Renea DeGeorge

Work History

Senior Planning & Operations

CareOregon Health Plans

05.2024 - Current

Work with Regional Leadership to manage Strategic Planning initiative with a goal of financial savings and improved outcomes.
Manage Team Process improvements and communication outlets and strategic improvements throughout regional teams.
Collaborate daily with Regional Executive leadership to manage, prioritize and implement projects for successful results.
Worked effectively across internal and external teams to move projects forward.
Implemented tracking, communication, and project documentation into Regional spaces.

Program Manager for Value Based Payments

CareOregon

10.2023 - Current

Participate and lead internal and external project stakeholders through a portfolio of project and program improvements
Conduct discovery meetings to identify program needs and requirements. Use that information to create project plans for executive submission and approval
Manage Value-Based incentive payment model program using external audit results as baseline. Reduced results from high risk to low-risk across all areas. Also implemented additional improvements across program for improved execution of elements
Create process improvements including system automations, new program materials, training items for department and programs, as well as create dashboards to monitor results
Remove team obstacles, improve processes, and develop understanding of team and partner roles to improve outcomes
Liaison between departments for planning and managing deliverables around strategic objectives
Develop and draft processes, policies, and training items throughout team

Value Based Care Program Manager

St Charles Health Systems

01.2022 - 10.2023

Manage multiple strategic projects with numerous sub-projects or workstreams
Collaborate with Chief Financial Officer (CFO) and Executive Leadership to set priorities based on business needs, resource capacity and risk exposure
Captured over two million dollars in savings by implementing improvements within payer credentialing area
Work with VP of Contracting and CFO on Medicaid and Medicare Contracts around shared risk, community surplus and improved metric outcomes
Maintain milestones and objective targets based on input from functional areas, stakeholders, and executive leaders.
Participate in pilot tests and implementation of new systems as well as vendor onboarding
Point of contact for departments for smooth and efficient program development by collaborating cross-functionally across departments

Program Manager for Strategic Partnerships

PacificSource Health Plans

06.2018 - 01.2022

Put into position personally created by Chief Medical Officer and Regional Executive Vice President
Managed JOC Meetings that included outlining and presenting material for Value Based Initiatives and executive sponsored projects, while assisting in developing future state of projects and outcomes
Managed multiple Committees associated with Central Oregon region. Planned, communicated, and monitored strategies for committee results and outcomes. Created and monitored dashboard for company reference
Met with project stakeholders on regular basis to assess progress and make adjustments
Collaborated with Executive Leadership and directly with Chief Medical Officer to set priorities based on business needs, resource capacity and risk exposure
Reduced Provider set up errors by 80% and reduced capitation payment errors by three million dollars in two- year time frame through PCP assignment optimization and process quality improvements
Managed annual planning meetings for JOC and Medicare Operations committees
Developed and maintained logistics workflows, procedures and analytical reports to executive leadership with regulation reviews and updates for all lines of business
Partnered with internal and external teams (Cust. Svc., Operations, Rev Cycle, Contracting, Quality) to review opportunities, implement improvements, and ensure department supports are optimized
Orchestrated smooth and efficient program development by collaborating cross-functionally across departments
Liaison for health system implementation of Epic EHR system

Provider Service Team Lead

PacificSource Health Plans

11.2017 - 06.2018

Mentored office employees on proper administrative procedures and how to use programs such as Facets and Sharepoint, keeping operations consistent and efficient for maximum performance
Recruited, hired, trained and supervised staff of 10 Statewide, and implemented mentoring program that offered positive employee engagement
Managed internal team programs, coordinated efforts throughout team members, and delegated responsibilities as appropriate
Monitored team results and adjusted priorities as required
Developed and implemented office management procedures to increase team productivity and accuracy
Developed internal requirements and standards to minimize regulatory risks and liability across programs
Monitored capitation and payment outcomes for company's largest Health System and collaborated with leadership for improvement projects

Provider Service Representative

PacificSource Healthplans

04.2016 - 11.2017

Supported three Health Systems and CCO Tribal Community to strengthen relationship and improve cost and utilization throughout all lines of business
Hosted and presented workshops and improvement meetings for internal and external stakeholders
Educated providers about billing, payment processing, and support policies and procedures
Managed relationships with over 50 providers throughout six counties and two CCO Regions while maintaining high standards of service
Facilitated inter-departmental communication to effectively provide customer support
Maintained up-to-date knowledge of product and service changes
Sought ways to improve processes and services provided
Ongoing communications and site visits to continually foster partnership growth and compliance

Account Manager & Implementation

UnitedHealth Group, UHG

04.2010 - 04.2016

Effectively managed and monitored 150+ Medicare Employer account portfolios
Conducted Medicare Presentations for Employer group populations nationwide
Liaison between client, company, and TPA's to resolve any issues and strengthen relationship to onboard employee groups
Implemented New Employer group accounts averaging 500 or more retirees, working via remote environments
Acted as Subject Matter Expert (SME) for ongoing product/client development
Identified potential obstacles and develop solutions to remain on track
Managed a diverse portfolio of accounts, ensuring timely communication and effective problem resolution.
Developed strong relationships within company departments and outside employer groups by exceeding service level agreements (SLA) and providing superior customer service
Conducted regular account reviews to identify areas for improvement and ensure continued success.

Summary

Overview

Work History

Senior Planning & Operations

Program Manager for Value Based Payments

Value Based Care Program Manager

Program Manager for Strategic Partnerships

Provider Service Team Lead

Provider Service Representative

Account Manager & Implementation

Education

Bachelor of Science - Business Management

Skills

Additional Information

Timeline

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