Melanie Heffelman
Vice President Health Plan
Phoenix,AZ
Summary
Accomplished executive leader at UnitedHealthcare, adept in strategic planning and team leadership, oversaw a $9B Medicare Advantage portfolio. Excelled in fostering growth, negotiating key contracts, and enhancing market strategies. Demonstrated expertise in federal policy and a proven track record in mentoring, with a focus on significant revenue and membership growth.
Overview
4
4
years of professional experience
Work History
Vice President Health Plan
Unitedhealthcare
02.2024 - Current
- Direct oversight of Arizona, Colorado, Kansas, Missouri, Nebraska Medicare Advantage lives equating to roughly 750,000 lives with 3% or greater increase in revenue year over year.
- Create comprehensive short and long-term growth plan inclusive of organic growth strategies, partnerships with delegates, health systems, hospitals, acquisitions, ancillary development, and other novel earning growth opportunities across West Region.
- Develop benefit offerings and build market strategy for each product focusing on member growth, retention, and expansion. Lead market discussion for in-depth understanding of all competitors, industry trends and market dynamics.
- Developed new revenue streams by identifying growth opportunities and forging strategic partnerships with key industry players.
Executive Director
UnitedHealthcare
02.2022 - 02.2024
- New business development for market entrants and contract negotiations for risk based agreements and global capitation. Partner with internal contracting, finance, and legal teams to develop and maintain competitive agreements for UHC Medicare Advantage.
- Lead all market strategies for relevant cross functional teams and owners – sales, Quality Field Staff, network, finance, operations, healthcare economics, marketing, and Optum.
- Support and develop internal team focusing on employee engagement, development, and retention.
Director of Operations
UnitedHealthcare
02.2020 - 02.2022
- Lead provider facing meetings to discuss market performance, strategy around STARS, CAHPS, HOS and RAF supporting Arizona, Colorado and New Mexico Medicare Advantage populations.
- Maintained 4 star revenue for 3 H plans supporting 525,000 Medicare Advantage lives.
- Internal subject matter expert for management and resolution of Complaints to Medicare, Net Promoter Score and customer service escalations.
- Development of member facing materials to ensure federal standards are followed while offering UHC branded and customized materials.
Education
Bachelor of Science - Dietetics
Arizona State University
Tempe, AZ 05.2001 -
Bachelor of Science - Sports Medicine
Colorado State University
Fort Collins, CO 05.2001 -
Skills
Team Leadership
Strategic Planning
Coaching and Mentoring
Decision-Making
Federal Policy
Timeline
Vice President Health Plan
Unitedhealthcare
02.2024 - Current
Executive Director
UnitedHealthcare
02.2022 - 02.2024
Director of Operations
UnitedHealthcare
02.2020 - 02.2022
Bachelor of Science - Dietetics
Arizona State University
05.2001 -
Bachelor of Science - Sports Medicine
Colorado State University
05.2001 -