Business Strategy: • Interim Chief Operating Officer for newly established health plan. • Interim Compliance and Security Officer. • Strategic support for executive team of multiple health plan founders. • Strategic planning and support for health system sponsored health plan launch. • Strategic planning and support for addressing provider network adequacy mandates. Project Oversight: • Successful health plan launches for multiple integrated health systems and Consumer Owned and Operated Health Plans (CO-OP). • Clients awarded contracts for multiple Medicare Advantage applications with CMS. • Clients warded HMO licenses (certification) with the state department of insurance. • Multiple successful vendor implementations.Process Management: • Streamlined healthcare consulting firm's risk adjustment business, cutting staffing needs by over 50% and enhancing client outcomes. • Designed, developed, and implemented provider data load process between client health plan and their third-party administrator. • Provider network adequacy management for multiple health plans. • Designed, developed, implemented and provided ongoing back-office risk adjustment processing for consulting firms risk adjustment clients.

Executive Vice President and Chief Operations Officer at Louisiana Health Cooperative, Inc., leading and managing all hands-on operational aspects and activities of information technology, member services, and third party administration. Mark also serves as the company’s security officer, overseeing the management of information security policies, procedures, and technical systems.

Fulfilled the role of Interim Director of Billing and Enrollment during OHP’s integration into Humana per the Humana acquisition of OHP. Responsible for the operation of the Premium Billing, Accounts Receivable, Enrollment, and Medicare Reconciliation functions. Additionally, responsible for the migration project of said operations into Humana’s corporate process and systems in Louisville, KY and Green Bay, WI. Position worked closely with Humana corporate counterparts to insure proper business process and data mappings were developed and implemented to insure seamless transition to Humana. Responsible for managing sensitive, and critical, employee retention program during OHP operational ramp-down following 60-90 day notice of reduction-in-force for all full-time staff members. Position reported to VP, CEO.

Responsible for providing centralized Program/Project Management for strategic corporate initiatives. Operational responsibilities included managing individual strategic projects, and providing overall coordination and management for the organization’s portfolio of projects and company-wide project managers. Position worked closely with executive management team and reported to VP, COO.Significant projects managed:•Development and implementation of Corporate Project Management Office•Design and Implementation of Product-wide Open-formulary Pharmacy Benefit (including custom information system development)•Design and Implementation of New Point of Service health plan product (including information system configuration)•Implementation of 2003 Medicare + Choice Plan Benefit Changes (including information system configuration)•Implementation of Third-party, Nation-wide provider network (including information system interfaces and support)•Medicare + Choice PPO Center for Medicare and Medicaid Services (CMS) Demonstration Proposal Project

Managed the team responsible for maintaining all corporate business applications. Responsible for establishing and maintaining the configuration of plan benefits, enrollment, medical management, member and provide services, and claims for the multi-state health plans operated by Centene. Assisted in developing and executing strategies for merging and migrating systems as required per acquisitions. Established formal change management for all systems. Assisted in the development of the CMS application to participate in the Medicare + Choice (Medicare Advantage) program, which resulted in Centene's first MA plan, which would be established in Texas.

Provide data analysis and ad hoc reporting necessary to support business operations.

I was recruited as part of the team to establish and manage the new Physician Hospital Organization unit at PacifiCare in Cypress, California. Working closely with partner organizations, I focused on setting up potential systems and processes for the unit. Unfortunately, the initiative was put on hold indefinitely when PacifiCare began acquisition discussions with a competitor.

In my role as a Program Analyst at Humana in San Antonio, Texas, I developed and generated reports necessary to support all departments. Worked closely with departmental stakeholders to understand how they used the various corporate systems in their daily roles, to include the specific screens and data elements that they deemed critical in their successful. Used that knowledge to better understand the overall operation of the health plan and to create reports that better supported departmental goals and daily operations.

In my role as a Financial Analyst at Humana in San Antonio, Texas, I was responsible for tracking and reporting hospital inpatient census data. This involved providing daily and weekly Admit and Days/1000 reporting across all business segments, as well as preparing provider information packets for capitation payments. I was able to automate the temporary role I was initially hired for within two weeks, which led to my full-time employment at the company.