Leading risk adjustment activity for the Medicare line of business.

Providing health plan operations consulting services to a variety of Medicare Advantage, Medicaid and Commercial health insurance carriers.

Great team at Centauri, if you're a health plan leader looking for a vendor with good people, good products, give them a try.At Centauri, I led the dual eligibility service line "Premium Assist", social services and risk adjustment operations. Quadrupled revenue for the dual eligibility business line in five years and left the team in position to continue to grow the business.

Provided risk adjustment, claims processing and product design consulting services to health plans and health plan vendors. Left to join the Centauri team to focus on health care dual eligibility and social service opportunities!

Left Cigna-HealthSpring in September, 2015 after having built and led the risk adjustment area for this Medicare Advantage contractor. Our team delivered 17 consecutive quarters that HSPG met or exceeded revenue forecasts prior to HealthSpring's acquisition by Cigna.

CIO for Medicare HMO. Led the company's IT dept through the implementation of Medicare Part D, including internal development of Part D CRM, Enrollment tracking, CMS 4Rx integration and significant modifications to the SQL data warehouse to support this new line of business which opened in January, 2006. Part of executive team that took the company public (NYSE: HSPG) in February, 2006. Asked to lead the Risk Adjustment area of the company in 2006 on the business side leading Medicare Data Quality and operations related to CMS data management. Helped grow this company from an initial $3 million in capital to a $3.7 billion valuation when it was acquired by Cigna in 2012.

Led the Claims, Enrollment, Member Services and Data Intake (Mail and Data Entry) functions this regional, hospital system owned health insurance carrier. Eliminated 90% of the claims backlog in the first 90 days of my tenure and improved the % of providers replying "would recommend plan to a colleague" from 41% the year before I arrived to more than 75% in my second year. Accomplished this by improving claims processing accuracy and turnaround times and adding transparency to the process. Established open lines of communication with key provider groups and assisted their business offices in reconciling their A/R to our claims paid.

Also served as Director of Membership Accounting (enrollment and premium billing) and Director of Medical Claims Processing for KP's Southeast Region in the 1980's and 1990's. More than ten years tenure with KP in progressively larger roles, leading hundreds of associates in the Consolidated Membership Accounting Service Center in the 1990's.