Michael Fabing

Michael Fabing Email and Phone Number

Principal Financial Advisor @ Blue Cross NC
Michael Fabing's Location
Estero, Florida, United States, United States
Michael Fabing's Contact Details

Michael Fabing personal email

n/a
About Michael Fabing

Experienced with Medicare Advantage product performance enhancement through revenue stream improvement, cost controls associated with appropriate medical management practices and administrative cost containment. Extensive experience with MA bid cycle at 3 MA plans from market leaders to plans with aggressive growth strategies. Advanced capabilities in data query, metrics development and data visualization for all audiences from front line associates to C-suite executives. Powerful background in medical management process and and optimization.

Michael Fabing's Current Company Details
Blue Cross NC

Blue Cross Nc

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Principal Financial Advisor
Michael Fabing Work Experience Details
  • Blue Cross Nc
    Principal Financal Advisor
    Blue Cross Nc Feb 2024 - Present
    Durham, Nc, Us
  • Aetna, A Cvs Health Company
    Lead Director, Medicare Market Performance
    Aetna, A Cvs Health Company Feb 2022 - Feb 2024
    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.
  • Arkansas Blue Cross Blue Shield
    Manager, Medicare Finance
    Arkansas Blue Cross Blue Shield Feb 2021 - Feb 2022
    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.
  • Kindred At Home
    Senior Manager
    Kindred At Home Sep 2020 - Feb 2021
    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.
  • Humana
    Finance Manager
    Humana Oct 2017 - Jan 2020
    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.
  • Humana
    Manager - Network Filing
    Humana Jan 2015 - Oct 2017
    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.
  • Humana
    Program Manager - Medicare Clinical Strategies
    Humana Dec 2012 - Jan 2015
    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.
  • Humana
    Process Manager - Medicare Clinical Strategies
    Humana Oct 2009 - Dec 2012
    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.
  • Humana
    Consultant - Medicare Clinical Strategies
    Humana Nov 2008 - Oct 2009
    Louisville, Kentucky, Us
  • Humana
    Project Analyst - Medicare Clinical Strategies
    Humana Aug 2008 - Nov 2008
    Louisville, Kentucky, Us
  • Humana
    Analyst - Medicare Clinical Strategies
    Humana Jul 2007 - Aug 2008
    Louisville, Kentucky, Us
  • Humana
    Specialist - Contract Load
    Humana Jun 2006 - Jul 2007
    Louisville, Kentucky, Us

Michael Fabing Skills

Process Improvement Health Insurance Medicare Business Analysis Healthcare Managed Care Insurance Sdlc Healthcare Information Technology Healthcare Management Software Development Life Cycle Medicaid

Michael Fabing Education Details

  • University Of Louisville
    University Of Louisville
    Finance

Frequently Asked Questions about Michael Fabing

What company does Michael Fabing work for?

Michael Fabing works for Blue Cross Nc

What is Michael Fabing's role at the current company?

Michael Fabing's current role is Principal Financial Advisor.

What is Michael Fabing's email address?

Michael Fabing's email address is mi****@****sas.gov

What schools did Michael Fabing attend?

Michael Fabing attended University Of Louisville.

What skills is Michael Fabing known for?

Michael Fabing has skills like Process Improvement, Health Insurance, Medicare, Business Analysis, Healthcare, Managed Care, Insurance, Sdlc, Healthcare Information Technology, Healthcare Management, Software Development Life Cycle, Medicaid.

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