Jeffrey Criswell

Specialization in medical trend analysis to drive performance improvements across multiple markets experiencing $2B+ in total spend

• Primary lead for multiple cross-matrixed projects to improve, implement, and create medical cost savings initiatives.
  Found and recovered $1M+ in claim cost savings.
• Recommended and aided in an enterprise wide approach to avoid a $40M+ risk to the business.
• Developed and trained current team on understanding CMS reimbursement, medical cost trend analytics, and medical cost solutions.
• Collaborated with multiple teams to innovate program initiatives to improve the health of certain cohorts with specific comorbidities.
• Partnered with contracting and FP&A departments across the enterprise to develop forecasts related to CMS reimbursement changes.
• Provided crucial presentations on utilization trends to medical directors and health service leads to give valuable insight on risk adverse members.

• Lead data and analytics consultant for 20+ Medicare ACOs.
• Create scopes of work and client recommendations for ACOs that drove solutions and success in the Medicare Shared Savings Program.
• Project lead for a Managed Services Organization where I successfully created, wrote, and developed their application for ACO Reach that was accepted by the Center of Medicare/Medicaid Innovations.