Michael Fabing Email & Phone Number

Durham, Nc, Us

Hartford, Connecticut, Us

Support and drive success for Medicare product development and ongoing performance opportunities for key markets at Aetna. Responsible for internal business consulting and performance management for 320K+ individual MA lives. Leading change and innovation through matrixed organizational structure to improve overall results in the MA book of business.

Little Rock, Ar, Us

Working with Lead Medicare executive and the newly appointed Medicare Advantage Organization to redesign products and expectations, from a flagging PFFS heavy portfolio experiencing double digit membership loss year over year, to a competitive product portfolio. Continuing to champion the benefits of a multi-year strategy to realize 3.5 and 4 Star revenue bonus and the resulting benefit enhancements to drive member value and membership growth. Leveraging over a decade of experience in one of the leading MA companies to find a path to not only retaining market share but dominating the MA market in Arkansas.

Atlanta, Ga, Us

Worked closely with senior level clinical executives to develop, refine and improve metrics and reporting for operational and emerging clinical programs.Developed clinical metrics set for first of its kind hemodynamic monitoring program in home care setting.Developed reporting for emerging clinical programs with a focus on outcome based measures to prove out the value of innovative clinical initiatives.

Louisville, Kentucky, Us

Worked closely with small (5 including myself) market leadership team on CMS bid strategy and plan design for 2019 and 2020 MA product offerings and expansion. 2019 MA growth will be 36,000 lives with 2020 early results tracking toward 60,000+ lives.Responsible for metrics package redevelopment and ad hoc reporting packages in various platforms including Tableau, Qlikview, MS Excel and Power BI. Transformed manual processes to streamlined, low/no touch solutions without IT resources.Leading team of 4 full time associates and 1 summer intern.

Louisville, Kentucky, Us

In my capacity as Network Filing Manager, my team and I were responsible for national county/contract expansions and network adequacy gap mitigation strategy.In the course of my 3 years in this role, CMS changed the regulations for filing to include all active counties on a contract that included expansions as opposed to only the expansion counties. CMS then further changed the rules to include active counties on non-expansion contracts within the scope of network adequacy review.These changes along with annual revisions to the exception process required coordinated response by IT partners, regulatory and legal partners as well as the operations team that I led. Although our initial submission of exceptions in 2016 was unprecedented in size for Humana we were able to attain a 100% pass rate for submitted exceptions.In this role, I served as the primary business side subject matter expert for IT development work on a proprietary SQL based application. That system (HSD Magic) was used by market based subject matter experts to document real time contracting efforts to close regulatory gaps in CMS network adequacy standards. Led team of 7 full time associates.

Louisville, Kentucky, Us

Led team of 13 associates responsible for metrics package development, daily, weekly and monthly operational reporting. My team was also responsible for business side systems development and incident management support for Humana’s proprietary, SQL based clinical workflow management and documentation system.This role supported the mature process developed throughout my multi-role career with clinical strategies. The foundational change that our team made to Humana’s clinical model is responsible for significant savings (~$450MM over 3 years) and remains the backbone of the Medicare clinical model.

Louisville, Kentucky, Us

Acted as direct liaison between market clinical operations leadership team and corporate clinical strategy and oversight group. Tasked with clinical operations support, serving as a strategy and process optimization subject matter expert. Assisted market based leaders with achievement of KPI goals. Provided market level insights for ongoing best practice sharing to ensure operational efficiency and optimization across the enterprise. Consistently met or improved metrics across the clinical operations of the Southern/Southeastern division of Humana’s Medicare (Retail) organization. Partnered with clinical leaders across the organization to meet or exceed targets associated with significant post acute APT reduction. Helped to pilot Skilled Nursing Facility quality and efficacy scorecard initiative in Gulf States (LA & MS) region driving significant transitions of post acute utilization from higher cost to lower cost settings without quality of care impact.

Louisville, Kentucky, Us

Louisville, Kentucky, Us

Louisville, Kentucky, Us

Louisville, Kentucky, Us