Martha Watson Email & Phone Number

Pittsburgh, Pennsylvania, Us

Partnering with others on the Population & Curated Health Models team to develop solutions to improve Highmark members' health, while simplifying the member and clinician journeys.

Pittsburgh, Pennsylvania, Us

Managing vendor performance for strategic partners Aspire (palliative care) and naviHealth (post-acute care), and Value Based Reimbursement vendors Nuna and StellarHealth including SLA/PG/KPI tracking, savings analysis, strategy, compliance oversight, operational issues, contract re-negotiations and amendments.

Pittsburgh, Pennsylvania, Us

I was recruited to join Highmark Health's new Medical Economics Department where I developed, coordinated and managed medical economics analysis, models, health outcome studies and related forecasting and actual results analyses to improve operating margin, primarily focused on medical spend. Business partners include finance, actuarial, informatics, strategy and planning, as well as business segments (e.g. ACA, MA, Group Risk and Non-Risk) as well as functional areas (clinical, pharmacy, provider networks and reimbursement, etc.),

Detroit, Michigan, Us

Building on my interest in reducing costs while maintaining quality and access, I transitioned into an "internal consultant" role, conveying the results of Health Care Value initiatives to BCBSM's business segments, CEO, large customers, corporate strategy, actuarial, pharmacy and finance partners. My area managed a $1.9B portfolio of benefit cost savings initiatives which continued to reduce BCBSM's benefit cost trends and maintained or increased competitive position. I successfully streamlined the reports and dashboards illustrating strategic value and was frequently recognized for teamwork for my collaborative efforts. In this role, I enjoyed mentoring other divisional employees, and also facilitated corporate "town halls" designed to educate the entire workforce on corporate strategic direction.

Detroit, Michigan, Us

As an integral part of BCBSM's Health Care Value division's team tasked with strategically identifying and implementing benefit cost savings initiatives, I helped significantly reduce BCBSM health care trends, bringing them below industry average. Using data analytics, benchmarking, business knowledge and research as well as creative problem solving and an aggressive business plan, we developed and launched a large portfolio of initiatives affecting reimbursement, use management, claim payment policy and quality of care. I also capitalized on strong professional relationships with initiative owners and actuarial to evaluate and certify financial impacts of these programs, developed a reporting system to track results and co-led a cross-functional team to prioritize initiatives based on strategic direction and funding availability. Efforts of this strategy were instrumental in meeting corporate financial goals during this period.

Detroit, Michigan, Us

In this analytical position supporting legislated reporting requirements regarding provider relationships in BCBSM's Office of the General Counsel I was tasked with demonstrating BCBSM's performance against PA 350's cost, quality and access goals under 23 provider class plans. I developed thorough knowledge of corporate claims, membership and provider participation data as well as partnered with many different corporate areas including medical affairs, reimbursement administration, product development, IT, governmental affairs, utilization review and value partnership to implement new provider programs. I also wrote and updated Provider Class Plans to reflect current corporate policy, made presentations to BCBSM's board of directors and customer councils and supported litigation efforts regarding provider issues.

New York, Ny, Us

In the early 1990's, MetLife managed much of General Motors' non-Michigan health care coverage. I enjoyed the challenge of consulting for a single "client" - at the time, the largest company in the world. In this position, I managed MetLife's healthcare pricing department for GM, supervising four analysts. We were constantly challenged by the GM finance and benefits area to determine the impact of proposed changes to healthcare, particularly those brought forward by Hillary Clinton. The most challenging assignment was to price every management and union healthcare benefit on a cents per hour basis for the 1993 UAW negotiations and respond quickly to questions arising in negotiations as various combinations of benefits were explored.

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I was recruited to help launch the healthcare consulting practice in Coopers & Lybrand's Detroit office in 1988. We were challenged to conduct the first post-retirement health liability valuations for many large companies as required by FASB 106. Ford Motor Company and Libbey-Owens-Ford were some of our first successes and our work was documented and published in a study for the Financial Executives Institute. In setting trend assumptions for these valuations, we realized that health care costs could not continue to escalate at the rate they had been or healthcare would become too great a portion of the GDP. Yet so many years later, healthcare costs and their rate of increase continue to be a hot topic. My C&L experience set the stage for my continued interest in solving the conundrum of providing the right healthcare to the right people in the right place at the right price.

Detroit, Michigan, Us

Here, my analytical skills were put to use in pricing new benefits, quantifying the effects of benefit plan design changes and preparing rate filings for individual and small group coverages. These assignments piqued my interest in the many facets of the dynamic world of healthcare.

Bachelor Of Arts (B.A.), Actuarial Science

Mathematics, Economics, Psychology, French

Education record

Education record