Lead enterprise Risk Adjustment

Lead Risk Adjustment for WA and OR clinics

Led Risk Adjustment and Quality product management, resulting in: - ~50% revenue growth - Developed strong 3-year product road map and strategy

Led an incredible Enterprise Risk Adjustment Analytics team that accomplished the following: - Improved Medicare submissions from 65% to 99%+ acceptance and automated the process to ensure future performance, adding $30M+ to the annual bottom line - Developed proprietary predictive analytics to ensure the right members are targeted for the right intervention at the right time, cutting costs by $20M+ annually. - Improved strategic outcomes by sharing accurate, insightful and timely information through the creation of a business intelligence platformAnd, personally, I built a world-class analytics team that I was consistently amazed by!

Led Risk Adjustment operations in 7 states

Member of Corporate Strategy team charged with developing strategy for Fortune 200 healthcare firm. - Closed strategic partnership with Amazon.com benefiting >300K members in WA and laying the groundwork for a broader partnership - Developed 5-year strategies for Medicaid, Medicare and Exchange lines of business - Developed 5-year Medicaid financial projection for the Enterprise

Lead risk adjustment functions for the Western Region, including CA, ID, UT and WA.

Lead Enrollment, Revenue and Risk Adjustment functions.

Chosen to lead strategic focus area; developed strategic vision and execution plan based on financial models and operational analysis; partnered with key providers to remove barriers to engagement and success; unified Risk Adjustment, Enrollment and Revenue Analytics into a Revenue Management function.• Increased risk-adjustment revenue by 52% through increased HCC capture: - Fostered provider engagement by listening to and addressing key provider partner concerns. - Developed actionable and engaging financial and operational metrics to ensure team and provider focus on key outcomes. - Instituted regular communications with key stakeholders (providers, internal partners, etc.)• Reduced unable-to-contact members by 33% by developing system to integrate data across systems.• Improved team performance by developing a strategic framework and operational plan around achieving goals and mentoring team members to succeed within that framework.• Improved performance by developing financial modeling and analytics function.

Responsible for all Financial Planning & Analysis and operations analytics including translating strategy into financial & operational plans, business analysis, financial planning and budgeting, forecasting, strategic and competitive analysis. Developed high performance culture through setting standards and coaching.• Implemented continuous improvement approach to $1.8B budget process over three budget cycles. • Improved operating income by $18M+ by developing a product optimization strategy. • Increased operating income by $20M by leading effort to correct external risk score calculation errors. • Improved executive engagement in financial performance by developing simple, informative reports and presentations.• Implemented Monthly Business Review process to embed Finance as a strategic business partner.• Effectively liaised with regulators, legislators and other external stakeholders.• Fostered an innovative culture by constantly leading the team to solve problems in new ways.

- Prepared health plan for growth by developing enrollment forecast to drive budget and staffing decisions. - Ensured focus on budget performance by implementing monthly financial review meetings with strategic leaders.

Drive strategic and financial planning and modeling, deal governance and operations strategy for $5B+ private equity fund• Drove development of $70M budget across 5 departments in 2010, 2011 and 2012, ensuring accurate, detailed financial planning in alignment with strategic and operational plans.• Brought expenses in 10% under budget through development of expense reduction plan and collaboration with partner organizations.• Improved revenue flow by efficiently managing and improving deal governance process/board.• Improved goal performance and operational efficiency by managing development of fund-wide metrics dashboard, completing fund-level annual goal in 2 months.• Awarded 3 fund-wide performance awards

Manage all aspects of Premera’s Enterprise Risk Management (ERM) program including program design and execution, quantification of risk, executive and Board reporting and, ultimately, developing a risk-aware culture.• Delivered 12 risk assessments each year on time through effective cross-functional collaboration at the C-level• Sourced, purchased and implemented enterprise risk software package• Developed health care industry ERM framework through collaboration with other ERM leaders across the nation• Published article in RIMS Magazine: ERM in the Trenches

Managed Premera’s sales compensation process, sales reporting and market share calculation methodology.• Engaged in development of market expansion recommendation that was accepted by EVP-Sales & Marketing• Improved accuracy of sales incentive models by 10% through automation and detailed error-checking• Developed procedure for modeling market share in various business segments used for internal analysis and external marketing• Improved budget accuracy and reduced budget prep time by over 75% by creating a simplified budgeting model

CEO of direct marketing firm responsible for sales, product management, team development and operational efficiency.• Increased sales by 25% by integrating market and customer information into the product development lifecycle• Improved product quality and customer satisfaction through effective vendor management• Opened new sales channels through business development and partnership efforts• Turned around annual loss to profitability in 1 year, achieving 15-20% profitability for all years of ownership• Successfully managed operations, research and sales teams including contract, part-time and full-time employees