Michael Burmeister
Groton,MA
Summary
Strategic operations leader with a proven track record in performance improvement and value-based contracting. Successfully led initiatives that exceeded financial targets while enhancing stakeholder engagement and driving business growth. Expertise in data-driven decision-making consistently improves operational outcomes and member experiences.
Overview
20
20
years of professional experience
1
1
Certificate
Work History
Head of Network and Value-Based Care
Central Mass Health LLC.
Worcester, Massachusetts
01.2025 - 06.2025
- Directed all facets of Provider Network Management, including strategy development and provider contracting.
- Led negotiations for managed care contract renewals with providers and health system partners.
- Analyzed pharmacy and care delivery strategies, implementing adjustments to meet targeted outcomes.
- Executed initiatives to enhance quality of care and improve patient experience within specialty networks.
- Nurtured relationships and ensured integration with UMass Memorial Health as primary payvider partner.
Corporate Director Network Strategy
AmeriHealth Caritas
Philadelphia, Pennsylvania
03.2021 - 04.2025
- Built and led team to execute strategic account plans and financial modeling.
- Communicated P&L levers while collaborating across functions to implement standardized tools.
- Surpassed corporate optimization goals with actuals of $62M, $152M, and $119M against targets of $40M, $140M, and $85M from 2022 to 2024.
- Executed provider network builds for entry into four Medicaid and three Medicare markets.
- Evaluated financial results and gathered market intelligence to identify performance improvement opportunities.
General Manager
Elevance Health - CareMore / Aspire
Hartford, Connecticut
09.2016 - 12.2020
- Orchestrated business and operational strategies with multi-site P&L accountability for market performance.
- Cultivated new payer partnerships encompassing national health plans and managed care entities.
- Promoted in 2018 from Provider Collaboration Programs Director due to exceptional performance.
- Initiated CareMore's first commercial offering, reaching 2,000 patients at home.
- Outperformed annual revenue expectations via robust partnership development and comprehensive business expansion strategies.
Market Director - Operations and Engagement
Humana
Richmond, Virginia
03.2013 - 09.2016
- Managed Medicare initiatives and operations impacting 140,000 lives in Mid-Atlantic Region.
- Achieved reduction in medical expense ratio from 87.6% to 84.4% through targeted initiatives.
- Extended business operations to encompass two new Medicare markets, and the Virginia MLTSS program.
- Executed market share growth strategies, improving quality and generating margin for region.
- Led a team of high-performing, customer-facing Provider Engagement Executives.
- Identified and implemented improvements to existing Customer Success processes and leadership capabilities to ensure success.
Education
Bachelor of Science - Business Administration, Psychology
The College of New Jersey
Executive Education - Accelerating Change Readiness and Agility
University of California - Berkeley
Skills
- Strategic execution
- Analytical thinking
- Contract negotiations
- Customer success strategies
- Revenue and growth initiatives
- P&L accountability
Certification
- PAHM – Professional, Academy for Healthcare Management
- HFMA – Healthcare Financial Management Association, Massachusetts-Rhode Island Chapter
Timeline
Head of Network and Value-Based Care
Central Mass Health LLC.
01.2025 - 06.2025
Corporate Director Network Strategy
AmeriHealth Caritas
03.2021 - 04.2025
General Manager
Elevance Health - CareMore / Aspire
09.2016 - 12.2020
Market Director - Operations and Engagement
Humana
03.2013 - 09.2016
Bachelor of Science - Business Administration, Psychology
The College of New Jersey
Executive Education - Accelerating Change Readiness and Agility
University of California - Berkeley