DYNAMIC HEALTHCARE EXECUTIVE and TRANSFORMATIONAL LEADER Performance-driven Vice President with 20+ years of experience aligning systems with business requirements, policies and regulatory requirements. Passionate about applying excellent organization and communication skills to manage and lead teams. Results-oriented individual well-versed in interfacing and consulting on business processes to drive results based on sound overall business judgment.
Overview
23
23
years of professional experience
10
10
years of post-secondary education
Work History
Vice President, Provider Cost Solutions
Highmark Health
06.2021 - 03.2024
Developed cost portfolio of programs to deliver >10M in value across engaged provider organizations; enabling redesigning of health system's cost structure;
Structured cost programs that combines design of shared cost structures, delivering cost reduction programs across multiple provider partners
Developed end-to-end logistics of payment framework to aide in redesign of how payers and providers transact, enabling redesign of end-to-end patient payment journey; $30M in value
Led initiative to further enable internal medical record data optimization to improve quality performance (STARS/HEDIS)
Development of provider financial performance dashboard to replicate provider financial statements for opportunity assessment
Led (interim role) enterprise interoperability strategy to optimize quality performance, drive administrative efficiency for payer and provider;
Spearheaded organizational restructuring initiatives, streamlining operations and reducing overhead costs.
Cultivated strong relationships with key stakeholders, including customers, vendors, regulators, and community leaders to promote collaboration and long-term success.
Established culture of continuous improvement, fostering innovation and driving sustainable growth across organization.
Leveraged technology to automate workflows and streamline processes, resulting in increased productivity and cost savings across organization.
Built high-performance teams through effective recruitment practices focused on competency alignment coed with ongoing performance management processes.
Vice President, Market Development
Integrated Home Care Services
10.2019 - 06.2021
Led and supported health plan value-based contract negotiations to include underwriting analysis and performance guarantees with CEO, CFO and CD&A officers
Led provider contracting, provider relations, recruitment, and strategic development for health plan partners
Successfully built provider network for DME/HH/H-IV for growth in PA, OH and AZ; driving >100,000 covered lives
Drove patient and provider service excellence, collaboration, and engagement through redesigning operational processes to improve provider and patient experience, key stakeholder and executive leader in claim’s platform migration
Establish collaborative relationships with plans through development of aligned objectives focused on patient experience optimization, high-quality care and cost containment through effective utilization management
Led redesign of company externally facing website to improve experience for providers, members and health plan partners.
Early Career Experiences
Geisinger Health System
08.2001 - 08.2019
Proven ability to develop and implement creative solutions to complex problems.
Demonstrated respect, friendliness and willingness to help wherever needed.
Proved successful working within tight deadlines and a fast-paced environment.
Worked flexible hours across night, weekend, and holiday shifts.
Delivered services to customer locations within specific timeframes.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
Exercised leadership capabilities by successfully motivating and inspiring others.
Executive Director, Strategic Partnerships
Geisinger Health Plan
01.2017 - 06.2019
Led and was responsible for partnership performance through business advisory, clinical advisory and quality advisory committees; growth of MA product to >20,000 shared lives, reduction of MA MLR below 85%
Responsible for development and execution of co-sponsored insurance products, network development, product financial performance, quality performance and clinical outcomes
Directed various enterprise-wide projects encompassing resource allocation, project adherence to business objectives, and identification of mitigating risk factors posing threat to project deliverables; led provider network team through external administrative cost reduction exercise with benchmarking vendor to reduce administrative costs
Led and executed development of joint funded CM/UM/DM model between health plan and provider partner
Facilitated all aspects of partnership renewals and executed collaboration agreements and participating provider contracts.
Spearheaded new program initiatives to address unmet community needs and advance organization''s mission.
Implemented innovative marketing strategies to raise brand awareness and drive revenue growth.
Oversaw financial management, ensuring fiscal responsibility and long-term sustainability for organization.
Developed strategic partnerships with key stakeholders to expand organization's reach and influence.
Forge strong relationships with board members, providing regular updates on organizational progress and soliciting their expertise when needed.
Managed diverse team of professionals, fostering collaborative work environment for increased productivity.
Evaluated program outcomes using data-driven metrics, identifying areas for improvement and implementing targeted interventions.
Collaborated with external organizations including non-profits, businesses and government agencies to create mutually beneficial partnerships.
Optimized operational workflows, reducing overhead costs and maximizing resource allocation.
Aligned department vision, goals, and objectives with company strategy to achieve consistently high results.
Executive Director of Operations
Geisinger Health System
, PA
08.2011 - 01.2017
Department of General Surgery, Plastic Surgery, and Center for Aesthetics and Cosmetic Surgery
Developed and implemented inpatient discharge planning program which imbedded APP’s in inpatient setting for timely discharges, improved hospital throughput while reducing operating costs; reduced LOS
Conducted clinical practice visit throughput assessment to aid in development of business case for increased APP’s in ambulatory environment to increase access
Conducted and led surgical institute clinical practice outreach site planning and execution; greater access to surgical care; align spend to preferred provider system
Led successful accreditation organizations educational programs (residency and fellowship) under ACGME
Led successful assessment, migration and implementation of new academic program management software, MedHub
Managed staff to ensure delivery of stellar service performance and execution of best-practice standards, including facilitation of all performance management activities for physician and non-physician staff
Collaboratively worked with clinical leadership to address issues while maintaining in-depth understanding of all revenue impacting activity
Collections, billing, access issues, discharges, care alignment, practice standardization, etc.)
Optimized facility layouts for maximum efficiency, improving workflow and decreasing overhead expenses related to wasted space or resources.
Implemented performance metrics to track progress, identify areas for improvement, and guide team efforts toward achieving goals.
Managed budgets, forecasts, and financial reporting to ensure optimal resource allocation while maintaining fiscal responsibility.
Drove employee engagement initiatives aimed at increasing retention rates among top performers within organization.
Championed process improvements through adoption of Lean methodologies, enhancing productivity across all departments.
Developed long-term strategies to drive continuous improvement in operations, resulting in increased revenue and reduced costs.
Championed culture of continuous improvement, empowering employees to identify and address inefficiencies or areas for potential growth proactively.
Education
Doctorate Health Administration (D.H.A.) - Healthcare Quality and Analytics
Capella University
Minneapolis, MN
05.2019 - 12.2022
Master of Health Sciences (M.H.S.) - undefined
Saint Francis University
Loretto, PA
Bachelor of Science (B.S.) - Business Administration
Misericordia University
Dallas, PA
Lean Six-Sigma Certification - Healthcare
Villanova University
Villanova, PA
Skills
Energetic
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Affiliations
American College of Healthcare Executives
America’s Health Insurance Plans
Healthcare Financial Management Association
Professional Highlights
Trusted, well-respected leader to driving operational excellence through critical thinking, sound judgment, and decisive decision-making to responsibly manage the integration, coordination, and direction, delivering on optimized results.
Consistently ensured delivery of high-quality, cost-effective healthcare in accordance with all regulations, licensing, and accreditation requirements while effectively promote and enhance positive patient/member experience.
Skilled relationship-builder cultivating strong working relationships with partners, peers, staff, executive teams, board members, and internal/external resources, as well as build talented networks of medical and clinical professionals.
Successfully built dynamic cross-functional teams to exceed company goals and timelines. Drove cultural change to improve efficiencies, resulting in better teamwork, streamlined processes, and improved overall quality and service.
Strong analytical and business acumen to identify opportunities for improvement and implement cost-effective solutions.
Boosted development of future partnership opportunities via thorough evaluation of viability and fit for organization. Clearly communicated insightful feedback and recommendations on wide variety of opportunities.
Proven record of superior performance throughout steady career progression with successful goal achievement
Successfully developed and serviced current and prospective provider partnerships while shaping and executing strategic partnership development.
Established long-range strategic and financial plans with consistent monitoring of department’s financial performance.
Facilitated key mergers and acquisitions based on market growth, strategic prioritization, and financial wealth. Managed institute operations to strategically advance growth and meet enterprise goals.
Initiated and drove strategic and tactical business plans in collaboration with senior leadership (i.e. budgets, facilities and capital analyses, market analyses). Including: Business Plan for the Development of a Comprehensive Breast Center, expansion of Bariatric Destination medicine program and the expansion of surgical services in a new ambulatory services center.
Timeline
Vice President, Provider Cost Solutions
Highmark Health
06.2021 - 03.2024
Vice President, Market Development
Integrated Home Care Services
10.2019 - 06.2021
Doctorate Health Administration (D.H.A.) - Healthcare Quality and Analytics
Capella University
05.2019 - 12.2022
Executive Director, Strategic Partnerships
Geisinger Health Plan
01.2017 - 06.2019
Executive Director of Operations
Geisinger Health System
08.2011 - 01.2017
Early Career Experiences
Geisinger Health System
08.2001 - 08.2019
Master of Health Sciences (M.H.S.) - undefined
Saint Francis University
Bachelor of Science (B.S.) - Business Administration