Karen D. Flores, MBA
Chanhassen,MN
Summary
Innovative and experienced healthcare leader with diverse expertise in building and scaling enterprise-wide initiatives. Skilled in collaborating across business segments, markets, and products to build robust solutions. Passionate about ensuring access to meaningful and quality healthcare.
Overview
13
13
years of professional experience
Work History
HEALTHCARE LEADER
UnitedHealth Group
08.2011 - Current
Senior Director, Talent Strategy and Mobility
Optum
04.2021 - Current
- Leading cross-functional strategy development efforts to deliver best in class internal mobility for employees including adoption of AI-powered internal talent marketplace, change management and organizational readiness.
- Lead team of 14 focused on execution of internal talent moves and redeployment of employees to support business priorities, including partnering with Talent Aquisition, People Business Partners, and other COEs to drive rapid identification and transition of talent moves.
- Program owner for employee career support programs including CareerCare, an internally developed program which provides career navigation support to 10K+ employees yearly
- Career pillar leader for the Unidos ERG with over 3K active members
VP, E&I Network Strategy
UnitedHealth Networks
01.2019 - 04.2021
- Expanded national network build of property casualty/worker's compensation network targeted to yield incremental $34M in revenue and $16M in annual medical expense savings to support Optum Worker's Compensation business
- Responsible for 18-person team executing contract paper, developing pricing strategies, leading negotiation efforts, network access analytics, and project reporting across 11 states and 50K contracts.
Director, Network Management MN Health Plan
UnitedHealth Networks
09.2017 - 01.2019
- Oversight for strategy and implementation of greenfield provider network build for Minnesota, North Dakota, South Dakota health plan across all lines of business (Commercial, Medicare, Medicaid)
- Led team of 17 network managers through contracting efforts which resulted in completing a network of 35K providers and over 200 hospitals with market competitive rates and overall aggressive reduction of unit costs to achieve $100M in claims savings.
- Developed market specific network strategies to allow for innovation in value-based contracting and new product development
- Completed 6-month advanced network leadership and contracting training program
Director
Harken Health
06.2016 - 09.2017
- Designed infrastructure to build and support a Harken Health provider network including a roadmap to innovate and execute best in class provider operations, internal contract maintenance and claims pricing.
- Maintained day-to-day oversight for all claims and clinical operations including approval of all appeals and DOI complaints, high-dollar claims up to $100K, claim inventory, productivity management and team development.
- Business owner of network tools to deliver accurate and timely provider data to downstream platforms including FACETS claims platform, provider search, and provider portal applications.
- Led team of 40+ claims and network operations employees
Product Director
Optum
01.2013 - 06.2016
- Led product development and performance management for ~$60M infertility product payer offering, with a strong focus on revenue growth, affordability initiatives for risk product, and expansion of new product offerings and extensions
- Implemented Rx clinical affordability program for infertility specialty medications achieving ~$10M incremental annualized savings for UHC commercial
- Established and executed annual strategic plan for infertility product suite including identifying M&A targets, new product extensions and clinical affordability strategies
Project Manager / Client Management
Optum
01.2013 - 06.2016
- Responsible for leading complex operational projects to identify, research and resolve large scale client service gaps across alllines of business for the Optum Physical Health program
Director
Ambrion, Inc
Executive Recruiter
Ambrion, Inc
District Manager
Aldi, Inc, Dwight, IL
Education
MBA - Strategy and Entrepreneurship
University of Minnesota - Twin Cities
Minneapolis, MN05.2011
Bachelor of Arts - Journalism And Mass Communication
Drake University
Des Moines, IA06.1999
Skills
- Strategy Development and Execution
- Product and Network Leadership
- Talent Strategy and Mobility
- Program development and delivery
- Contract Negotiation
- Project Management
- Clinical management strategies
- Operational Leadership
- P&L >$50M
- Local market health plan experience
- High performing teams
- Enterprise Matrix Leadership
- Retail consumer experience
Accomplishments
- Product Leadership : Achieved record profitability increase of 29% and 50% reduction in pharmacy PMPM for women's health infertility product
- Talent Mobility : Annual redeployment of 1500+ employees and retention savings of $25M
- Network Development : Led two broad scale network builds with aggressive contracting timeframes
achieving significant competitive positioning with providers and savings of $100M
Volunteer Activities
- Joyce Preschool (Minneapolis) Board Member and Vice Chair 2020-Present
- Prospanica (formerly National Society of Hispanic MBAs) National Board of Directors – National Vice-Chair 2015-2019; Chapter president for Minneapolis-St. Paul Chapter 2013-2015
- Named to 2022 UHG DEI Executive Sponsorship program
- Named Minnesota Hispanic Chamber of Commerce 2011 “20 on the RISE” leader
Languages
Spanish
Native or Bilingual
Timeline
Senior Director, Talent Strategy and Mobility
Optum
04.2021 - Current
VP, E&I Network Strategy
UnitedHealth Networks
01.2019 - 04.2021
Director, Network Management MN Health Plan
UnitedHealth Networks
09.2017 - 01.2019
Director
Harken Health
06.2016 - 09.2017
Product Director
Optum
01.2013 - 06.2016
Project Manager / Client Management
Optum
01.2013 - 06.2016
HEALTHCARE LEADER
UnitedHealth Group
08.2011 - Current
Director
Ambrion, Inc
Executive Recruiter
Ambrion, Inc
District Manager
Aldi, Inc, Dwight, IL
MBA - Strategy and Entrepreneurship
University of Minnesota - Twin Cities
Bachelor of Arts - Journalism And Mass Communication
Drake University
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