Drew Joyce Email & Phone Number

Charlottesville, Virginia Area

HMO Affiliates, LLC is a nationally recognized and established managed care consulting firm with extensive experience in development and operational management of Health Plans.• Consulted on ACO CO-OP application and development and Medicaid RFP development.• Contributed insurance, managed care, operational, and health care marketing expertise to hospital and clinic health care providers. • Generated operational, contracting and marketing plans, drafted responses, implementation plans and schedules to support successful development.• Strategic planning for insurance and healthcare providers planning for the changing insurance environment.

Charlottesville, Virginia Area

• Reporting to the CEO of the Medicaid Division, member of national senior leadership team responsible for the largest Medicaid growth in Coventry history – Dec. 2011 membership up 50% to 690K members; revenue up 70%, same store profit contribution up 10%. • Active in growth strategy, RFP / State negotiations, development of health care savings, network expansion & management, quarterly reporting and centralized prior authorization development. • Stabilized Coventry’s first centralized prior authorization function meeting staffing and production goals. Developed processes and organization to triple staff and volume.

Charlottesville, Virginia Area

• 260,000 members; 65% VA, 35% WV; 40% Commercial Risk, 30% Medicaid, 30% ASO.• Coventry’s 4th largest health plan. Staff included 200 employees in 5 offices. Added CEO direct reporting responsibility; Commercial Sales and Medical Directors. Human Resources staff through matrix relations. • Engaged in extended push to improve pricing and profitability, through improved medical cost positioning. Established three multi-disciplinary teams to improve positioning in all lines, Operations- claim payment/editing savings; Network- quality performance/fee evaluation, and Medical Management- utilization and quality program savings. • Year over year profit contribution increased 37% or $26 mm to 15% of Revenue.• Increased underwriting / sales discipline; reduced MLR by 500 basis points to 78.1% with loss of less than 7% of revenue.

Charlottesville, Virginia Area

• Reporting to the CEO, maintained previous responsibilities and added; Network Development, Health Services, Quality, and West Virginia Commercial Sales. • Key staff expanded to include Director-Sales WV and Chief Financial Officer in 2008. • Focused West Virginia strategy on Medicaid expansion. Completed contracting and expansion into all but 3 counties- yielding 90% growth.• Developed WV’s first HMO POS product and individual non-employer group trust filed in WV and sold in VA and WV.• Expanded VA HMO service area into DC metro area.• Successfully addressed contract and network challenges to maintain unit cost and access position.

Charlottesville, Virginia Area

• Reporting to the CEO, responsible for the following functions for all business lines; budget, audit, reporting, State and Federal compliance activities, medical economics, multi-functional medical savings initiative process, RFP review and approval, VA / WV Medicaid Program (Member outreach, State liaison, contract renewal) , Medicare bid/contract renewal. Underwriting, Actuarial, Claims, Customer Service, Legal and Facilities Management reported to me through matrix relationships. • Key staff included VP-Operations, Controller, Director of Medical Economics, Director- Medicaid Programs. • Active in integrating two health plans in Virginia in 2002. Organization of integrated staff functions, network relations during conversion claim / Rx changes. • Grew Virginia membership by 28% from 2002 to 2009 and WV membership by 28% from 2006 to 2009. • 2002 to 2009 MLR avg. 79.8% (worst year 83%) and average corporate profit contribution equal to 12% - one of the best in Coventry. • Planned and managed integration of Virginia and West Virginia health plans in 2006

Durham, North Carolina

• Financial Management, Strategic Planning and M&A reporting to owner of multiple health plan organization.• Acquisitions and restructuring of health plan holdings resulting in divesture of North Carolina holdings and building a 400,000 member insurance operation in Florida. • As CFO, planned and managed one-year orderly wind-down of 12,000 member North Carolina Health Plan, Doctors Health Plan. Interfaced with regulators, organized, planned and retained staffing.

Baton Rouge, Louisiana Area

• Chief Financial Officer and HMO operational head for troubled hospital owned Health Plan with approximately 21,000 Medicare+Choices, 50,000 at risk commercial members and 120,000 self-funded TPA covered lives. • Assisted with attempts to market health plan to potential purchasers.

Greater New Orleans Area

• Chief Financial Officer for Advantage Health, a Louisiana, statewide, hospital owned HMO formed in 1994, and Healthcare Advantage, a rented network manager serving 250,000 covered lives. • Financial leadership through development of the HMO from 7,900 members in July 1996 to 73,500 commercial, individual and 20,000 Medicare risk members in December 1997. • Managed Claims and Customer Service function to successfully stabilize operations, resolve claims payment and systems issues.• Assisted with sale of PPO network management business, March 1999. Planned and assisted with execution of plan closure and market withdrawal, June 30, 1999.

San Jose, California

• Managed start-up of Lifeguard's insurance subsidiary, Lifeguard Life Insurance Company. Certificate of Authority issued Dec. 30, 1993. First products filed June 1994. Statewide PPO introduced July 1995.• Responsible for product development, underwriting, actuarial, and revenue receivable.• Assisted with growth of Northern California HMO from 107,000 members to 173,000. • Developed POS product, small group market entry, and Medicare risk program start-up. • Planned and managed Lifeguard's acquisition and operation of Travelers Health Network of California. Managed all functions including claims and customer service of this health plan on a separate PC system through system conversion and integration.

Dallas/Fort Worth Area

• Financial officer for national managed care department consisting of 10 HMO legal entities and 42 integrated managed care local medical management sites with over 500,000 members and over $100 million operating expense budget.• Named CFO for Travelers Health Network, Inc., responsible for centralized financial leadership and oversight of Traveler’s holding company for 10 HMOs.

Bloomfield, Ct

Bloomfield, Ct.

Master Of Business Administration (Mba), Finance & Accounting

Bachelor'S Degree, Biology, General