Michael Lutz Email & Phone Number

Delaware City, DE, US

Washington, DC, US

Washington, DC, US

Washington, DC, US

Supported multiple health plans with their corporate strategy to develop new products, geographical service areas, and internal processes in support of sustained membership growth across all lines of business including Medicare, Medicaid, and commercial, including pharmacy benefits programs.Provided technical consulting to Medicare Advantage plans’.

Mclean, VA, US

• Provide research and policy recommendations to leadership staff at the Centers for Medicare and Medicaid Services (CMS).
• Develop policy briefings for the Administrator, her Deputy Administrator/Chief of Staff, and Directors of the Center for Medicare (CM) and the Center for Consumer Information and Insurance Oversight (CCIIO) around.

• Provide consulting support to private health insurers, state and local governments for Medicare and Medicaid products.
• Assisting a state agency with planning and design features to restructure their state-wide Medicaid program.
• Assessing the dual eligible individual population and providing program design recommendations to a state Medicaid program.
• Providing product design and implementation guidance to a Blue Cross Blue Shield plan looking to expand its Medicare Advantage product portfolio through a partnership with a major medical delivery system in its market.

• Responsible for all Health Services operational and strategy projects across six states for multiple Medicare health plans focused on the dual-eligible population.
• Provided clinical quality improvement reporting directly to the Boards of Directors for two plans.
• Led all activities for multiple projects including specialist referral implementation and readmission reduction strategies (net savings to company projected at $14 million in 2012).
• Managed a diverse staff of all levels including a Director, Managers, and line-level staff. Activities under my direct responsibility cover the entire East Region and include: o Clinical Quality Improvement, NCQA.
• Led all Health Services efforts in the launch of a new Medicaid plan in Texas, generating $115 million per year in revenue. Responsibilities include working with external providers and regulators for Texas’ Health and.
• Led activities associated with the company’s behavioral health insourcing initiative.

Falls Church, Virginia, US

• Provided consulting support to private health insurers, state and local governments, and industry associations on a wide array of coverage issues from product development, operational efficiency and improvement, and.
• Projects for which I served as project manager included assisting: o The Centers for Medicare and Medicaid (CMS) with developing and implementing Medicare Advantage application network criteria requirements, SNP access.
• Oversaw project management, project design, staffing, and deliverables for projects ranging from $50,000 to $2.25 million.
• Conducted frequent business development meetings with existing and potential client executive staffs highlighting the firm’s abilities to bring innovative, value-added approaches to business problems.
• Source of Medicare industry and products knowledge for a firm of over 140 consultants. Provided training sessions for all new staff on Medicare and the insurance industry including how each market has developed, how.

Philadelphia, PA, US

• Assisted with the development of the business case and outlined the operational dependencies for senior executives regarding the launch of a Private Fee for Services product.
• Participated as a core team member in a corporate project mapping the product and marketing strategies for the Medicare lines of business for the next 3 to 5 years. This project scope included in-depth market analysis.
• Participated in the creation and development of a new business area to implement the launch of Medicare Part D products.
• Developed processes and procedures to insure ongoing compliance with Medicare reporting requirements.
• Developed and maintained reporting procedures for Government Programs marketing and retention for senior management.

Philadelphia, PA, US

• Provided oversight to continuous quality improvement initiatives across the operations division.
• Established internal consulting type of organization to review and solve quality, productivity, and efficiency issues.
• Oversaw special projects including: process mapping/improvements to call centers; researching a variety of processing issues and fixes; process mapping claims activity from initial submission through adjudication; and.
• Developed and piloted nine timings studies for claims operations.
• Directed the creation and implementation of reports to identify quality and compliance trends and issues.
• Contributed to regular meetings with senior management to identify issues and present resolution.

Mba, Risk Management And Insurance

Ba, Economics

Diploma, Advanced Academic