Lead the Humana Healthy Horizons (Medicaid) Clinical Strategy Advancement and Evaluation (CSA&E) team of 50+ direct and indirect associates and their counterparts across all Medicaid markets. Report to the Medicaid Chief Medical Officer, with a mission to empower sustainable healthcare transformations and improve individual health outcomes through innovative, data-driven, and equitable clinical strategies and solutions, ensuring the highest quality of care and value for Humana Healthy Horizons beneficiaries. We execute this mission through two teams: Equitable Population Health & Innovation Managemento Center for Equitable Population Health – Includes: (1) National Pop Health and Health Equity Frameworks, (2) National Pop Health and Health Equity Market Support, (3) National CBO Partnership Framework, (4) Clinical Model of Care Strategy and Design.o Strategy Advancement - Clinical RFP Responses & Playbook), covering clinical, HRSN/SDOH, Health Equity and Population Health domains.o Innovation & Product – Lead Health Management innovation portfolio, including: (1) Clinical Vendor Discovery, (2) Product Development, (3) Portfolio Governance, (4) Humana Community Navigator (findhelp) national program management. Clinical Analysis & Effectivenesso Data Engineering & Governance - Identify data and analytics gaps and develop global data strategy to enable efficient PHM analytics.o Insights & Business Intelligence - Measure, track, and share insights for a standardized set of clinical measures, in support of central, market and business development teams. Includes the following BI tools: Physician Productivity Dashboard (PPD), Health Risk Assessments Analytics Dashboard (HRAA), Medicaid Member Intelligence Dashboard (MID), Clinical Performance Management (CPM) Analytics, and Population Health Analytics Suite (PHAS).o Center of Clinical Effectiveness - Evaluate clinical programs and products for efficiency and effectiveness.

Led enterprise social needs team of 50 direct and indirect associates. Reported to Chief Medical Officer, with mission to improve the health of members and communities through development and integration of solutions that addressed unmet social needs. Grew Bold Goal market infrastructure to 20 communities, deploying localized strategies, community engagement, and business support. Drove adoption of SDOH pilots, supplemental benefits, and other related services, improving HRQoL, health outcomes, and member growth and retention. Oversaw SDOH insights, business intelligence, and informatics, growing screening to 20%+ of Medicare Advantage (MA) population, certified 100+ data sets, and launched and grew Population Health Analytic Suite to 2,000+ associate users. Operated SDOH innovation and product development, developing rapid learning process, codified product stage gates, and overseeing portfolio of 30 initiatives, leading to scaled programs and supplemental benefits. Social Health Access Referral Platform (SHARP), scaled to 5K associate users, and 70K referrals for SDOH gap closure by 2Q2022. Matured provider-focused SDOH initiatives, including value-based payment innovation and integration of data, analytic and screening tools into care management systems, providing clinicians real-time access to social risk information. Led SDOH strategic partnerships and campaigns, partnering with Volunteers of America on a multi-state community health worker initiative and integrated health and housing approach. Launched Far From Alone, loneliness awareness campaign, bringing together partner organizations and promoting resources. Advanced SDOH thought leadership and communications, contributing to improved business development, brand, and member growth. Supported RFPs, leading to 3 state Medicaid and 8 Group Medicare contract wins. Launched population health website, developed member and provider education materials, spoke at multiple conferences and events.

Led expanded scope within the Bold Goal initiative, including 15 associates focused on population health and SDOH Analytics, Insights, Strategy and Execution, Thought Leadership, Communication and Marketing. Matured SDOH data ecosystem. Implemented data governance process, certified 20+ data sets for inclusion in Longitudinal Health Record, building first PowerBI population health insights dashboard. insights generation, including annual member surveys (scaled from 1 to 6M), SDOH predictive models and Social Risk Index, peer-reviewed research publications and quarterly policy briefs. Demonstrated statistically significant improvements in HRQoL for Bold Goal communities, identifying associations between SDOH and healthcare resource utilization. Developed strategies and product development pipelines for food insecurity, loneliness, and other SDOH domains. Pilots included: Papa, Mom's Meals, Feeding America, Uniper, and Friendship Line. Co-developed first SDOH-focused MA supplemental benefits through value-based insurance design (VBID) and special supplemental benefits from chronically ill (SSBCI), including Healthy Foods Card grocery benefit for 70,000 members. Launched industry first SDOH Value Based Payment Innovation program, incentivizing primary care physicians to screen, document and refer for SDOH. Spearheaded SDOH-focused COVID-19 response. Delivered 1.5M meals to 100K members to address food insecurity.

Built HRQoL and SDOH measurement and learning team, including data collection, informatics, and research. Led insights, strategy, and measurement for Humana’s Bold Goal of improving health by 20%. Measured HRQoL (using CDC’s Healthy Days tool), SDOH, clinical leading indicators, and business performance metrics. Initiated and scaled HRQoL and SDOH screening from zero to 1M+ members / year, leading to key insights, such as Unhealthy Days per chronic condition, correlation of Healthy Days with disease progression, top SDOH that impact HRQoL, and value analysis showing 1 Unhealthy Day = $15.64 PMPM increased medical spend. Created SDOH data ecosystem to standardize and structure HRQoL and SDOH data for use in reporting, patient stratification and advanced analytics. Developed informatics tools to create population health insights and measure performance, including Bold Goal Performance Scorecard (40+ key performance indicators), Market Health Scorecard (community initiative performance), Community Health Directory (external geospatial data), and Research and Insights Hub (collection of key insights). Published peer-reviewed population health research, including 40+ manuscripts and posters.

Directed Retail Segment clinical consumer strategy. Advanced clinical models of care for Retail product members through development, implementation and evaluation of initiatives aimed at preventing and delaying progression of chronic disease. Programs included: Stay Healthy Humana, virtual diabetes prevention program, diabetes self-management program, and MyHealth (Diabetes and CHF app). Led HumanaOne (Affordable Care Act plans) Right Level of Care and ER diversion strategies. Initiatives included: Right Level of Care communications, Personal Nurse intervention for high ER utilizers, and telemedicine pilots. Drove Medicare Chronic – Special Needs Plans (C-SNPs) strategy, including benefit design, formulary, marketing tests, condition verification, and member growth. Led PDP to C-SNP and organic marketing campaigns, contributing to growth to 26,000 members, and reducing voluntary turnover rate of 8%. Contributed to award-winning clinical research, collaborating on clinical, quality and population health studies. Served on Publications Committee, Analytical Steering Committee and Joint Research Governance Committee.

Enterprise-wide chronic condition subject matter expert, providing thought leadership, strategic direction, consultation, research collaboration, and clinical program leadership. Monitored chronic condition healthcare utilization, costs, and trends, leveraging insights to inform new strategies. Developed new interventions and provided oversight and continuous improvement for established clinical programs, leading to better health outcomes.Key Projects: Disease Management Transformation (Insourcing disease management programs, $4M cost savings). COPD and CHF Readmission Reduction Program (Nurse practitioner in-home post-acute visits). Asthma Program (Clinician guidance and self-care education, $1.3M / yr. cost savings, 3:1 ROI). Obesity and Pre-Diabetes Program (Clinical assessments and curriculum, $1.2M / yr. cost savings, 4:1 ROI). Sleep Apnea Transformation (Facility to home sleep testing, sleep therapy compliance program, $10M cost savings). Annual Influenza Surveillance, Communication, Vaccination and Reporting.

Oversaw strategic design and development of interventions to address health promotion and chronic conditions. Key Project: Led enterprise-wide H1N1 Influenza strategy, monitoring pandemic, coordinating communication internally and externally, and acting as liaison to national organizations (CDC, AHIP), awarded Humana STAR Award.