead multi-physician pediatric cardiac practice to include 5 Cardiologist, 2 Thoracic Surgeons, 3 Cardiac Anesthesiologist and 3 Critical Care physicians
- Implemented and managed billing process for large hospital organization anesthesiology practice & cardiology practice to include 4 hospital locations
Education
High School Diploma -
Sinclair Community College
Dayton, OHSkills
- Strategic Planning
- Verbal and written communication
- People Management
- Operations Management
Accomplishments
- Awarded Key Contributor Award 2021 Centene Corporation for successful implementation of new Health Plan 500k plus membership
- Lead project team to design a new medical office vision from concept to implementation
- Successful implementation of new anesthesiology billing system resulting increased ROI of 25 percent, including process improvement of coding, compliance, and billing practices
- · Key systems include Microsoft Office Products; Excel, Word, PowerPoint, Microstrategy, TruCare, Tableau, QuickBase, Amisys, SharePoint, SmartSheet & multiple EMR systems
Timeline
Director of Clinical Initiatives & Strategy
Optum, WellMed, UnitedHealth Group
04.2022 - Current
Manager of Project Implementation/Program Manager
Centene Corporation
09.2019 - 03.2022
Site Manager III
BayCare Medical Group
12.2014 - 08.2019
Regional Practice Administrator
Florida Hospital Physician Group
04.2013 - 12.2014
Practice Manager of Operations
Arnold Palmer Children's Hospital
05.2007 - 04.2013
High School Diploma -
Sinclair Community College