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Work History

Apr 2012Present

Area Vice President , Employer Sales

Optum Rx

New business development through broker and consultant channel. Primary function involves managing the sales process in the assigned territory for prospective clients and strategic existing account renewals. Develop and execute strategies and tactics for territory planning, pre-RFP prospecting and relationship development, proposal development, pricing development, presentation and delivery, negotiations, closing and contracting. Other responsibilities include the development of the annual sales plan, the development of the overall sales strategy and long- term projections. Participate in major pricing decisions. Develop and maintain professional relationships with clients and prospective clients

Aug 2010Mar 2012

Chief Operating Officer

PENSA Health Management, Inc.

Responsible for all aspects of the development and management of the company’s products and services including dental and pharmacy product offerings.Developed and rolled out a pharmacy procurement model and analytic tools that provided significant savings opportunities to plan sponsors and health plans. Assisted in the expansion of a national dental plan operations into the Florida market. Developed and executed market expansion strategies to  increase the scope of the service model to include plan sponsors and benefits consultants.  Oversaw the marketing campaign to expand the pharmacy services model in the southeast region.

20072010

Director Southeast Sales

Medco Health Solutions

Responsibility for product management and sales to employer accounts, consultants, and brokers. Develop strategic partnerships with local, state and federal authorities for the management of pharmacy benefits.

·Developed the Southeast region into the fastest growing region within Medco.

·Exceeded corporate sales goals by over $30M per year for the region.

·Within 36 months new sales of over $200M were achieved.

·Directed a team of nine Account Executives resulting in the addition of over 30+ new clients annually.

20062007

Sales Director, SE Region

Medimpact Healthcare Systems

Responsibility for product management and sales to national accounts and health plans in the southeast. Developed strategic partnerships with clients to assist in lowering the overall cost of pharmacy benefit plans through the use of focused clinical programs and pricing alternatives. Delivered consistent results and positioned the company to win new business.

20052006

Principal

Independent Healthcare Consultants

Provided healthcare/managed care consulting services. Representative assignments include pharmacy, contract negotiation, relationship development, data integration, and reimbursement.  Advised plan sponsors on strategies to improve clinical as well as cost outcomes for their members. Worked extensively with a national out patient surgery provider to reduce costs by $60M.

19962004

President and Chief Executive Officer

BayCare Health Network

Directed network development, marketing and sales, finance, and all operations of the plan and its product offerings.Accountable to the Board of Directors for the overall performance of the organization and the accomplishment of strategic goals and objectives.

·Within a 30 month period, increased plan membership from 122,000 members to 800,000+ members        (Commercial and Worker's Compensation).

·Reduced operating expenses by 46% while increasing revenues by 507% during the same time period. Increased revenues by $285M through aggressive underwriting and contract re-negotiations.

·Developed and implemented a fully insured PPO product.

·Held simultaneous position as President of Welcome Care Health Plans, a Medicaid HMO plan.

·Organized and operationalized the functional areas of Provider Relations, Finance, Marketing/Sales,    Contracting, Credentialing, Utilization Review, and Systems.

·Established and maintained good working relationships with leaders/decision makers. Provided strategic guidance on managed care issues to provider sponsored network consisting of 18 hospitals and 3,000 physicians. 

19941996

Vice President Health Services

Aetna Health Plans

Managed the managed care network operations in Central and South Florida.Directed provider relations, contracting, quality management, utilization management, credentialing and data management.

·Developed HMO product in Central Florida with lowest medical PMPM costs within Aetna Health plans nationally.

·Managed a team of 9 direct reports and 315 operations staff.

·Developed and implemented a dedicated HMO utilization management unit for Central Florida which reduced utilization of inpatient services by 17% savings over $21M annually.

·Reduced unit costs by 45% through reconfiguration of existing network and renegotiation of contracts. Delivered $55M in annual savings over 2.5 years.

19851994

Metropolitan Life Insurance Company

Metlife Healthcare Network, Inc.

Director, Network Operations – 1991-1994

Senior Network Manager – 1990 - 1991

Network Development Consultant – 1988-1990                               

Professional Relations Manager – 1987-1988                                   

Provider Relations Representative – 1985-1987                             

Education

Summary

An innovative and results driven leader with over 25 years of  experience focused on achieving exceptional results in a highly competitive healthcare environment. Diverse background including payer, provider and pharmacy positions. Seasoned at cultivating and developing long-term customer relationships.

Consistently exceed performance expectations while improving efficiency, driving profitable results and reducing costs. In-depth knowledge of healthcare care operations and pharmacy. Track record and passion for developing staff and delivering strategies linked to corporate goals which drive revenue growth, operational excellence, and cost savings. A conscientious, multi-talented, self-starter with excellent interpersonal communication skills. 

References

References available on request.

Areas of Expertise

  • Revenue Generation
  • Operational & Strategic Planning
  • Marketing/Sales
  • P&L Management/Budgeting
  • Pharmacy
  • Customer Relations
  • Leadership Development
  • Contracting
  • Medical Management
  • Strategic Selling
  • Revenue Growth
  • Cost Reduction
  • Relationship Development

Objective

My future plans are to secure a senior management position where I can drive company growth through leveraging my strengths:

1. Strategic thinking and strong business alignment

2. Leadership and passion to instill confidence in others

3. Results based on best practices

4. In depth knowledge of health plan operations, health benefits, and pharmacy benefit management

Interest

  • Volunteer, Habitat for Humanity
  • Leadership Tampa Bay
  • Merck Southeast Customer Advisory Board
  • Tampa Bay Association of Health Underwriters
  • The Ohio State University Alumni Association - Life Member
  • National Association of Health Underwriters
  • American College of Healthcare Executives
  • Florida Association of Managed Care Professionals
  • Academy of Managed Care Pharmacy

Certifications

2-15 Life, Health and Variable Annuity Insurance License

Florida Department of Financial Services