Collaborative Health Systems, a Centene company, is a management services organization that partners with primary care providers/physicians as they move to value-based payment systems.

• Fulfills a key executive leadership role over clinical operations, managing a team of senior medical directors, medical directors, psychiatrist medical directors, a chiropractor, physical therapists, and dentists. Recruited and onboarded six new medical directors. Improved operating performance across all lines of business with TAT over 98%.• Innovated a pilot nutrition program for the benefit of high-risk Medicaid members, working with a community partner to address food insecurity through a curbside food market, leading to reductions in ER visits and increased engagement with primary care providers.• Collaborated with the New York State Department of Health and a Value-Based Purchasing partner to build a community-wide postpartum telehealth program.• Worked with Chiropractic Medical Director to launch/expand a musculoskeletal preventive health program.• Developed, promoted, and contributed to the implementation of an enterprise affordability program.• Serves as the Clinical Lead supporting over $400K in annual community investments.• Leads the development of advanced data analytics initiatives to foster data-driven decisions relating to clinical programs and care improvement.• Clinical lead for value based payment partnerships driving collaboration, savings targets, metric agreement, contracting and performance evaluations.

• Delivered results that included a 20% increase in membership and improved NPS, as well as high provider satisfaction and quality performance.• Partnered with key stakeholders within executive leadership, clinical operations, and data analytics to build risk profiles of the population to gain insight into target/match programs, improve case management, and track the impact of programs.• As clinical lead, contributed to the design and validation of predictive analytics models for risk of readmission, future costs, and opioid use.• Redesigned and re-engineered clinical operations to a member-centric focus, and integrated behavioral health and physical health teams.• Redesigned the Bright Beginnings maternal/fetal program to improve patient outcomes and increase engagement. Served on the NYS Postpartum workgroup.

• In 18 months, reversed a revenue loss within the line of business of $100M to a gain of $38M.• Implemented summary dashboards and focused on KPI performance to satisfy SLA requirements with Excellus.• Redesigned case management, moving away from disease-specific focus to a holistic member centered approach driven by risk profiles.• Spearheaded a redesign of the Affordability process and led a presentation to Excellus demonstrating ROI and PMPM performance overall and within case management cohorts.

• Directed a team responsible for Meaningful Use presentations, influencing the adoption of workflows that achieved 99% compliance with Meaningful Use requirements.• Served in a leadership or contributory role in the development of documentation, care management, and reporting tools for population health management.• Led a team dedicated to collecting data and building reports for Meaningful Use, PQRS, Medical Home, Chronic Care Management, CMS Bundle Payment plans for total joints and CHF, DSRIP, and Provider Access.• Served as the Chair of a committee of Clinical Informaticists engaged in key decisions for the design, education and build of electronic health records systems. Led the transfer of data from the Touchworks system to the new Epic system.