Providence, Rhode Island, United States
A finance executive focused on strategy, innovation, data and technology with over 20 years of experience driving notable results in both finance and business operations. Mark also has strong leadership and people skills demonstrated by the ability to build and manage small and large cross-functional teams in a highly matrixed organization.
Oversight of company’s financial viability, managing over $450M in revenues. CFO+ role with broad management of financial, treasury, risk adjustment, actuarial, contracting, and analytic functions. • Collaborate with Sales and broker community to become the fastest growing MA plan with Oregon (40% growth.) • Develop and execute the financial and pricing strategies to drive MA revenue growth, operational efficiency, and profitability while ensuring execution against strategic objectives. • Led the actuarial team and collaborate with product teams in plan design and evaluation, driving the full lifecycle of bid planning through AEP/OEP and implementation of benefit design. • Assess potential mergers, acquisitions, and strategic partnerships from a financial and strategic perspective
Senior most financial executive and member of executive leadership team with oversight of company’s insurance and health solutions, representing nearly $2B of revenues. Oversee broad financial, treasury, investment management, as well as business planning, actuarial and pricing, data analytic, LEAN management system and IT functions. • Achieved financial turnaround with five consecutive years of positive earnings, increasing risk-based capital by over 200 points to 700% and surplus by 43% to $423M. Results driven by strong financial discipline relating to revenue optimization, capitalizing on operating expense efficiencies and diligent medical cost management strategies • Collaborated with Sales team to grow strategic segments (Medicare / Self Insured) by 10% since 2015, including win of State employee benefits contract • Integral part of team that successfully negotiated an IT, operational and pharmacy strategy that is expected to generate over $250M of savings over the life of the contracts • Implemented new risk contracts across Accountable Care Organizations, transitioning market from shared savings to downside value-based risk models • Led due diligence and creation of joint venture with Oak Street Health, introducing a disruptive primary care model serving the Medicare market • Developed and implementing digital transformation strategy, updating core infrastructure, while creating a strategic roadmap that will enable best in class technologies (data lake, machine learning and predictive models)
Member of senior leadership team responsible for overall direction of company’s insurance operations and financial leader overseeing key financial and strategic functions. • Provided leadership in developing and accelerating company’s strategic investment activities • Oversaw organization’s accounting principles, practices, procedures, policies, and initiatives and preparation and presentation of financial reports to executive leaders, Board of Directors and external stakeholders • Led pricing and actuarial functions, developing rates for Commercial products and Medicare bid • Managed key relationships with Board Finance Committee, external auditors, regulatory finance staff, company bankers, credit rating agency, and investment managers
Executive with oversight of all financial controls (accounting/reporting, taxes, treasury, and internal audit), pricing and data analytic functions of the organization. • Drove operational and financial efficiencies, establishing core metrics designed to optimize financial performance while maximizing capital position, resulting in +30% EBITDA growth YOY • Instrumental in negotiating profitable client contracts, resulting in expansion to a national footprint (from 12 to 42 states) diversifying revenue streams across both risk and non-risk product offerings (+30% top line growth) • Developed business model and financial incentives for new MSO / ACO product line, with anticipated sales of +30k members and $5M EBITDA within first year • Implemented data warehousing structure, combining clinical and claim data to produce robust set of business intelligence tools for providers and payer clients, allowing for enhanced population health / quality and cost management programs • Worked with investment banking partners to position company for sale. Company was sold to Evolent in 2017
Led product organization within Accountable Care division, responsible for the creation and implementation commercial Accountable Care Organizations between Aetna and selected provider partners, including: development and marketing of joint insurance products, coordinated care delivery, differentiated member experience, and the overall improvement in efficient and effective use of the healthcare system. • Managed over $25M IT portfolio, developing foundation capabilities necessary to integrate payer and provider functions, delivering a differentiated product and member experience • Developed go to market strategy in priority markets, launching innovative health products directing the team from ideation to implementation. • Developed and executed diversified product distribution strategy that leveraged new channels such as public and private health exchanges, purchasing coalitions and direct sales
P&L ownership (General Manager) of the Select Account segment, which is one of the largest business segments within Aetna; accounting for approximately 10% of total revenue ($4B) and membership (1M). The segment is uniquely positioned, accommodating the needs of smaller sized businesses as well as emerging companies (50 to 300 employees). Since joining the segment, membership and revenue have grown over 10%, while outperforming the industry average (flat growth). • Developed and launched new self-funded product to capitalize on market opportunities due to health care reform. Product highlighted in Hartford Business Journal and other professional periodicals • Created market optimization strategy, addressing profitability concerns in underperforming markets. Implemented “fresh start” pricing initiative to reduce risk selection within book of business. Partnered with Sales and premier brokers, creating new commission and compensation structure • Provided thought leadership and strategic positioning regarding private exchange opportunities emerging as part of healthcare reform. Identified and retained third party vendor, creating a new interactive administrative platform that provides a consumer shopping experience new to industry. Anticipating over 100k new members over 3 years resulting for new capability • Identified top performing verticals within Segment; initiating relationships with key constituents while highlighting Aetna’s capabilities and driving potential sales opportunities. Resulted in sales and retention of 60k profitable members in 2012
Finance lead supporting the CFO of Business Operations, providing financial oversight of all Aetna businesses. Developed financial analysis highlighting both over and underperforming businesses, driving mitigation actions to ensure earnings targets were achieved. • Led team which developed analysis and content for quarterly business reviews and earnings calls, collaborating with Segment CFOs to understand business drivers while implementing mitigation strategies to ensure optimal earnings growth • Supported Business Operations CFO in management of P&L and development of earnings forecast resulting in sustained revenues over $30B in an increasingly competitive pricing environment. Managed several strategic expense reform initiatives to ensure optimal cost structure achieved • Managed configuration and designed functionality of new planning and forecasting tool and management information system