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Summary

Eight year career in Healthcare, IT, and Business Development.

Strategic growth catalyst.

Seasoned story teller.

Experience

Network Program Manager

OPTUM- UnitedHealth Group
Jun 2016Present
  • Manage territory of Maine, New Hampshire, and Vermont consulting providers on improving quality of care and risk adjustment through Optum tools and programs focused on  Medicare Advantage market.
  • Utilizing data analysis, identify and target providers who benefit from Medicare Risk Adjustment training and documentation/coding resources.
  • Partner with physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships.
  • Develop comprehensive, provider-specific plans to increase their RAF performance.
  • Train providers on  Risk Adjustment programs and tools, and work toward the adoption of these programs in to their practices.
  • Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts.

Manager- ACA SHOP

National Government Services (Anthem Inc.)
Aug 2015June 2016
  • Hired, coached, and empowered team of customer service all stars for the federally funded ACA SHOP Call Center.
  • Stood up Portland, ME SHOP Call Center location to partner with virtual team.
  • Built and developed staffing model to ensure contract performance against call volume forecasts.

Senior Account Management Analyst

Anthem Blue Cross Blue Shield
Jun 2014Aug 2015
  • Created, tested, and implemented marketing strategy for Business Solutions Team.
  • Support change management within Business Solutions Team's Strategy and Account Management office.
  • Enhance IT value to internal business partners through proactive communication and account management.
  • Match business needs with innovative IT solutions.
  • Lead Discovery phase and feasibility studies for business partners.
  • Drive adoption of IT solutions and processes through increased IT literacy.

Senior Account Consultant

Anthem Blue Cross Blue Shield
Aug 2009Jun 2014
  • Drive the development and execution of marketing materials for the world’s largest group health benefits plan.
  • Strategic focus on market analysis and content delivery to member level decision makers.
  • Grow and maintain a membership of over 75,000 lives across Maine and New Hampshire with over 99.5% rate of retention.
  • Mentor, train, and empower team of Open Enrollment Marketing Consultants to promote enrollment growth initiatives.
  • Lead consultant on Go to Market healthcare strategy and market segmentation committees.
  • Research and implement viable technologies, such as iPad and CRM updates to enhance value dialogue in the field.
  • Winner of the 2012 Blue Cross Blue Shield Association Rookie of the Year Award.

Education

MBA 2018 Candidate

Saint Joseph's College
Oct 2014Present

Leadership MBA

B.B.A.

University of Maine
Sep 2004Dec 2008

Business Administration and Organizational Development

Certifications

Life and Health Producers License

Maine Bureau of insurance
Jan 2010Present

Active Producers License in Maine and New Hampshire

Fellow, Academy for Healthcare Mangement

AHIP
Jul 2011Present

Fellow and Professional Designations: 2011 PAHM, 2012 FAHM

Certified Risk Adjustment Coder

AAPC
2017Present

CRC Risk Adjustment Certification

Skills

Risk Adjustment Consulting

Provider Education, Process Improvement, HCC Methodology, Clinical Documentation Improvement, Certified Risk Adjustment Coder (CRC)

Strategic Communication
High Energy. High EQ.  Focused on all perspectives and productive negotiator.
Account Management
Well rounded management of expectations for several disciplines within Healthcare/IT. 
Team Building

Realizing potential and building trust of teams from 3 to 50

Solution Selling
Seasoned sales and consulting with award winning speaking engagements and formal training.
Technology

SFDC, Tableau, Access, Health BI