Kevin Christopher Email & Phone Number

Value Based Contracting New York and New Jersey• Responsible for contracting, negotiating, implementing, and executing commercial ACO/PCMH programs as well as Medicare Collaborations.•Develop presentations to present quarterly financial results to provider groups indicting time in point performance.•Develop action plans to improve performance, STAR ratings, lower medical benefit ratios, and deliver value.• Ensured quality measures are met and supplemental file feeds installed to close gaps in care with various provider groups.• Actively managing relationships with the provider groups - Coordinating cross functional teams of care management, local market, and informatics to support critical engagement activities and to achieve and surpass performance targets.• Responsible for coordinating all types of account servicing in order to implement, maintain operations, and realize benefits according to the value-based contract (VBC) arrangement. • Ensures the achievement of financial, clinical, and operational VBC goals.

New Jersey

• Responsible for provider recruitment, contracting, and re-contracting activities, including complex contracting and discussions. • Negotiated ancillary contracts and provider contracts for Bergen County, NJ. Worked closely with MEU to evaluate proposals, develop rates and make fair offers to group based on market relativity and market need. Worked closely with legal to ensure redlines are within State and Federal guidelines and fair to both the provider and Aetna. • Completed 28 successful negotiations with various provider groups including a large physician systems renewal with a combined spend of over $300 million.• Managed value based ACO programs to ensure success and cost savings for our membership.• Collaborate cross-functionally on the implementation of large provider systems, to manage cost drivers, data reports and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.• Maintained provider rosters including CAQH as well as maintenance within Smart Front End and EPDB. Interacted with PDS to ensure providers were correctly setup and rates were paying correctly.• Optimized interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships and partnered on the development of business strategy and programs to support the operational plans.

• Data Analytics; provide data analytic support to all attribution based value based contracting, VBC, arrangements within the Northeast Market.• Determined which medical cost categories are driving overall trends and determined the root causes and trend drivers.• Utilize SAS to generate databases to further deep dive into groups results.• Generate ACO and PCMH Direct models for Aetna’s VBC arangements.• Contracting; determine which VBC arrangments provide value for both Aetna and provider groups and develop proposals based on the individual merits of each group.• Presentations; developed joint operating committee presentations for each VBC arrangement and presented results both in person and through webinars.

Farmington, Ct

• Benefit Configuration; ensured the successful configuration of pharmacy benefits across ConnectiCare, Inc. and Express Scripts. Acted as a resource to ConnectiCare operational areas in support of the pharmacy claims adjudication process and responding to issues related to plan/ benefit design.• Worked in conjunction with various team members across ConnectiCare, Inc’s organizations to ensure benefits are live, accurate, and working per business requirements.• Manage Express Scripts relationship; facilitated meetings with Express Scripts to resolve pharamacy issues in a timely manner. Partnered with clinical, business and IT teams to solve organizational issues as well as develop project plans across organizations.• Quality Orientation; Assumed responsibility for providing the highest level of quality and service for our members. • Provided data analytics to determine issue root cause and risks; determining paths to resolution. Determined member impacts and associated financial fallout from pharmacy related issues.• Claims Analytics, provided pharmacy trend reports to team and perform additional claims analysis. Reviewed transaction reports to determine impacts of benefit related issues and provide full financial analytics to senior management. Manipulated pharmacy data and provide deep dive analytics into various components of the pharmacy division.• Subject Matter Expert; acted as a benefit subject matter expert for the pharmacy team related to benefits and benefit logic built throughout ConnectiCare and Express Scripts.

Hartford, Connecticut Area

Worked in the project management organization specifically related to the integration of pharamacy operations from Coventry Healthcare to Aetna.- Responsible for the development and implementation of project plans related to pharmacy and enterprise initiatives.- Assist in data analytics to determine root cause issues and risks to determine paths to resolution.- Develop project presentations for senior leadership.- Provide executive level status reports on PMO activitity relating to business integration efforts.- Leveraged Sharepoint across pharmacy operations to collaborate with multiple teams and companies.- Develop agendas, minutes and summary reports.

Hartford, Connecticut Area

Managed and responded to Request for Proposals regarding group insurance products.•Crafted clear concise messages to better position Aetna in the market place; answers questions in proposals that demonstrate Aetna’s capabilities and strategically position us.•Demonstrated Product Knowledge; answered highly complex RFP questionnaires asking in-depth questions regarding our products. Developed content for new product initiatives.•Strict attention to deadlines; worked under strict deadlines where being late would disqualify the proposal.•Multitasking; managed multiple proposals at the same under heavy workloads.

• Positively influenced business growth; acquired new accounts through effective sales presentations, product marketing, and launch.

• Compiled and analyzed information from various sources; created spreadsheets to improve decision-making efficiency. Displayed value-added options to determine an appropriate media-buy through a third party vendor, and recommended strategies for improved placement of banner promotions.• Leveraged excellent communication and interpersonal skills to liaise with media representatives; wrote numerous press releases, posted upcoming events to online calendars and social networking sites, and coordinated animal and new exhibit photos.• Performed radio and television interviews, with appearance in a “Mystic Matters” installment aired August, 2010.

• Gathered, evaluated, and determined relevant information; transformed facts into newsworthy press releases and optimized presentation to support agency goals. • Interviewed public officials; incorporated information and quotes into a 50th anniversary report. • Achieved excellent turnout for an agency shredding event; used a variety of electronic and print communications media to generate the maximum amount of event promotion at no expense.

Master Of Business Administration (M.B.A.), Project Management

Bachelors, Communications Minor In Economics