Oversee population health business operations for the clinically integrated network.

Responsible for the management and operations of the Patient Quality Alliance clinically integrated network (CIN); including provider recruitment and contracting, credentialing processes, vendor/consultant relations, implementation of population health technology platforms, program/project management, payer relations and value-based contracting, product development and plan benefit design, oversight of population health management and care management programs, budget management, and strategic planning. Accomplishments include growing the network to over 1,000 providers across the care continuum, increasing the number of covered lives from 1,100 in 2015 to over 30,000 in 2019, expanding the service area from 2 counties to 8, and earning nearly $5 million in shared savings as a return to the network.

In an effort to change the way healthcare is delivered, I led and project managed the development of two accountable care organization (ACO) based commercial products within the state of Idaho. The products were supported by two separate clinically integrated networks, tasked with better coordination of care, reducing waste, improving quality, and participating in shared savings...eventually shared-risk. These products allowed the realization of providers, payers and patients working together collaboratively to reduce costs and over-utilization, increase transparency, maintain quality, and improve health outcomes. We also explored opportunities for alternate reimbursement methodologies, such as bundled or episodic payments, PMPM for population health management, and withhold/capitation as we worked to move away from fee-for-service reimbursement or production-based medicine. I also coordinated/managed various other projects including multiple initiatives to reduce cost & utilization, an ER reduction campaign to promote primary and urgent care, a project to coordinate the accounting process for the payment of fees associated with the HCR/ACA insurance exchange, an RFP process to select a PBM vendor, the selection and implementation of an exclusive specialty pharmacy vendor, and PBM contract negotiations.

Assisting Dr. Bruce Croffy, Senior Vice President and Chief Medical Officer, in the Medical Quality Management Department

Private practice counseling office specializing in counseling individuals with depression, anxiety, body image issues, eating disorders, relationship and sexual issues.

Plastic, cosmetic and reconstructive surgery practice.