Andy Heim Email & Phone Number

Stratford, Ct, Us

Boston, Massachusetts, Us

Medically Home is the industry leader in offering Acute-level Hospital at Home Care. MHG is filled with an exceptional group of healthcare disrupters, pursing a passion to provide better care. Offering hospital-level care through a decentralized health care delivery model, we have been able to serve over 30,000 patients and growing every day. As the Vice President of Fulfillment Operations, I have the pleasure to lead a talented group of individuals focused on coordinating in-home services on behalf of our wonderful patients.

Eden Prairie , Mn, Us

I was recruited to lead a centralized team accountable for patient services supporting the dispense and administration of Infusion medication. Specific tasks include customer service, benefit verifications, prior authorizations, clinical evaluations, and document management. I provided executive leadership for a team growing to 700 employees, overseeing approximately $50M of annual SG&A budget. I launched key scalability discipline including establishing quality and training programs, capacity management models, standardized reporting, and metrics management. I successfully measured the team through Net Promotor Score, performance quality, turnaround time, continuous improvement, cost management, and team development metrics.

Eden Prairie , Mn, Us

I earned a promotion into an executive leadership role, where I was responsible for driving clinical operations business results supporting Medicare and Medicaid members. I drove success measures focused on clinical affordability improvement (member cost reduction), member enrollment in various clinical programs, member and staff satisfaction, and overall financial discipline. This promotion expanded my executive leadership to lead a team of 1100 employees nationally who provided Clinical Case Management activities. This team maintained an annual SG&A budget of approximately $120M and revenue exceeding $250M. My team and I achieved exceptional 2019 business results across all teams, highlighted by realizing $297M in clinical affordability, while also exceeding targets with annual enrollment of over 300K members. I attained a division-leading Relationship Net Promotor Score (NPS) of 73 and Event-triggered NPS of 79 in 2019. I was also able to achieve exceptional Employee Experience results including an Employee Engagement score of 87%. Lastly, I lead the generation of over $8M in efficiency cost savings results versus a target of $6.4M (120% of target) in 2019.

Eden Prairie , Mn, Us

Promoted into a leadership role responsible for driving business results within Clinical Operations supporting specific clinical programs for Medicare members. Success measures focused on clinical affordability improvement (member cost reduction), member enrollment in various clinical programs, member and staff satisfaction, and overall financial discipline. Overall leadership accountability for approximately $40M in SG&A budget and revenue of nearly $50M. I successfully provided leadership for approximately 650 employees nationally, supporting many clinical and non-clinical functions. My team and I achieved exceptional and improving results year over year. In 2018, business results improved across all teams, highlighted by exceeding clinical affordability by 31% (total of $71M result) and exceeding member Enrollments by 4%. I led repeated successful program redesign efforts focused on key clinical support for Heart Health, Diabetes, Critical Illness, Palliative Care, and Nurse Triage processes.I was awarded the Collaboration Cup award highlighting the integration with Service partners to support a member’s service and clinical needs holistically. We were the sole recipient of this award across all of UnitedHealth Group in 2018.

Us

I was recruited and hand-selected to coordinate the Operational Implementation of Health Insurance Exchanges as a component of the Affordable Care Act. I successfully implemented the Exchange model by directing a team of Project Managers tasked with coordinating across dozens of functional teams impacted by Health Insurance Exchange regulations. I compared State Exchange requirements against current business capabilities and implemented solutions for the identified gaps. I used my extensive industry and company knowledge to develop creative solutions to address evolving government requirements. I facilitated Executive review sessions to communicate the progress of current Exchange business results and future implementations. I also effectively communicated with industry leaders regarding proposed legislation and ongoing Exchange administration.

Us

I directed a team of approximately 275 people tasked with crucial administration processes including employer and member enrollment activities, annual renewals, and benefit plan changes supporting medical insurance for Small Business customers. I led all aspects of administration including training documentation, quality management, production results, forecasting, staffing, and legislative compliance. I provided leadership for key metrics and resource budget management of approximately $15 million. I successfully managed a multilayer team consisting of 9 independent work teams and was accountable to a matrix of leaders within sales, operations, and corporate departments. I improved production results, quality results, and budget by a minimum of 10% each year, through various process refinement tools like Lean, Six Sigma, and similar techniques. I performed as the long-term operational relationship owner over TPA / Vendor relationship for the largest customer in United Healthcare Small Business representing $20 million in annual revenue. I established an overseas operation and closely managed the vendor relationship to ensure metrics were achieved. I received recognition as an emerging executive leader and was selected to participate in an exclusive UnitedHealthcare Executive Development Program which is awarded to less than 1% of employees within the company.

Us

UnitedHealthcare , Minnetonka, MN | Associate Director of Operations – Small Business Case Installation UnitedHealthcare, Minnetonka, MN | Operations ManagerUnitedHealthcare, Minnetonka, MN | Business AnalystMetraHealth/UnitedHealthcare, Minnetonka, MN | Senior Customer Service Representative