Senior Vice President, Value & Population Health, PacWest Division
Denver,CO
Summary
Results-driven Senior Vice President of Value Based Care and Population Health with forward-thinking approach centered on delivering on revenue, cost reduction, and compliance expectations within managed care portfolio.
Overview
18
18
years of professional experience
Work History
Senior Vice President, Value & Population Health
OptumCare
01.2021 - Current
Oversee value based care portfolio for PacWest Division across CA, WA, OR for 700,000+ global risk members with total revenue $6.2B
Strategic and operational leadership for population health management, medical expense and affordability initiatives, risk adjustment, quality (Stars/HEDIS), patient safety, social determinants and behavioral health, home care, community outreach
Developed a team seven VP with a staff of 750 teammates to execute on value-based care priorities, with a dyad partnership to five Chief Medical Officers.
Established partnerships with vendor, community, and payor to ensure to execute on market strategies to provide care to our value-based communities.
Implemented and drove cost of care initiatives across six verticals: medical expense, facility utilization, pharmacy, network strategy, disease management, and payment integrity, to realize $240M in savings across three years.
Drove strategic operational and company procedural improvements resulting in 18% increase in coding and documentation improvement
Vice President, Clinical Performance, Corporate
OptumCare
01.2019 - 12.2020
Responsible for execution of enterprise risk adjustment strategy across 27 Optum Care Delivery Organizations (CDOs)
Led market relations, vendor management, patient outreach teams supporting all CDOs
Supported delivery of clinical programs, including risk adjustment, quality, affordability, and technology solutions
Accountable for coding and documentation improvement, prospective and retrospective activities, provider education, quality gap closure, network management, membership growth, encounter data submissions and reconciliation
National Vice President, Risk Adjustment
DaVita Medical Group
01.2017 - 01.2019
*Drove 8% YOY improvement in coding and documentation accuracy, resulting in $200M+ in incremental care funding
Led national strategy through implementation of clinical and operational programs to support MA product line
Responsibility for six geographic markets and a growing national infrastructure
Oversight of execution and staffing for risk adjustment, fee for service, coding and compliance programs
Senior Director Client Services, Risk Adjustment
The Advisory Board Company
01.2015 - 01.2017
Delivered strategy and consulting services to clients on risk adjustment, population health, EMR optimization
Brought to market five risk adjustment consulting and technology products, with focus on point of care tools
Senior Director
Performance Technologies
01.2012 - 01.2015
Team leader in National Strategic Accounts sector, comprised of organizations with portfolios over $5M annually
Launched ambulatory technology platforms focused on performance of employed physician networks
Developed technology platform product pitch, technology demonstration, target market, and marketing collateral
Director, Program Management & Integration
Novant Healthcare
01.2010 - 01.2012
Led multidisciplinary teams associated with business growth, enterprise standardization, mergers & acquisitions, Medicare Bundled Payments
Managed acquisition and integration of large hospital systems, including transition of IT, payroll, accounting systems, employee benefits adoption, cultural assessments, materials management, sourcing, and supply chain
General Operations Manager
NOVANT HEALTH, MEDQUEST ASSOCIATES
01.2009 - 01.2010
Managed free-standing ambulatory facilities. Included management of EBITA, payroll, training, branding, vendor management, licensure & certifications, CON approval
Increased volume by 14%. Achieved highest network volume percentage to budget at 179%, since acquisitio
Supervised 90+ employees at three facilities, including physicians, technologists and administrative staff
Regional Operational Manager
Novant Health, Inc
01.2007 - 01.2009
Responsible for clinic productivity, clinic workflow optimization, operational efficiency, patient call centers. Managed, coached and trained employees across four regions. Set expectations and accountability measures.
Authored and implemented Corporate Business Standards focusing on operational improvement and customer service.
Area Marketing Manager
Novant Health, Inc
01.2005 - 01.2007
Executed marketing campaigns through mix of advertising and public relations
Responsible for competitive market analysis, identification of market position and competitive advantage