Summary
Overview
Work History
Education
Skills
Websites
Published Article And Teaching Experience
Timeline
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Rebecca Rice

Richboro,PA

Summary

Highly accomplished Healthcare Consulting Executive with repeated success implementing large, system-level projects requiring cross-organizational collaboration. Proven success delivering multi-million dollar cost-saving initiatives while serving as a trusted strategic business partner. Strong people leader with innovative mindset and skilled at leveraging transformative technologies to streamline processes and optimize workflows.

Overview

28
28
years of professional experience

Work History

Vice President, Utilization Management Clinical Value Affordability (Medicare Advantage)

United Healthcare
01.2021 - Current
  • Manage a team of program managers focused on delivering clinical value programs for Medicare Advantage members
  • Collaborate with the markets, Healthcare Economics, Value Creation, Vendors, Optum, Optum at Home to ensure alignment with Enterprise goals and strategic direction
  • Present novel ideas around affordability and cost efficiencies to gain alignment from the states for Medicaid Dual Special Need Plans (DSNP) and the markets for Medicare as well as gain approvals from all level of stakeholders to continue pursuit of initiatives towards goals
  • Deliver $500+M in affordability savings using utilization management, population health, and complex care programs
  • Maintain and manage significant pipeline of ideas across Medicare and Medicaid DSNP to achieve goals and ensure multi- year progress
  • Set and manage prior authorization strategy across Lines of business and across United Health Group, ensuring that the total cost of care remains affordable for our members.

Global Senior Director, Clinical Transformation (Medicare, Medicaid and Commercial)

Optum
01.2016 - 01.2021
  • Partnering with the lines of business and the clinical operations teams to define clinical priorities and implement strategies to save expenses while still providing optimal patient care
  • Managed a team of 11 direct reports comprising project managers, project directors, and six-sigma black belts
  • Achieved $80M in affordability savings utilizing automation and artificial intelligence solutions
  • Identified key obstacles to achieving high customer satisfaction through organizational transformation, recruiting, coaching, and development to align and enable future growth
  • Implemented strategic partnership between Optum Global and Enterprise Clinical Services, allowing resources to be leveraged at a lower fee while delivering innovative clinical solutions
  • Led multi-disciplinary teams consisting of design experts, technology, project managers, and subject matter experts to deliver high-impact results
  • Served as an integral part of the senior leadership team, delivering thought leadership and strategic planning.

Senior Global Project Manager

GP Strategies
01.2012 - 01.2016
  • Sponsored overall enterprise-wide Volume to Value training for all sales segments for Cigna Healthcare
  • Managed the overall budget for Cigna University for the Growth college segment of $4.5Million.

Director

Vynamic
01.2010 - 01.2012
  • Effectively led multiple projects through the entire project lifecycle and reporting activities for client stakeholders
  • Oversaw vendor and project management and reporting across client and software vendors
  • Managed the non-profit cardiovascular foundation operations at a large pharmaceutical company.

Senior Consultant

DReiner Associates
01.2009 - 01.2010
  • Managed the acquisition and integration of a small pharmaceutical company purchased by a larger multi-national pharmaceutical entity and assisted with integration.

Vice President, Sales

PSL Research
01.2008 - 01.2009
  • Developed the US Business working with the established UK and Canadian data research sales models
  • Managed accounts and sales P&L for GSK and Centocor.

Senior Project Manager

PharmaPro
01.2001 - 01.2008
  • Successfully implemented a new sales training tool, training over 3500 sales representatives in 9 months with rollouts in new cities monthly
  • Identified opportunities for improvement and recommended solutions to enhance business processes and system enhancements.

Senior Consultant

PriceWaterhouseCoopers
01.1997 - 01.2001
  • Created a project management office (PMO) for enterprise-wide projects to gain efficiency and consolidate resources
  • Led the communication and training implementation of an enterprise-wide sales force automation rollout across 3500 sales representatives.

Technology Consultant

Arthur Andersen
01.1996 - 01.1997
  • Managed clinical software implementations for healthcare companies using Oracle and SAP software
  • Conducted seminars as part of a strategy to manage the transition from non-technical to technical environments.

Education

MBA -

Drexel University
Philadelphia, PA

BA -

Drexel University
Philadelphia, PA

Skills

  • Consulting
  • Engaging Communicator
  • Leadership & Team Building
  • Strategic Oversight & Execution
  • Budget & Fiscal Management
  • Market Insight

Published Article And Teaching Experience

  • Adjunct Professor at Drexel University, Strayer University, University of Phoenix, and Bucks County Community College
  • Published paper on Kafka and Labor law with a legal studies professor while at Drexel University

Timeline

Vice President, Utilization Management Clinical Value Affordability (Medicare Advantage)

United Healthcare
01.2021 - Current

Global Senior Director, Clinical Transformation (Medicare, Medicaid and Commercial)

Optum
01.2016 - 01.2021

Senior Global Project Manager

GP Strategies
01.2012 - 01.2016

Director

Vynamic
01.2010 - 01.2012

Senior Consultant

DReiner Associates
01.2009 - 01.2010

Vice President, Sales

PSL Research
01.2008 - 01.2009

Senior Project Manager

PharmaPro
01.2001 - 01.2008

Senior Consultant

PriceWaterhouseCoopers
01.1997 - 01.2001

Technology Consultant

Arthur Andersen
01.1996 - 01.1997

MBA -

Drexel University

BA -

Drexel University

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