Manchester, New Hampshire, United States
Health care executive with strategic vision and strong record of growing margin, expanding markets and building successful business relationships among providers, payers and consumers of health services.
Responsible for developing, leading and overseeing implementation of provider solutions strategies in eastern seaboard markets. Collaborate with commercial, Medicare and Medicaid P&L leaders to define and execute network-based growth initiatives. Facilitate creation of innovative relationships to improve provider experience, enhance quality of care, and increase affordability. Evaluate and intervene to mitigate cost of care trends.
SVP, Excellus Health Plan. 2009 to 2020, led health care delivery, population health, cost management and quality improvement activities. Responsible for clinical and provider strategy and operations, network management, provider partnerships, value-based payment (VBP), CM, DM, UM, pharmacy, and related functions. CEO, Lifetime Care. 2014 to 2019, accountable for performance of the largest home care, hospice and home infusion organization in the Rochester NY market. Oversaw realignment and divestiture of Lifetime Care October 2019. CEO, Lifetime Health Medical Group. Between 2014 and 2017, accountable for performance of primary care clinics in the Rochester and Buffalo markets, including physical and behavioral health services, retail pharmacies, urgent care and related services. Led strategic assessment, marketing and sale of medical group assets December 2017.
Increased margin through market expansion and cost management strategies. Launched individual commercial and Medicare Advantage products, including sales & marketing, product development, and CMS filings. Oversaw provider contracting, provider relations, key partner negotiations, medical policy, utilization management, complex case management and related functions.
Positioned UnitedHealthcare as an alternative to established payers in the Massachusetts and New Hampshire markets.
Responsible for development, negotiation and implementation of fee-for-service and risk relationships with physicians, hospitals and integrated provider networks in Eastern Massachusetts.