Summary
Overview
Work History
Education
Skills
Other Experience
Community Service
Timeline
Generic

Patsy Bouzan

San Diego

Summary

With extensive experience in managing care contracting, I excel at developing effective strategies and leading negotiations with managed care payors for a wide range of services, including acute care inpatient and outpatient services. The contracting scope also covers physician and ancillary providers which comprising over 1,000 UC San Diego faculty, community care physicians, and clinically integrated network providers in Southern California. As the co-chair of the University of California (UC) system-wide managed care committee, I collaborate with six health systems/medical groups to optimize synergies. Building strong relationships with internal and external stakeholders is a fundamental aspect of my approach. I possess exceptional knowledge of the managed care market in Southern California, particularly in San Diego, Riverside, Orange, and Imperial Counties, as well as a deep understanding of payor products, physician-hospital relationships, primary care alignment, and management services organizations (MSOs). Actively participating in strategic discussions, I contribute to increasing market share through membership growth, clinical relationships, and highly specialized services. Additionally, I conduct and oversee comprehensive financial analyses to evaluate contract performance and assess different financial and risk scenarios to determine optimal payment levels and risk tolerance.

Overview

27
27
years of professional experience

Work History

Chief Contracting Officer

UC San Diego Health Contracting
10.2020 - Current
  • Directs the UC San Diego Health managed care contracting office and oversees a team of contract managers and project analysts to negotiate managed care, governmental, and provider agreements
  • Analyzes performance across the entire system to identify areas of opportunity and collaborates with clinical teams to account for procedural and technological innovations
  • Focuses on revenue enhancements with trend increases and market share growth that outpaces competitor systems
  • Identifies market opportunities and key partners in San Diego and surrounding regions through a variety of channels including business development, marketing and broker networks

Deputy Chief Contracting Officer

UC San Diego Health Payor Contracting
01.2016 - 01.2020
  • Negotiated the UC San Diego Health payor contracts in accordance with Hospital, Physician Group, Population Health, Clinically Integrated Network and Strategic Affiliation operations
  • Collaborated with departments to identify areas of opportunity around rate structure and unique services
  • Served as chief proponent for hospital and physician contract interest to ensure that hospital is able to maintain margin and reinvest in technology and optimized patient care
  • Led UC wide initiatives such as UC Self-Funded Plan benefit restructuring and strategic planning as well as major payor negotiations

Director, Physician Contracting

UC San Diego Health Contracting
01.2002 - 01.2016
  • Led negotiations for UC San Diego Medical Group including capitated and fee-for-service contracts
  • Identified optimal contracting terms including analysis of Division of Financial Responsibility, value of services, and capitation rate
  • Successfully negotiated double digit trend increases for both capitated and fee-for-service contracts on behalf of UCSD Medical Group Physicians to improve financial performance
  • Negotiated provisions that would provide for additional revenue when patients transferred to UC San Diego after receiving a highly complex diagnosis

Manager, Eligibility & Data Analysis

UCSD Medical Group Managed Care
01.2000 - 01.2002
  • Managed the Eligibility & Enrollment Department and Data Analysis units for the managed care department
  • Developed workflows to improve enrollment data integrity and processes for reconciliation
  • Managed team of analysts who handled reporting on population health including claims expense, utilization statistics and enrollment
  • Worked with leadership to develop strategies to improve performance and identified key opportunities to enhance operational efficiencies and revenue

Managed Care Analyst

UCSD Medical Group Managed Care
01.1998 - 01.2000
  • Developed portfolio of reports for population health purposes including inpatient and outpatient claims expense, clinical utilization and compared UCSD statistics against published benchmarks
  • Assisted physician leadership in identifying outliers and other high cost services to improve performance

Education

Master of Health Administration -

Cornell University

Bachelor of Science - Animal Physiology & Neurosciences

University of California, San Diego

Skills

  • Provider Contract Negotiations
  • Strategic Planning
  • Risk & Market Analysis
  • Affiliations/Partnerships
  • Process Improvement

Other Experience

  • Guest Lecturer, US Healthcare System Urban Studies & Planning

Community Service

Team Manager – DMCV Sharks, Volunteer – DM Little League

Timeline

Chief Contracting Officer

UC San Diego Health Contracting
10.2020 - Current

Deputy Chief Contracting Officer

UC San Diego Health Payor Contracting
01.2016 - 01.2020

Director, Physician Contracting

UC San Diego Health Contracting
01.2002 - 01.2016

Manager, Eligibility & Data Analysis

UCSD Medical Group Managed Care
01.2000 - 01.2002

Managed Care Analyst

UCSD Medical Group Managed Care
01.1998 - 01.2000

Bachelor of Science - Animal Physiology & Neurosciences

University of California, San Diego

Master of Health Administration -

Cornell University
Patsy Bouzan