As the Chief Executive Officer of Champion Payer Solutions and Balance Health Plan, I oversee the strategic direction and operational excellence of a transformative healthcare organization. Focused on driving sustainable growth, maximizing efficiency, and delivering innovative management solutions, Champion Payer Solutions partners with healthcare providers to enhance patient outcomes and unlock value. By fostering collaboration and leveraging cutting-edge strategies, we are positioning the organization as a leader in the evolving healthcare landscape.

Transcend Health is a leading health population company committed to optimizing the well-being of communities through innovative and data-driven solutions. We leverage cutting-edge technology, analytics, and a deep understanding of healthcare dynamics to empower organizations in achieving better health outcomes on a large scale.https://transcendhealth.io/

VPMV is a consulting and advisory company that helps healthcare businesses (i.e. health plans, Independent Physician Associations (IPAs), physician groups, health systems and hospitals) to strategize and optimize their value-based care propositions. In particular, VPMV specializes in value-based care opportunities and population health management for: • Primary Cares Initiative• Medicare Advantage (MA)• Medicaid Managed Care• Advancing American Kidney Health Initiatives• Chronic Special Needs Plan (C-SNP)• End-Stage Renal Disease (ESRD) As Founder and Principal:• Identify and develop new business engagements.• Based on clients’ needs, develop business proposals, statement of work, project scope, budget, and timelines.• Assess current capabilities of an organization and provide recommendations for high priority opportunities.• Analyzed and quantify the potential clinical quality outcomes as well as the financial impact of the opportunities.• Assist in implementation and improvement of value-based care programs.• Provide project trainings to clients as needed.

Legacy Health Plan is a start-up health plan focused on serving Medicare Advantage (MA) members and Chronic Special Needs Plan (C-SNP) members in Southern California. As Senior Vice President of Quality Programs and as Managing Partner, serving on the senior executive leadership team:• Instrumental in design, implementation and execution of strategic and business plan of organization. • Identified and developed new business opportunities, especially pertaining to value-based care opportunities. • Instrumental in the development and execution of IPA provider contracts. • Responsible for the development and operational execution of Quality programs (STAR HEDIS, CAHPS, HOS, Quality Improvement initiatives, etc.) through our Model of Care (MOC) framework.• Responsible for risk adjustment and hierarchical condition category (HCC) coding initiatives.• Provide oversight of care coordination efforts, such are care management, utilization management, disease management, and transitions of care.

As Vice President of Operations and member of C-suite leadership team: • Oversaw and co-supervised the overall management, continuous improvement and growth of nearly 40 medical and surgical specialties at 15 locations with an annual revenue of ~$140MM.• Responsible for all population health management programs and the execution of all value-based contracts for a value-base care population of over 42,000 members. • Responsible for operational oversight of our accountable care organization, NM Care ACO, LLC. • Provided strategic vision for population health management operations. The population health management departments include: Affiliate / IPA Network, Clinical Quality, Care Management, Medical Coding, HCC Risk Adjustment, Hospitalists, SNFists, and Home Care, and Pharmacy Management. • Engaged, developed, and built the physician network.• Implemented and evolved key performance indicators to drive accountability and continuous improvement for clinical, operational, and financial outcomes.

As Regional Operations Director: • Oversaw the overall management, continuous improvement and growth of 13 dialysis facilities with a regional revenue of ~$60MM in the Orange County area.• Oversaw the design, development and construction of 7 new clinics in the Orange County area. • Worked closely with ancillary services such as pharmacy, laboratory, skilled nursing facilities, hospice, home therapies, etc. • Participated in due diligence of potential acquisitions as well as oversaw the transitional process of those acquisitions.• Provided leadership and direction to assure the highest quality patient care services and continuous operational improvements with a focus on cost effectiveness.

As national leader for Renal Case Management business line:• Responsible for the development, operations and support of the Renal Case Management program in the U.S. • Planned, executed, and finalized the RCM strategy.• Managed and sustained high performance excellence, resulting in 9% reduction in average hospital length of stay and 16% reduction in 30-day readmission rates.• Responsible for coordinating the efforts of a matrixed team to ensure all aspects of the project lifecycle from project initiation through execution and reviews were completed on time.• Participated and coordinated with Integrated Care Services on accountable care organization (ACO) strategy and integrated delivery care network (IDCN) strategy.

As Regional Operations Director:• Oversaw the overall management, continuous improvement and growth of 15 dialysis facilities with a regional P&L of ~$21MM in the San Diego area and the Orange County area.• Worked closely with ancillary services such as pharmacy, laboratory, skilled nursing facilities, hospice, home therapies, etc.• Oversaw the design and construction of new units and unit expansions/renovation.• Participated in due diligence of potential acquisitions as well as oversaw the transitional process of those acquisitions.• Provided leadership and direction to assure the highest quality patient care services and continuous operational improvements with a focus on cost effectiveness.

As Regional Operations Director and member of the executive leadership team:• Oversaw all management and strategic/operational functions of an integrated network of community-based, ambulatory care clinics in conjunction with the county medical center.• Developed and managed Kern Medical Center Health Plan. • Developed and implemented a proprietary electronic claims processing system.• Developed, implemented and maintained systems, including processes and procedures, to provide coordination of primary and specialty care health services.• Collected and reported network data, including balanced scorecards, monthly data dashboards and report cards.

As Assistant Department Administrator of Harbor MacArthur Medical Office Building (one of the largest ambulatory/outpatient facilities in Orange County): • Co-managed outpatient programs, services and operations in a large multi-specialty ambulatory medical office building. • Ensured continuous improvement by designing and implementing systems, processes, and methods to improve patient care delivery.• Monitored financial performance and identified and implemented strategies to reduce costs and improve quality of care services.• Managed and resolved human resource, labor relations, employee and safety/risk management issues.• Acted as patient advocate and resolved patient care issues.

As Associate Director of Internal Audit and Compliance, served as department head and reported directly to Chief Executive Officer (CEO):• Coordinated and managed all internal audit activities based on an analysis of their relative risk to QTC. • Performed operational compliance audits for all QTC medical evaluation facilities throughout the U.S., including audits of laboratory, diagnostics tests, and x-ray.• Compiled and presented findings and process improvement recommendations to operations leadership and CEO.• Audited and reviewed provider contracts to ensure proper payment for all relevant services rendered. • Performed quality reviews of medical reports and worked with physician liaisons to provide feedback and re-training, as needed.• Revised and trained office managers on provider scheduling requirements. • Using LEAN theory, created a process improvement plan for materials management.• Developed a KIOSK project to capture customer satisfaction ratings.• Developed or revised needed policy and procedures.

As Manager of Health and Human Service Business Unit: • With a thorough understanding of Federal and State policies and regulations and by applying operational process improvements, optimized Medicare and Medicaid claims for numerous state and county departments in California, Wisconsin, Pennsylvania and Colorado. • Assisted San Diego County Tuberculosis Clinics with optimizing Medicaid billings through best practices, business process improvements and staff trainings regarding relevant Federal and State policies and regulations.• For San Bernardino County Department of Aging and Adult Services, project managed a Personal Care Services Program (PCSP) eligibility review.• Served as project lead for a rehabilitation facility in La Mesa, California, and conducted an operational analysis to optimize cost efficiencies and maximize Medicare and Medicaid cost recovery.