Doris Kraemer Email & Phone Number

Experienced consultant to healthcare organizations providing assistance with developing strategic goals, evaluating clinical operations, and managing care across the continuum.Advising companies on specific areas of health care reform, system enhancements and resource utilization. Helping organizations identify and manage populations at risk for chronic disease management, institutionalization and long term care.Assisting individuals with understanding Medicare, Medicaid, health insurance and long term care insurance benefits. Offering geriatric care management services including: cognitive and functional assessments, home safety assessments; care planning and coordination; supervision and training for private caregivers.

Demonstrated steadfast cultural leadership through successful integration process post acquisition maintaining highly functioning staff.Provided strategic oversight and launched new Care Coordination unit including re- engineering case management processes to reduce Genworth's long term care claims by $1.9 MM in first year. Delivered high volume Care Coordination services within 6 months of implementation while achieving a 97% quality rating. Identified opportunity to reduce unit cost by 13% through technology enhancements and outsourcing to offshore vendor.Thought leader and key contributor for new business opportunities including: market research, program development, operational implementation, financial modeling and implementation of client satisfaction survey. Provided subject matter expertise for RFP submission. Presenter for AARP Life at 50 Conference in Washington D.C., Alzheimer's Association National Diversity Conference, numerous radio shows and Long Term Care Insurance Agents meetings.

• Led mission driven Start-up Company to profitability and sale to Fortune 500 Company within eight years. • Launched nation’s first comprehensive long term care provider database featuring over 96,000 providers with proprietary rating methodology that established company as leading experts in long term care. Recognized as one of fastest growing companies by Inc.com in 2007. • Established national network of more than 6,000 long term care providers offering pre-negotiated discounts as part of CareScout’s referral program while generating income of more than $60MM for participating providers.• Developed strategic relationships with nation’s largest long term insurance carriers growing revenues of more than $3MM in new Care Coordination business.• Created nationwide network of more than 2,000 Registered Nurses. Provided oversight for nurse’s enrollment, contracting, automated on-line training, quality assurance and compliance needed to maintain effective network.Managed national call center of Nurses, Social Workers and Senior Advisors to assisted families and patient with long term care decisions, health assessments, care coordination and provider selection.Designed and implemented provider credentialing program generating additional revenue that advanced claims approval process.

Created partnership model for patients and providers enabling HPHC to improve clinical outcomes, service quality and utilization of post acute care continuum. Working with Medical Directors and PCP's across New England led team of clinical consultants that designed and implemented changes to patient care delivery process resulting in projected savings of $12MM. Established programs to manage vendor network including: facility credentialing, contracting, incident reporting and performance measures to meet NCQA accreditation. Recipient of two staff achievement awards for Quality of Care and Utilization management.Developed Hospice admission criteria through collaboration with hospitals, physicians and specialists by coordinating use of new benefits that improved access to services and utilization of contracted vendors resulting in increased patient satisfaction. Member of HPHC Ethics Committee assisting organization with evaluating medical management decisions and implementation of prescription formulary. Initiated, piloted and evaluated Interqual criteria for Acute Rehab, Long Term Care Facilities and Home Care with regional case management staff resulting in HPHC licensing improved criteria. Participated in HPHC's strategic initiative for Congestive Heart Failure disease management overseeing the RFP process, vendor selection, program implementation and quantifying outcome.

• Led parent organization to profitability and sale by reshaping business practices and expanding vendor contracts, managing operations, assisting with program sales and delivering specialized care management services for self insured groups, unions, and indemnity carriers. • Launched Certified Home Health agency within first year. Coordinated medical and nonmedical care with physicians, patients and families, insurers, community resources and other providers.

Developed Medicare certified home health agency and non-medical home care company to support strategic goals of organization. Provided skilled nursing service and therapies to senior population in Metro Boston area. Coordinated care with community resources and state home care programs under Executive Office of Elder Affairs. Achieve high rate of patient and physician satisfaction with services provided. Secured relationships with local managed care organizations, established programs with high tech home care vendors and met or exceeded compliance with regulatory agencies while leading company to financial success.

Start-up, for-profit, Medicare Certified Home Health Agency and Private duty home care company successfully acquired after achieving JCAHO accreditation and statewide expansion to six offices.