Leading financial teams comprised of Decision Support, Actuarial Services, Risk Adjustment Analytics, Enterprise Analytics and Medicare Coding.Expert in financial modeling (program, policy, and ad hoc organizational changes), contract modeling (hospital, professional, ancillary), capitation (DOFR considerations, reinsurance, kick payments), shared risk pools (SRP), quality incentives (QI), pay for value (P4V), Fee-for-Service (FFS: APR-DRG, MS-DRG, Per Diems, Fee Schedules, Billed Charges/Charge Master, Outlier logic), budget development (forecasting of membership, revenue, medical costs), cost and utilization trending/forecasting, Medicare (CMS) risk adjustment (HCC, RAF, RAPS/EDPS), Medi-Cal risk adjustment (CDPS), and healthcare underwriting. In depth knowledge of actuarial services (IBNR, Medi-Cal RDT: rate development template, Medicare bid, DHCS/CMS Audits). Extensive health plan, commercial, Medicare, and Medicaid revenue/payment experience. Oversight of organizational financial planning, operating strategies, and financial outcomes. Key financial spokesperson for internal and external executive leadership.