Leena Mehta Email & Phone Number

Cary, Nc, Us

Chapel Hill, North Carolina, United States

Work From Home

Oversight of Population Health Management (PHM) and accountability for Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) performance. • Committed 10 plus years to a Federally Qualified Health Center (FQHC), Piedmont Health Services, Inc. (PHS); – first as a resource member, then Community Board member, Quality Committee Chair and currently Board Chair.• Ensured PHS compliance with the Program of All-Inclusive Care for the Elderly (PACE) requirements, and JCAHO surveys twice; Led the PHS Board through the CEO transition.• Influenced Human Resources (HR) to add an Inclusion platform to the employee networks; Nominated to be an Officer of GlobalNet Inclusion Network that was sponsored by HR to showcase various cultures, and exchange of ideas.• Collaborated with BCBSNC Value Based Care (VBC) team and liaised with the BCBS Association to allow Value Based Care Shared Savings implementation to the FEP (Federal Employee Program for Health Benefits) in the first version; The Accountable Care Organizations (ACOs) received bonus if the attributed FEP members improved quality outcomes at lower total cost of care. • Identified gaps in the Disease Care Management program; Build strategies to implement Medication Therapy Management (MTM) and Social Determinants of Health (SDOH); Developed a Population Health Management (PHM) program in compliance with National Committee for Quality Accreditation (NCQA) standards. • Championed the HEDIS work with stakeholders. As a result of the collective effort, BCBSNC received performance-based Excellence Awards of $9.2M in Yr. 2018 and $10.7M in Yr. 2021. • Pitched for a Member Navigation Tracker at an enterprise-wide innovation showcase, a Digital Process Automation event; The idea for optimizing operational efficiency across BCBSNC was selected by an executive panel as the ``most promising idea'' and that is now being developed.

Durham, North Carolina, United States

Implemented a Medication Therapy Management (MTM) pilot to provide population management services; this pilot generated cost savings of approximately $775,000 in two years.• Chaired the Quality Assurance & Performance Improvement (QAPI) Committee in 2016 and 2017; Complied with Health Resources and Services Administration (HRSA) requirements. • Identified opportunities to apply necessary technology and improve clinical operational efficiencies; Implemented a scheduler using Artificial Intelligence; Similarly, implemented mobile-based digital care programs. • Collaborated with HR to recruit exceptionally skilled clinical providers; Hired and created an integrated care team to provide holistic care based on evidence-based clinical guidelines, and appropriate care navigation.

Durham, Nc - Usa

Collaborated with the commercial line of business to implement the Patient-Centered Medical Home (PCMH) Incentive Program to increase quality based PCMH recognized practices in BCBSNC’s provider network. The patient attributed PCMH practices grew from 10.9% to 38% within five years. • Enhanced the chronic disease management (DM) program for the ‘Top 5’ conditions based on lessons learned; Implemented ‘Opt Out Simplification’ project for consistent application of streamlined workflows.• Planned and developed budgets; Monitored operational and program expenses, performed variance analysis, and forecast future expenses; Expenditures were controlled and within the planned budget.

Continued progressing in my role to ensure pilots and programs were implemented, as planned and budgeted.• Influenced the Wake County Commissioners to introduce the House Bill 2 to prohibit smoking in public places and places of employment; Effective January 2nd, 2010, the bill became the law.• Collaborated with Public Health surveyors to support the Wake County Community Assessment; Identified community priorities.• Partnered with the community stakeholders at the Obesity Summit; Developed a program plan with focus on children making healthy behavior changes, influenced by schools and pediatricians.• Participated at the Health Promotion Chronic Disease Prevention public event; Educated the attending public about Asthma care.• Facilitated development of BCBSNC clinical quality care management programs to result into quality outcomes; Improved four prioritized HEDIS quality measures outcomes related to the four chronic conditions.

Durham, Nc

Planned, developed, and implemented an in-house chronic disease management program for the FEP patients with the ‘Top 5’ chronic conditions. The program was recognized as a ‘best practice’ and presented to all the Blue Plans at the FEP Operations Conference. • Planned, designed, and provided educational materials for members enrolled into a Chronic Disease Management program; Updated content used from professional organizations: American Diabetes Association, CDC.gov, US Preventive Services Task Force (USPSTF) and National Heart Lung Blood Institute (NHLBI) in alignment with the Triple AIM. • Partnered with the skilled care team to develop adequate tools for documentation, tracking, and reporting; Developed Job aids for consistent application of standardized processes that enabled active patient engagement, motivational interviewing, health risk assessment, and complex health care navigation for effective health management of FEP members.

Durham, Nc

Facilitated weekly meetings with a team of Directors to gather status on prioritized corporate projects for Senior Leadership Team (SLT) reporting. • Worked with Deloitte consultants to plan strategies and solutions for corporate projects. • Planned, developed, monitored the annual budget for PMO.• Conducted monthly variance analysis and accruals submission.

Blue Cross Blue Shield (BCBS) Association's Service Performance review of BCBSNC operational transactions related to FEP, Blue Card, and Commercial business segments that resulted in exemplary Plan Performance results, BCNC ranking among the top 4% Blue Plans. • Supervised nine auditors who reviewed randomly selected samples of claims, inquiries, and enrollment for all business segments daily based on BCBS Association's Service Performance guidelines.

Durham, Nc

Facilitated PMO Meetings for development progress status gathering, mitigation planning, and documentation for weekly Executive Leadership Team (ELT) reporting.• Led the HIPAA (Health Insurance Portability and Accountability Act) project during the Initiation and the Definition stages to level set industry coding standards, privacy, and security requirements across BCBSNC business areas.

Durham, Nc

Performed health data analysis to infer and gain insights that were presented to leaders for their decision-making.• Conducted provider network analysis to find gaps in counties where adequate care was not available or accessible.

Master Of Public Health (Mph), Health Policy And Management

Activities and Societies: Executive Public Health ProgramWorked full time at BCBSNC while acquiring MPH degree through an Executive Program

Master Of Business Administration (Mba), Health/Health Care Administration/Management, Gpa 3.9

Activities and Societies: Internship - Hospital Administrator of United Health Systems- Summer internship at Binghamton Psychiatric.

Master Of Public Health - Mph, Public Health Policy And Management