Kimberly Olsen Email & Phone Number

Florida, United States

Eagan, Mn, Us

Eagan, Mn, Us

Prime manages medicine coverage for people across the U.S. and is owned by 14 not-for-profit Blue Cross and Blue Shield health plans. As a member of the Client Engagement team, this position is responsible for aligning Prime's value proposition in the Florida market. This role serves as the lead, primary contact and liaison for Florida Blue and oversight of Capital Health Plan. This position is responsible for ensuring alignment of Prime's annual and three year performance objectives to Florida Blue's pharmacy strategy and profitability objectives. The role establishes and maintains relationships with the client's decision-makers, health plan account and sales divisions, and Prime's functional areas to enhance collaboration, and ensure delivery of exceptional service to the Florida market.

An expert in the field providing expertise, guidance and advice on health care business related issues. Proficient in Managed Care operations, Network Management/Provider relations, government programs, business strategy, revenue optimization, business models and recommendations for improvement or change. Experienced in regulatory compliance, accreditation and able to review documentation practices and ensure that Medicare, Medicaid or third party payer standards are being met. Experienced with alternative payment and care delivery models including Accountable Care Organizations, Patient Centered Medical Home and bundled payment.

As a member of the Sr. leadership team, this position has accountability for all Network Operations and Marketing functions. Duties include all aspects of provider network management encompassing contracting (language development, negotiation and execution), strategic network growth, ongoing network development and maintenance, relationship management (Provider Relations), credentialing, meeting accreditation (NCQA) standards. Vendor management includes Behavioural Health, vision, dental, transportation and Pharmacy Benefit management selection and vendor relationship management. Marketing for the purposes of member retention and growth includes development of the Marketing strategy, social/electronic media campaigns and website optimization. This position must ensure contractual compliance with the Agency for Health Care Administration Statewide Medicaid Managed Care program. Project Management concepts are routinely utilized.

The Chief Operating Officer for Family Care Partners is responsible for providing the leadership, management and vision necessary to ensure that the physician group has proper operational controls, administrative and reporting procedures, and people and systems in place to effectively grow the organization and to ensure financial strength and operating efficiency. This position requires a performance of all duties in a manner that promotes and reflects Family Care Partners mission and core values. The COO works effectively with all physicians and leaders, vendors and contacts that support operations. Lead/supported the implmentation of alternative payment models including an Accountable Care Organization (ACO) (including the advanced payment model) and patient centered medical home recognition through NCQA.

Jacksonville, Florida, Us

• Development of concept designs for alternative healthcare delivery models and payment arrangements, including Accountable Care Organizations, Patient Centered Medical Home, bundled payment, with a focus on innovation and transformation of healthcare.• Analyze and understand the organizations strategy as well as the business direction and strategies that impact program designs.• Ensure alignment to the organization and business’ mission and objectives.• Serve as the business lead for the future state design.• Translate high-level business strategies into operational strategies and practical solutions.

Jacksonville, Florida, Us

• Developed statewide physician network contracting policy and standards for the 28,000+ office based physician, across all BCBSF commercial and Medicare networks. • Responsible for the financial performance of over $4B in allowable charges and $2B paid annually.• Effectively implemented multiple medical cost management and utilization management programs. • Managed an administrative budget in excess of $5M annually.• Successfully implemented corporate goals and strategies. • Developed, motivated and lead a team of up to 71 FTE’s, in multiple office locations

Jacksonville, Florida, Us

• Developed physician contracting plans, goals and negotiation parameters for the North Geographic Business Unit. Translated the goals into strategies and effectively implement the strategies through financial and situational analyses and direct provider negotiations. • Established and maintained positive business relationships with key external stakeholders. Directly interacted with executive staff in order to maintain effective, positive business relationships. • Conducted qualitative and quantitative analysis to develop, implement and maintain contractual arrangements for Traditional, PPO, HMO, Advantage 65 and Medicare and More programs. • Provided leadership, problem solving capabilities and healthcare industry and plan expertise gained through education and experience to support regional and corporate efforts to gain new accounts and implement/improve corporate processes related to healthcare management.

Bachelor, Healthcare Administration

Certification, Medical Assistant