Charity Hefley-Leigh, PT, MBA
Aiken,SC
Summary
Accomplished executive with over 15 years of progressive leadership in provider network development, contracting, and business operations. Expertise includes building competitive, broad-access networks while driving profitable performance and implementing innovative value-based care initiatives. Proficiency in financial modeling, network pricing analysis, and strategic planning to align organizational priorities. Recognized for fostering collaborative relationships, resolving complex operational challenges, and delivering actionable recommendations that enhance network quality and efficiency.
Overview
21
21
years of professional experience
Work History
Director of Network Development
OptumHealth
03.2023 - Current
- Led cross-functional teams to implement network management projects, ensuring alignment with organizational goals. Example: Led regional process improvement project to address provider attribution disputes and implemented across 4 states with over 3,500 disputed patients submitted and addressed within 6-month time frame.
- Analyzed market trends and competitor activities to identify profitable growth opportunities and network expansion that led to 93.7% YOY increase in total at-risk lives for the market.
- Championed collaboration between network development and market operations to resolve technical, operational, and organizational challenges impacting network performance.
Provider Relations Manager
Optum Home and Community
12.2021 - 02.2023
- Served as liaison between payers and providers, ensuring efficient care transitions and closing gaps via risk stratification and predictive analytics.
- Developed comprehensive reports highlighting trends and performance metrics of providers through data analysis and delivered actionable recommendations to optimize network performance.
- Managed 68 Skilled Nursing Facilities and delivered performance reviews on a quarterly basis with notable metrics of 14.9% 30-day acute readmission and 16.3 ALOS.
- Fostered strong, positive relationships with key acute and post-acute care providers by coordinating, facilitating and leading partnership meetings aimed at enhancing efficiency of patient care delivery.
Vice President of Business Development
HealthPro Heritage
01.2020 - 12.2021
- Delivered consultative clinical strategies with post-acute care providers, including skilled nursing facilities, home health agencies, senior living communities, physicians, discharge planners, and outpatient therapy providers to develop high-performing networks.
- Negotiated, reviewed, and amended provider contracts to establish strategic partnerships in excess of $4M in revenue/year.
- Supported over 60 contracted providers and presented quarterly JOCs to review performance trends and develop collaborative high level work plans to maintain alignment with organizational goals.
- Championed product innovation ideas that led to launching a new business line to deliver at home extended care services.
Vice President of Training and Development
Great Expressions Dental Centers
04.2018 - 08.2019
- Managed large-scale projects and introduced new systems including implementing a digital learning management system that was fully integrated with the Human Resource Information System that automated role-specific curricula for new employee onboarding and annual trainings.
- Led a team of 3 Instructional Designers that created over 100 individual staff development courses for clinical and non-clinical staff.
- Planned and developed content for leadership meetings and facilitated over twenty-five design thinking sessions to drive innovation and transform processes.
- Implemented a Learning Management System fully integrated into the Human Resource Information System that resulted in automated management of role-specific curricula and enhanced ability to create and track professional development plans.
Vice President- Vitality Rehabilitation
Genesis Rehabilitation Services
06.2005 - 03.2018
- Promoted through roles of increased scope and accountability, advancing through several multi-state operations and customer service leadership positions before assuming the Vice-President role to launch a new service line. Led collaborative, cross-functional teams to develop clinical pathways focused on value-based care delivery model Ensured seamless transitions of care and rehabilitation services through cooperative relationships with preferred partners for 5,000 patients/day in 100+ markets across 27 states.
- Collaborated with post-acute providers and conveners to develop successful strategies and implementation plans for multiple value-based care initiatives, including Bundled Payment for Care Initiatives (BPCI) Model 3, Accountable Care Organizations (ACOs), Medicare Shared Savings Program (MSSP), and Comprehensive Care for Joint Replacement (CCJR).
- As a Senior Area Director, presided over 135 rehabilitation contracts, including Continuing Care Retirement Communities and outpatient therapy clinics across SC/GA/MS/LA with five Regional Clinical Operators, over 1,000 employees, and $40 million in revenue.
Education
MBA - Health Care Administration
University of South Carolina
Aiken, SC05-2023
Bachelor of Science - Physical Therapy
Medical University of South Carolina
Charleston, SCSkills
- Network development and contracting
- Financial Modeling & Rate Decisions
- Data Analytics & Performance Gap Solutions
- Value-Based Care & Incentive-Based Payment Models
- Strategic Planning & Trend Management
- Operations & Organizational Leadership
- Relationship Building & Stakeholder Engagement
- Project Management & Process Improvement
Timeline
Director of Network Development
OptumHealth
03.2023 - Current
Provider Relations Manager
Optum Home and Community
12.2021 - 02.2023
Vice President of Business Development
HealthPro Heritage
01.2020 - 12.2021
Vice President of Training and Development
Great Expressions Dental Centers
04.2018 - 08.2019
Vice President- Vitality Rehabilitation
Genesis Rehabilitation Services
06.2005 - 03.2018
MBA - Health Care Administration
University of South Carolina
Bachelor of Science - Physical Therapy
Medical University of South Carolina