Emily Thorsen Email and Phone Number
Glen Rock, NJ, US
Emily Thorsen's Location
Glen Rock, New Jersey, United States, United States
Emily Thorsen's Contact Details
Emily Thorsen work email
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About Emily Thorsen
Emily Thorsen is a Senior Director, Payor Strategy and Contracting at Ophelia.
Emily Thorsen's Current Company Details
Ophelia
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Senior Director, Payor Strategy and Contracting
Glen Rock, NJ, US
- Website:
- ophelia.com
- Employees:
- 315
Emily Thorsen Work Experience Details
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Senior Director, Payor Strategy And ContractingOpheliaGlen Rock, Nj, Us
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Payor Account ExecutiveOphelia Apr 2024 - PresentNew York, New York, United States
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Corporate Director, Medical Strategic InitiativesAmerihealth Caritas Jul 2022 - Mar 2024• Responsible for Medical Services’ operating performance across all lines of business (LOB), with a particular focus on the 10 Medicaid health plans. Reported directly to SVP, Associate Chief Medical Officer (CMO). Part of AmeriHealth Caritas’ first Corporate leadership structure designed to cultivate greater population health alignment, efficiency & scalability• Working at the intersection of the health plans & Corporate Population Health division to drive strategic collaboration, flow critical information & decision points, triage needs for cross-functional alignment & support, identify appropriate resources or intake processes & execute Medical Strategic Initiatives with LOB & health plan CMOs• Developed, launched & managed a cross-functional, executive Joint Operating Committee (JOC) model between the health plans and Corporate Population Health team; deployed the 10 Medicaid health plans in 2023 & expanding to Medicare & Exchange LOBs in Q2 2024• Created & launched in Q1 2024 a delegated Clinically Integrated Network / Advanced Medical Home Level 3 provider performance model on CM, quality and utilization for one of the Medicaid health plans. State-required 80% member delegation (278k lives) costing health plan $33M. Preparing for Q2 2024 deployment of scalable provider performance operating model across Medicaid health plans • Built & implemented a living Market Partnership & Communication Dashboard across all LOBsCodifying CMO workstreams with applicable outcome targets, risks, interventions & financial implicationsConducting quarterly strategic assessments of CMO workstreams to inform Corporate planning & responsiveness -
Chief Of Staff To The CmoStrive Health Jun 2021 - Jul 2022• Responsible for planning & directing the oversight, financial & operational activities for the Office of the CMO, including serving as a thought partner for annual goal development & execution, presenting department updates in executive forums, overseeing communication strategy, quarterbacking strategic cross-functional projects, providing guidance to department workstreams, overseeing staffing & onboarding, managing department budget & serving as a proxy for the CMO• Served as a subject matter expert (SME) for our Chronic Kidney Disease (CKD) / End Stage Renal Disease (ESRD) Care Model; supporting 16 Markets & 44k patients • Partnered with interdisciplinary team to develop Strive’s first systematic approach to monitoring company-wide performance, including monthly operating reviews, roadmap prioritization, department goal scorecards & budget management tools• Established & deployed department’s first waterfall framework for annual goal development, sprint cycles, workstream alignment, cross-functional dependency planning & performance tracker. Mobilized high-functioning teams to accomplish efforts such as obtaining NCQA accreditation, launching a clinical governance committee & standing up a Project Management Office • Launched Strive’s Clinical Advisory Board- a group that advises on the design, implementation & evolution of the Care Model. Facilitating development of contracts, recruiting members, overseeing compensation, driving quarterly meetings & executing updates as applicable• Supported development of company Marketing strategy, roadmap & topic submission process; facilitating creation of Care Model content (5 pieces published in 2021, 6 YTD in 2022) & conference preparation• Co-founder & co-lead for Strive’s Women & Allies Employee Resource Group (149 members); also quarterbacked Strive’s Diversity, Equity & Inclusion (DEI) Committee• Member of Strive’s COVID Committee, developing protocols & processes for responding to the pandemic -
Director, Provider Performance & IncentivesEvolent Health Jan 2019 - May 2021• Responsible for provider engagement strategy & operations, provider performance & evaluation, value-based payment (VBP) methodologies & shared savings distributions; reporting directly to Chief Medical Officer• Responsibilities included managing all Medicaid client relationships (4 Medicaid health plans in KY & FL) working with leadership to develop provider performance reporting & VBP incentive programs including activity-based incentives, outcome-based shared savings & capitation programs. Additional responsibilities included serving as SME for business development & Medicaid & Medicare client partners- Medicaid health plan 2019 VBP programs drove up to $756k in provider performance-based earnings; $1.5M across 3 Medicaid clients• Lead VBP programs including designing performance metrics & monitoring, developing VBP contract amendments, facilitating provider group negotiations, leading implementations & driving ongoing operations through earnings payouts • Organized network-wide provider engagement strategy by weaving together workflow design, actionable reports supporting incentive performance & population health management, Evolent’s population health technology platform, provider education & local plan clinical/provider relations teams• Developed intellectual property on risk, capitation & VBP programs for Medicaid & Medicare lines of business• Supported implementation of 3 new provider-sponsored Medicaid health plans within 6 months of State approval• Facilitated the design, conducted qualification analysis & operationalized a UM gold card auto-authorization incentive program for 3 Medicaid health plans• SME content lead & writer for 6 Medicaid health plan Request For Proposals • Managed Medical Expense Initiative campaigns evaluating savings opportunities around: operations, Rx, quality, clinical programs, UM, financials, payments & network contracting• Coordinated 3 vendor management contracts for 2020 MA health plan implementation -
Associate Director, Clinical Operations & NetworkEvolent Health Oct 2017 - Dec 2018• Quarterbacked 17 rapid cycle innovation pilots for Evolent’s Chief Innovation Officer. Developed and managed key performance indicator (KPI) dashboard for ongoing pilot evaluation and determination if pilots would advance to core programming; mentored project managers to design and monitor Leading and Lagging KPIs• Developed, implemented, and managed 2018 VBP shared savings program for Evolent’s largest partner, a Kentucky Medicaid health plan. Program was designed to improve quality of care & utilization, lower costs, support provider engagement, enhance risk adjustment coding accuracy, and elevate patient experience - Annually updating VBP program design for 2 consecutive years of operations, expanding the number of contracted provider groups - Program covering 120,000 attributed lives for 2,100 PCPs demonstrating YoY lower Medical Loss Ratio (up to 2.9%) and shared savings (up to $6.7M) - Designed all program scorecards, engagement materials, performance reports and payout tracking mechanism• Created Evolent’s intellectual property related to VBP and provider compensation strategies (“VBP Playbook” & accompanying PowerPoint slide library)• SME on VBP and risk arrangements for a Texas Medicaid health plan RFP• Coordinated UM incentive program design for 3 Florida Medicaid health plan RFP award readiness review
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Project SpecialistMontefiore Health System Jun 2016 - Oct 2017• Designed network contract metrics that drove MHVC’s performance for DSRIP outcome-based targets and supported creation of an integrated delivery system between the network’s PCPs, hospitals and community-based organizations • Developed 7 county strategic roadmap supporting DSRIP performance and preparing MHVC’s network for VBP under the New York State Innovator Program• Supported hospital systems, independent providers, and community-based organizations through governance structure guidance, workshops and site visits to discuss application of toolkits, reporting and workflow resources• Organized provider workshops around ED care triage, mental health crisis stabilization, substance use disorder referrals, and asthma management• Collaborated with two other DSRIP networks in New York to create a region-wide approach to crisis stabilization services; developed and conducted trainings on our Cross-Network Crisis Stabilization Protocol Report • Publications, contributing author - Institute for Healthcare Improvement, April 2017: Rapid Cycle Improvement in “Action:” Community Partnerships Addressing Social Determinants Reduces ED Utilization - 9th Annual Conference on the Science of Dissemination and Implementation in Health, December 2016: Assessment of Organizational Readiness and Capacity to Implement Tobacco Cessation Services in a DSRIP Performing Provider System -
Senior AssociateAvalere Health Apr 2014 - Jun 2016• Promoted to manage 3-5 life sciences and health plan retainer relationships and projects on an ongoing basis; our deliverables helped clients understand and respond to Affordable Care Act exchange implementation, Medicaid expansion, state waiver innovations, and state and federal insurance market reforms • Spearheaded project for a health plan client to restructure its compliance department and build a system to efficiently monitor and triage actionable regulations and guidance -
AssociateAvalere Health Apr 2013 - Apr 2014• Analyzed consumer understanding of and access to health insurance benefits across commercial insurance, public health exchanges, and government programs
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Teaching AssistantColumbia University Mailman School Of Public Health Sep 2012 - Dec 2012• Supported professor teaching by identifying new readings, holding office hours, and grading evaluations -
Research AssistantColumbia University Mailman School Of Public Health Sep 2011 - Dec 2012• Contributed to study published in Health Informatics Journal: Appointment Reminder Systems and Patient Preferences: Patient Technology Usage and Familiarity with Other Service Providers as Predictive Variables
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Grants And Public Policy Graduate InternSusan G. Komen For The Cure - Greater Nyc Affiliate May 2012 - Sep 2012Greater New York City Area• Evaluated grant recipient progress and presented funding renewal recommendations -
InternNew Jersey Cancer Education And Early Detection Program Sep 2010 - Feb 2012Morristown, New Jersey• Expedited patient access to cancer screening by interviewing women for program eligibility, documenting enrollment information, and administering the participation survey
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Reservations Assistant/Student SupervisorMacalester College Oct 2007 - May 2010St. Paul, Minnesota• Managed Reservations Department team staffing and addressed elevated client needs -
InternAmphion Innovations May 2008 - Aug 2008New York, New York• Contributed to investment evaluations by investigating and reporting on orphan drug pursuits
Emily Thorsen Education Details
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Health Policy And Management
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Economics And Psychology
Frequently Asked Questions about Emily Thorsen
What company does Emily Thorsen work for?
Emily Thorsen works for Ophelia
What is Emily Thorsen's role at the current company?
Emily Thorsen's current role is Senior Director, Payor Strategy and Contracting.
What is Emily Thorsen's email address?
Emily Thorsen's email address is et****@****lth.com
What is Emily Thorsen's direct phone number?
Emily Thorsen's direct phone number is +157138*****
What schools did Emily Thorsen attend?
Emily Thorsen attended Columbia University Mailman School Of Public Health, Macalester College.
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Emily Thorsen
Computer Science Student At Skidmore College Pursuing A Career In Software Development.Lititz, Pa -
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