United States
Experienced transformational leader and Chief Medical Officer with a demonstrated history of working in the hospital and health care industry. Skilled in managed care, population health, hospitalist services, post-acute care, health care consulting, disease management, pay for performance, process improvement, Medicare, Medicaid and health plan operations. Having spent the last 25 years of my career in value based care initially on the provider side and subsequently on the Medicare Advantage plan side, I have a very unique perspective on what works and does not work in population health and value based care. I have had the opportunity to lead large teams on the provider side to deliver high quality care that was cost effective and used those learnings to transform care across the country when I worked as a Clinical Transformational Leader for Davita Medical Group. In my current role was part of a team of executives that helped the company go public. I am a seasoned and strategic operator and have led operations for both plans and provider organizations while functioning as the clinical leader of the business to deliver high quality care with best in class utilization outcomes.
Managed a broader scope of responsibilities to support the needs of the business, including the technology, claims, member experience teams, STARS, risk adjustments, credentialing, UM, CM, home base care delivery and clinical operations. Managed a large team of 700+ direct and indirect reports approx. 64% of the company. Accountable leader for STARS program with more than 95% membership enrolled in 4 STAR or higher plans. Successfully scaled home-based care delivery teams across multiple counties and states, ensuring exceptional utilization and improving member experience. Pioneered a 24/7 virtual access to care model, reducing unnecessary visits to the ED or hospital. Spearheaded the implementation of new systems and processes, resulting in best-in-class clinical outcomes.
Advised private equity-backed population health and home-based care startups with initial business cases, patient engagement strategies and care plans to manage medical loss ratios (MLRs).