Vanessa Guzman
New York
Summary
Dynamic professional with extensive expertise in health outcomes, healthcare initiatives, and community engagement, focused on whole-person transformation and empowerment. Proven ability to create, plan, implement, and integrate strategic directions at SmartRise Health and Ella Es Health, driving corporate alignment and innovative provider payment models. Skilled in developing comprehensive transformation plans and strategic visions tailored to organizational goals and customer needs. Committed to enhancing program evaluation processes and identifying partnership opportunities that deliver measurable value.
Overview
21
21
years of professional experience
1
1
Certification
Work History
CEO & President
SmartRise Health
New York, NY
05.2020 - Current
- Proven expertise in health equity, whole-person transformation and empowerment, corporate strategic alignment, provider payment models, population health and quality improvement.
- Overall responsibility for creating, planning, implementing, and integrating the strategic direction at SmartRise Health and Ella Es Health.
- Including, creating, and designing corporate and individual transformation plans and strategic visions for customers and the organization.
- Program evaluation and partnerships opportunities and value.
- Created a new global coaching and community engagement business unit, utilizing top transformation and healthcare improvement leaders as advisors.
- Helped organizations gain over $7000M in shared savings, quality improvement and population health strategies over the last four years.
- Since May 2020, delivered value propositions, strategic plans and marketing products to clients, increasing customers and sales performance across 48 partners and customers, including stewards such as NCQA and CMS, and global organizations, such as Pfizer and the United Nations.
- Developed partnerships across the healthcare landscape including: Policy reform and stakeholder engagement, COVID-19 Vaccine Deployment strategy in New York City, Pharmaceutical-payer channel - value proposition engagement and provider-payer integration, Remote patient monitoring - Chronic condition management and behavioral health, Patient engagement - Front-end and dynamic content, Social determinants of health referral systems, Risk adjustment - Prospective and Retrospective Coding.
Associate Vice President, Quality & Network Management
Montefiore Health System
Bronx, New York
01.2017 - 05.2020
- Responsible for leading Montefiore Health System's efforts relating to: Quality Care Programs; implementation of accountable care organizations (ACOs) MACRA/MIPS and Value-Based Payment (VBP) Models; implementation of health information and IT solutions, inclusive of: reporting platforms, electronic health and medical records (EHR / EMR), clinical claims data, information and communication streams, and HIE interoperability to support population health management and social determinants of health (SDOH) programs.
- Oversee a budget of approximately $390M in annual quality incentives, bonuses and downside risk.
- Responsible for overseeing and implementation data exchange processes, reporting applications and standards, cloud-based platforms, and IT solutions such as; telehealth, patient engagement tools, connectivity standards to regional health information organizations (RHIOs) and [meaningful use] of electronic health records across Health System's 11 hospitals, 6,400 providers and associated clinicians and staff.
- Create annual provider services, quality & patient care plans and budgets, to advance quality measures in value based programs, expand and/or define provider and hospital infrastructure and clinical support and achievement of VBP measures for all payers.
- In conjunction with the SVP & VP of Operations, develop the strategic direction of the use of IT solutions such as the achievement of meaningful use standards including the proper use of the EHR, the expansion of IT solutions related to new provider and hospital sites, reporting and analytics platforms, referral management, community linkages and telehealth.
- Lead the organization's efforts in regards to Next Generation ACO quality and network management functions oversee progress toward project implementation, accomplishment of established measure achievement, and drive the process of clinical improvement activities.
- In conjunction with the Chief Medical Officer, responsible for leading the Care Management Organization's efforts to reduce preventable resource use, clinical documentation strategy to support the HCC coding payment model and maximizing value based purchasing.
- Assist in developing evidence-based guidelines, monitor the achievement of CMS quality measures and shared savings in the ACO.
- Implement patient engagement programs designed to improve H-CAHPS and ambulatory CAHPS scores, improve patient clinical adherence and enhance network management and leakage efforts.
Quality Improvement, Assistant Director & Director
Montefiore Health System
Bronx, New York
10.2012 - 12.2016
- Along with the Chief Medical Officer designed and development of the Quality Improvement program and provide leadership to ensure creation and implementation of processes to improve provider understanding and integration of Ambulatory Quality Improvement measures including HEDIS/QARR and ACO performance standards.
- Led the development of systems that effectively communicate quality performance data to oversight organizations and health plans.
- Coordinated the development of meaningful and effective patient outreach strategy using available resources and evaluates resources required for expanded outreach effort.
- Developed and implemented a provider engagement strategy to support approximately 5,000 providers.
- Led the development of quality reporting tools, such as provider feedback reports, GPRO submission and data exchange program with health plans and payers to support VBPs.
- Designed and implemented an automated, technology-driven patient engagement approach, leveraging IVR and multimedia platforms to increase clinical adherence and patient linkage to primary care services.
Quality & Optimization, Manager
Montefiore Health System
Bronx, New York
10.2010 - 10.2012
- Oversaw IT Optimization and Quality Initiatives activities throughout 138 Montefiore Ambulatory facilities.
- Accountable for integrating Montefiore quality initiatives such as Meaningful Use, HEDIS/QARR, Accountable Care Organizations (ACO) and Patient Centered Medical Home (PCMH) into electronic medical records (Centricity-EMR) deployment procedures and team operations.
- Responsible for integrating institutional requirements from HIM, Billing Compliance and Regulatory Affairs into IT and C-EMR processes such as workflow, content (medical records), user training and compliance, and hardware setup.
- Developed CEMR Quality Assurance program in 2011, including design, implementation, and monitoring/controlling processes.
- Developed and/or adjusted processes associated to: facility performance improvement reporting, facility workflow and content re-design and implementation, Application QA to Production and tracking processes, and user training and communication methodologies.
- Within 5 months of Optimization program initiation, Meaningful use compliance increased by 48%, up to date team has successfully attested for nearly 500 ambulatory providers.
- Workflow/Compliance incidents decreased by 52%. Patient Care and Safety associated with unsigned documents have improved by 74%.
Director, Market Research Healthcare Sector
Majestic Research
New York, New York
10.2007 - 10.2010
- Managed core business and operational development functions (e.g. purchasing, human resources, finance, quality control, material management) within market research operations.
- Supervise staff of 5 and direct systems implementations to support contracts such as GE Healthcare, Pfizer, and AstraZeneca.
- Challenged to initiate improvements for under-performing areas, including data acquirement, team output and product deliveries.
- Developed and implemented a SQL database that served a data backup, scheduler, and consolidated analysis tool for all research projects.
- Led teams in design and development of US & EU research products.
- Increased gross profit margins 17% by restructuring organization through root cause analysis and process management.
- Improved on-time delivery of reports from 58% to 93% within 1 year by implementing project planning system on teamwork, quality and scheduling dashboard redesign.
Manager, Business Development
Medicexchange
New York, United States
01.2007 - 10.2007
- Developed 'Go-to-Market' strategies to penetrate customers and markets with potential for growth.
- The key to this business was to identify partnership opportunities, generate leads and identify new product introduction, while working with existing offerings and developing marketing plans for the region being targeted.
- Played key role in increasing sales in less than 1 year through effective marketing, press release and website management.
- Assisted with the acquisition of partnerships with major publishing players and medical device manufactures to reduce in-house sales expenditure and overhead costs.
Manager, Quality Assurance & Implementation
Synamed- Electronic Medical Records
New York, New York
02.2005 - 01.2007
- Led the product quality of the electronic medical records system, by designing and testing the release of new versions of the software functionalities, fixes and new products.
- As a small company, there was a need for structure in QA measures with minimal budget and large scale improvement.
- Designed a multi-step QA cycle that enabled all healthcare professionals using the EMR to view requested functionalities in multiple versions of the software.
- Ensured all EMR services provided met or exceeded 'Meaningful Use' requirements.
- Enabled HL7 connectivity between the software and major labs, such as Labcorp and Quest Diagnostics.
Education
Master of Science - Biomedical Engineering
Columbia University, Fu Foundation of Engineering & Applied Science
New York01.2007
Certification - Quality & Organizational Excellence (CMQ/OE)
American Society for Quality
01.2012
Certification - Quality Engineer (CQE)
American Society for Quality
01.2012
Bachelor of Science - Biomedical Engineering
Columbia University, Fu Foundation of Engineering & Applied Science
New York01.2006
Skills
- Value-based Care
- Population Health Management
- Quality Reporting/Process Engineering
- Strategic Planning
- Budget Planning & Administration
- Stakeholder Engagement
- Didactic and Experiential Learning and Education
- HIT/HIE/Digital Health and Interoperability
- Contracting Management
- Leadership/Matrix Organization
- Executive Coaching
- Network Management
- Federal and State Policy Implementation & Continuity
- Regulatory Compliance Management
- Data Visualization, Warehouse, Reporting Design and Structures
Accomplishments
Executive Leadership & Board Governance
- Board Member, New York eHealth Collaborative (NYeC): Provide strategic governance for New York State’s Health Information Exchange (HIE), advising on statewide data policy, interoperability, and the integration of social determinants of health (SDoH) data into clinical workflows.
- NCQA Clinical Program Committee Member: Collaborate with national experts to shape quality measurement standards and clinical performance metrics, directly influencing HEDIS specifications and national accreditation frameworks.
- IHI Certification Designer: Engineered proprietary change management and leadership curricula based on Institute for Healthcare Improvement (IHI) standards, certifying healthcare executives in performance improvement and patient safety protocols.
- Architected a comprehensive Health Equity and Quality Transformation framework that integrated data analytics with population health interventions to drive cost savings and revenue capture for health systems.
- Designed and launched a year-long Health Equity Fellowship, cultivating an internal cohort of certified leaders through project-based curriculum focused on quality improvement and community-focused care.
- Spearheaded "Whole Woman Care" and "Food as Medicine" clinical pathways by integrating specialized digital health platforms (Ella Es Health, Cena Health) into existing Value-Based Care (VBC) arrangements.
- Established a foundation for National Culturally and Linguistically Appropriate Care (CLAS) standards across client organizations, ensuring compliance with NYS and Federal health equity mandates.
- Optimized VBC contract performance for health systems and payers, maximizing quality-based reimbursements and securing new revenue streams through strategic incentive alignment.
- Mitigated significant financial and reputational risk by addressing CMS Star Rating declines and adverse audit findings through targeted root cause analysis (RCA).
- Directed the implementation of the CMS GUIDE Model (Guiding an Improved Dementia Experience), reducing caregiver burden and emergency department visits while maximizing Shared Savings Program (SSP) performance.
- Utilized the IHI Breakthrough Series (BTS) Change Management Model to design Learning Collaboratives that delivered lasting, transformational change across multi-site health systems.
- Engineered data-driven Root Cause Analysis (RCA) protocols incorporating human factors engineering and process mapping to identify underlying gaps in clinical workflows.
- Led technical systems integrations for HEDIS and Star Ratings tracking, leveraging platforms like Cozeva to automate care-gap identification and streamline EHR-to-quality data flow.
- Operationalized SDoH strategy by integrating the Findhelp platform into population health workflows, ensuring the closure of non-clinical care gaps (housing, food, and transport).
- Transformed Community-Based Organization (CBO) value propositions into formal, sustainable contracts with payers by validating their impact on health outcomes and disparity reduction.
- Scaled community-facing programs for underserved and at-risk populations, measurably improving connectivity and performance metrics for health plan partners.
Certification
Quality Engineer Certification - ASQ
Organizational Excellence Certification - ASQ
Certified Professional in Clinical Health Equity (CPCHE), IHI
Languages
English
Italian
Spanish
Timeline
CEO & President
SmartRise Health
05.2020 - Current
Associate Vice President, Quality & Network Management
Montefiore Health System
01.2017 - 05.2020
Quality Improvement, Assistant Director & Director
Montefiore Health System
10.2012 - 12.2016
Quality & Optimization, Manager
Montefiore Health System
10.2010 - 10.2012
Director, Market Research Healthcare Sector
Majestic Research
10.2007 - 10.2010
Manager, Business Development
Medicexchange
01.2007 - 10.2007
Manager, Quality Assurance & Implementation
Synamed- Electronic Medical Records
02.2005 - 01.2007
Certification - Quality & Organizational Excellence (CMQ/OE)
American Society for Quality
Certification - Quality Engineer (CQE)
American Society for Quality
Bachelor of Science - Biomedical Engineering
Columbia University, Fu Foundation of Engineering & Applied Science
Master of Science - Biomedical Engineering
Columbia University, Fu Foundation of Engineering & Applied Science
Credentials
- ME
- MS
- CQE
- CMQ/OE
Locations
- New York, NY, 10013
- Connecticut, CT, 06877
Personal Information
Title: CEO & President
Awards
- Modern Healthcare's Diversity Leader Award, 2018
- Milli Awards, 2018
- Becker's Hospital Review Rising Stars Under 40 Award, 2018
- Modern Healthcare's Up and Comers Award, 2017