David Gentile Email & Phone Number

Miami-Fort Lauderdale Area

• Provide strategic oversight and operational leadership supporting provider Stars and Risk Adjustment programs
• Oversee Stars and Risk Adjustment enterprise strategies for priority setting to ensure achieving goals and targets with emphasis on contractual goals exceeding $60M (Stars upside/downside risk)
• Established business case leading to $5M investment in Stars improvement including large expansion of a highly talented Stars team and investment in various tech-based and analytics initiatives
• Responsible for goal/KPI setting (annual/monthly) and ramp plans for enterprise Stars and Risk Adjustment
• Create market-based plans leading to achieving $20M to $60M 3-year annual revenue objectives for Stars program
• Worked jointly with clinical leadership team to develop a comprehensive playbook for Stars, Risk Adjustment and Coding Accuracy

Bloomington, Indiana, United States

• Provided strategic operational leadership of payor member onboarding and engagement programs
• Tasked with leading a suite of innovative products connecting Medicare Advantage beneficiaries to early access to care including programs & initiatives associated with Risk Adjustment and Stars
• Established clear strategic vision with 3-year product roadmap that led to a successful launch of a new clinical data driven platform leveraging interoperability between high quality providers and health plans
• Platform provides early insight into new patient clinical conditions, risk adjustment and quality measures
• Created “Operations Excellence” playbook to ensure program goals and outcomes are exceeded
• Augmented and aligned program solutions with vendors who provide speed to market/ongoing efficiencies

Tampa/St. Petersburg, Florida Area

• Provided strategic oversight and operational leadership of Stars quality activities and outcomes
• Led corporate quality strategy, program execution, Stars governance, and oversight
• Established clear strategic vision, which includes specific 3-year quality goals and targets for the enterprise
• Developed Stars Playbook and annual work plan that perpetuated the Stars program towards additional $500M in annual revenue over the past three years
• Examples of sizeable turn-around and improvement include HEDIS and health plan operations measures, Appeals/Grievances, Complaint/CTMs, Health Risk Appraisal and TTY/LEP
• Oversaw $60M Quality budget and implemented $50M investment in internal and external programs, campaigns and initiatives leading to increased member and provider engagement and satisfaction

In partnership with senior leadership, identify, review, analyze and prioritize proposed projects to ensure consistency with corporate strategies and objectives. Primary liaison to senior management and project sponsor community. Continuously upgraded the tools, templates, artifacts and processes, as department increased from three to fifteen project.

Through strong vendor management, continued to integrate IT vendor solutions within business areas augmenting their various processes and systems. Implemented Home Health Assessment service which continues to provide annual revenue enhancement for Medicare population by increasing accurate coding assignment and reducing risk of expiring HCC scores.

Managed budgeting, administration, facilities management, application development, workflow planning, and staff development. Led two $3-$4 million custom reengineering and data warehousing projects both of which led to increased client commitments for long-term projects. Led large and complex projects from customer ideation through design, construction and.