Jane Ellen Casey
Wall Township,NJ
Summary
Experienced with team leadership, strategic planning, and operational management. Utilizes effective communication and organizational skills to drive project success. Track record of fostering productive work environments and achieving set goals.
Healthcare professional with a track record of providing valuable insights and strategic solutions to diverse clients. Adept at leveraging analytical skills and industry knowledge to drive impactful outcomes. Known for fostering team collaboration and adapting to dynamic environments, ensuring project success.
Overview
36
36
years of professional experience
Work History
Medical Economics Consultant, Clinical Analysis
Horizon Blue Cross Blue Shield of NJ
Newark, NJ
02.2020 - 04.2026
- Evaluated financial performance metrics and provided strategic analytical insights to enhance collaboration with internal stakeholders and external partners.
- Developed and executed financial strategies for hospital payment program (HPP) aimed at optimizing medical economics outcomes.
- Conducted financial reporting analysis and forecasting to enhance value-based compensation models.
- Conducted proactive evaluations to identify and address risks associated with program development.
- Directed comprehensive oversight of value-based program dashboard reporting, encompassing executive summary presentations and detailed analysis of medical cost trends.
- Facilitated value-driven presentations for partners, concentrating on critical insights, KPI benchmarks, and actionable recommendations.
- Developed and refined processes to improve service delivery and client satisfaction.
Manager, Managed Care
CentraState Healthcare System
Freehold, NJ
08.2019 - 01.2020
- Formulated and assessed payment rates and strategies for managed care contracts.
- Executed comprehensive reviews of managed care contract language to ensure compliance and clarity.
- Oversaw contract management processes to ensure compliance and facilitate contract renewals.
- Facilitated negotiation and execution of value-based performance plans, Episodes of Care and bundled payments.
- Managed comprehensive financial analysis and projections to support effective negotiation outcomes.
Provider Performance Manager
AMERIHEALTH NJ
Cranbury, New Jersey
10.2018 - 08.2019
- Directed complex contracting and negotiation efforts to secure fee-for-service reimbursement agreements, enhancing financial operations for hospital systems and physician groups.
- Spearheaded initiatives to enhance overall medical cost efficiency and quality standards.
- Conducted thorough analysis and review of provider contracts to assess financial impact and optimize terms.
- Assisted in resolving complex provider service complaints. Researched issues and collaborated with internal and external partners to address escalated matters.
Manager, Revenue Operations and Contracting, Assistant Finance Manager, Senior Financial Planning Analyst
HACKENSACK MERIDIAN HEALTH
Edison, New Jersey
01.2004 - 09.2018
- Developed and analyzed managed care contract models to support effective negotiation strategies aimed at maximizing revenue.
- Managed comprehensive migration process for newly acquired hospitals, focusing on adherence to HMH payor contract requirements.
- Leveraged expertise in relational database management systems to enhance data mining capabilities.
- Analyzed payor financial performance by tracking volume, charges, product revenue, and contribution margins.
- Assisted senior leadership by providing financial analysis and support for important business initiatives. Outlined financial requirements for board and bond agency approvals.
- Evaluated financial data to generate comprehensive feasibility reports for capital acquisitions and ad-hoc projects.
- Compiled detailed profitability reports for service lines by campus and payor to support strategic decision-making for directors and business unit leaders.
- Programmatic profit and loss statements.
- Conducted comprehensive performance assessments biannually and annually to enhance employee growth.
- Oversaw staff supervision and development initiatives to enhance team performance.
- Spearheaded operational efficiency initiatives to optimize patient care delivery processes.
- Led operational efficiency initiatives to enhance patient care delivery processes.
Manager, Community Health Center, Manager, Budget and Reimbursement
VISITING NURSE ASSOCIATION OF CJ
Red Bank, New Jersey
01.2000 - 01.2004
- Developed the annual operating and capital budget.
- Oversaw all Grant financial activity and reporting.
- Prepare and present monthly financials to the board.
- Preparation of the Medicare and Medicaid Cost Reports.
- Liaison with governmental and independent auditors.
- Preparation of Quarterly Expense variance reports.
Reimbursement Analyst
MONMOUTH MEDICAL CENTER
Long Branch, New Jersey
01.2000 - 01.2000
Budget and Reimbursement Analyst, Senior Accountant
UNIVERSITY OF MEDICINE AND DENTISTRY
01.1990 - 01.2000
- Developed the annual operation budget.
- Preparation of all Grant Report of Expenditures.
- Preparation of the Medicare Cost Report.
- Account analysis and reconciliations.
- Journal entry preparation.
- Financial Statement preparation.
Education
Bachelor of Arts - Economics, Concentration in Finance
Douglass College, Rutgers University
New Brunswick, NJSkills
- Problem-solving
- Attention to detail
- Team leadership & development
- Decision-making
- Time management
- Strategic planning
- Documentation and reporting
- Staff training and development
- Complex Problem-solving
- Healthcare analytics
CORE COMPETENCIES & PROFESSIONAL ACCOMPLISHMENTS
- Developed complex financial models with sensitivity and risk capabilities.
- Work collaboratively with senior leadership in developing feasibility studies, revenue models for managed care, hospital operations and clinical administration.
- Developed saving analysis for Medical Economics cost trend reduction initiatives.
- Provide actionable data driven analysis to Medical Management and Network to enable critical decision making.
Timeline
Medical Economics Consultant, Clinical Analysis
Horizon Blue Cross Blue Shield of NJ
02.2020 - 04.2026
Manager, Managed Care
CentraState Healthcare System
08.2019 - 01.2020
Provider Performance Manager
AMERIHEALTH NJ
10.2018 - 08.2019
Manager, Revenue Operations and Contracting, Assistant Finance Manager, Senior Financial Planning Analyst
HACKENSACK MERIDIAN HEALTH
01.2004 - 09.2018
Manager, Community Health Center, Manager, Budget and Reimbursement
VISITING NURSE ASSOCIATION OF CJ
01.2000 - 01.2004
Reimbursement Analyst
MONMOUTH MEDICAL CENTER
01.2000 - 01.2000
Budget and Reimbursement Analyst, Senior Accountant
UNIVERSITY OF MEDICINE AND DENTISTRY
01.1990 - 01.2000
Bachelor of Arts - Economics, Concentration in Finance
Douglass College, Rutgers University