Led strategy team charged with development of second generation of Blue Cross NC’s signature value-based care program, Blue Premier, including expansion into specialty care models while continuing to support development of the ongoing original program for legacy participants.Conducted deep-dive evaluation of the original program.Expedited development of second program generation while continuing to support the ongoing original program by re-organizing the team, resulting in a seamless transition for program participants to new models.Produced comprehensive negotiation packages by working closely with actuarial, clinical, and contract management support to develop recruiting strategy for new program candidates.Created strategy roadmaps for value-based oncology and orthopedics models.

Led strategy development and operational planning for Blue Cross NC’s value-based provider agreements, including BCNC’s signature program Blue Premier, across commercial and Medicare Advantage lines of business. Program savings from 2019 - 2022 exceeded $500M.Extended value program arrangements across North Carolina to include all major health systems and 400+ independent providers.Ensured program alignment with national quality standards, which resulted in greater ease of compliance for program participants.Operational oversight included internal and external program reporting, direct provider consultation and support, and working closely with actuarial teams to monitor program financial performance.Delivered program results to senior management and worked with corporate communication staff on press releases and other publications.Ensured program alignment with corporate strategy by advising product development and strategy leads.

Co-led, with an internal Medical Director, team focused on primary care cost and quality strategy.Created five original independent primary care ACOs using a third-party aggregator and a new primary care reimbursement schedule.Reached agreement with national ACO aggregators on strategic operating and ACO agreements, cementing long-term strategic alignment among the parties.Contracted and directed implementation for four national Advanced Primary Care (APC) physician practices to facilitate their entry into the NC market for Medicare Advantage products.Designed and implemented a clinical Provider Engagement program to enhance ACO performance.

Built and led team charged with development and execution of innovative, non-traditional healthcare programs to lower cost and improve quality.Slowed primary care cost trends in NC via the Blue Quality Physician Program (BQPP), which financially rewarded independent primary care physicians for performance against quality metrics.Led expansion of BQPP to include most NC independent obstetrics and gynecology practices.Enhanced clarity and delivery of BQPP provider reporting by partnering with internal Innovation Lab.Designed and executed successful pilot for reimbursement redesign for palliative care providers in NC.Delivered $15M+ per-year savings in oncology care by implementing a medical oncology management program across all lines of business.

Responsible for centralized program/project management, identification and implementation of complex solutions involving reimbursement methodologies and contracting initiatives; aligning resources within division to most efficiently deliver program/product

Manage diagnostic imaging program, focusing on medical expense initiatives and quality.