AMY R. O’CONNELL
Summary
Visionary and results-driven healthcare executive with a proven track record of leading enterprise-wide network strategy, market expansion, and value-based transformation across national health plans. Adept at aligning cross-functional teams, optimizing provider performance, and driving sustainable growth through data-driven decision-making and strategic partnerships. Recognized for cultivating high-performing teams, influencing C-suite stakeholders, and delivering measurable impact in complex, regulated environments. Passionate about advancing access, affordability, and innovation in healthcare delivery.
Overview
15
15
years of professional experience
Work History
Senior Director Network Strategy & Development
CENTENE CORPORATION
01.2022 - Current
- Drive enterprise-wide network strategy initiatives to enhance provider performance, access, and cost-efficiency across national markets, aligning with corporate growth and regulatory objectives
- Lead cross-functional teams including market CEOs, actuarial, analytics, and clinical leaders to implement value-based contracting and innovative network models
- Architect and execute a national roadmap for network transformation, resulting in measurable improvements in provider engagement, member satisfaction, and operational efficiency
- Mentor and develop a high-performing team of directors and managers, fostering leadership capabilities and succession planning
- Advise executive leadership on strategic M&A opportunities, leading due diligence and integration of acquired networks into Centene’s operational framework
- Represent network strategy in enterprise governance forums, contributing to long-term planning and investment decisions
- Promoted September 2024
Director Market Success
BRIGHT HEALTH CARE
01.2021 - 01.2022
- Led market review with internal stakeholders and developed moving-forward strategy across the Exchange and Medicare Advantage lines of business for all Florida markets
- Managed 7 senior provider relations representatives with focused attention on improving team morale and effectiveness
- Built provider relations structure and standards in Florida and developed external educational onboarding materials
- Directed cross-functional teams on resolving operational inefficiencies and establishing best practices for complex claims disputes across the organization
- Worked directly with large health systems and major care partners to cultivate relationships and assist in resolving complex issues related to contracts, fee schedules, provider data, claims and payment
- Acquired WellCare 2020
Director Network Strategy & Performance
CENTENE CORPORATION
01.2019 - 01.2021
- Managed network team that operated as the link between Corporate, Health Plan and Product organizations; drove network strategies and key performance initiatives across 36 health plans for all Medicare national lines of business by providing guidance, actionable data and best practices to meet corporate goals
- Oversaw network design and composition to ensure competitiveness and growth through expansion and contract alignment; demonstrated successful filings for 327 new service areas and 3 new markets in 1 year
- Identified cost reduction opportunities by analyzing out of network utilization trends and proposing reimbursement rate guardrails and structure to senior leadership
- Drove multi-year network development strategies, estimated resource requirements and managed risk mitigation
- Aligned more members to high quality and cost efficient health care providers by developing strategies and reporting all 36 health plans could use to identify high performing, cost effective providers
- Promoted November 2021
Manager Provider Engagement Strategy
HEALTH CARE SERVICE CORPORATION
01.2014 - 01.2019
- Developed, implemented and maintained contractual arrangements, program design and day to day operations with 2 third party vendors on programs aimed to reduce medical spend by 40% for high cost members
- Served as the primary relationship manager for a portfolio of 11 hospital and health care system clients; worked with client teams to enhance fee for value performance through data-driven process improvement and risk mitigation to ensure significant value was generated from shared risk arrangements
- Launched 15 new Value Based clients in 1 year through contract negotiations, in-person program training and preliminary data evaluations
- Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas
- Promoted February 2018
Senior Tax Accountant
KPMG
01.2013 - 01.2014
- Redesigned financial models and renegotiated contracts for over 20 Value Based clients in less than 6 months through close collaboration and partnership with actuarial and legal departments
- Monitored project timelines and ensured that clients generated significant value from shared risk arrangements
- Promoted September 2014
Corporate Accountant
NATIONAL SURGICAL HOSPITALS
01.2012 - 01.2013
- Educated organization on compliance and implementation of Affordable Care Act Regulations
- Advised senior leadership on savings opportunities through partnership with finance and mergers departments
Tax Accountant I
AEGON (Transamerica)
01.2011 - 01.2012
Education
Master of Business Administration - Healthcare Management
Loyola University
Chicago, ILBachelor of Science - Accounting & Management
Iowa State University
Ames, IASkills
- Collaborative leadership
- Culture transformation
- Team management
- Policy development
Timeline
Senior Director Network Strategy & Development
CENTENE CORPORATION
01.2022 - Current
Director Market Success
BRIGHT HEALTH CARE
01.2021 - 01.2022
Director Network Strategy & Performance
CENTENE CORPORATION
01.2019 - 01.2021
Manager Provider Engagement Strategy
HEALTH CARE SERVICE CORPORATION
01.2014 - 01.2019
Senior Tax Accountant
KPMG
01.2013 - 01.2014
Corporate Accountant
NATIONAL SURGICAL HOSPITALS
01.2012 - 01.2013
Tax Accountant I
AEGON (Transamerica)
01.2011 - 01.2012
Bachelor of Science - Accounting & Management
Iowa State University
Master of Business Administration - Healthcare Management
Loyola University
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