Michael Phipps Email & Phone Number

Valhalla, Ny, Us

Managed Underwriting on more than 150 large subscriber clients in the Central region with over $15MM in bottom-line revenue to the practice.Sold aspects of USI's offerings while educating clients on benefits and opportunities thereof. Leveraged USI’s proprietary 3D (Cotiviti based) system to directly research financial and clinical questions and concerns. Provided case studies and written guidance to clients leveraging this massive warehouse of data with over 50MM lives included. Initiated research on clients based on their performance month to month. This ensured clients were never “catching up” on issues but were ahead of the curve on leading indicators.Assessed risk to determine the appropriate price, coverage, and terms and conditions. Brought policy to completion with recommending and binding coverage, invoicing, and policy issuance. Identify the need, order, and evaluate additional risk assessment information.Underwrite within defined broad limits and authority. Served as a subject matter expert to review insurance coverages and policies.Underwrite and analyze new and renewal accounts for the most complex assignments.Communicated with agents and clients to obtain supplemental underwriting information.Developed and maintained working relationships with agencies, carriers, and other key individuals within our industry. Communicated effectively through broker negotiations to ensure new business flow and profitable production. Established underwriting policy and procedures. Provided performance reports to management.Trained and Coached other underwriting team members as needed.Analyzed and rate endorsement requests.

Saint Louis, Mo, Us

Analyzed the cost, utilization, and performance of various subcontracted clinical vendors on behalf of the Health Care Analytics team. Valuation and outcomes management with focus primarily on financial outcomes. Managed 8 major contacts with a team of 4. Manages day-to-day operations for intake and work assignment for RFPs, Reconciliations. Maintain a thorough understanding of the RFP process, MCO contract requirements, reconciliations and reporting requirements. Meet established Quality Standards and help drive higher standards. Establishes base line for team performance and to improve productivity, timeliness and quality Maintains team documents, files, standards, operating procedures and guidelines. Identify competing timelines and actively engage team members and cross functional teams to prioritize deliverables. Helps create strategic vision for data warehouse enhancements/improvements to serve Analytics needs.

Dublin 2, Ie

Manage strategy development and functional insight operating model skills to influence clientdigital agenda. -Partner with clients to make bold decisions intersecting business and data / analytics. -Participate in development of innovative solutions for clients across the Healthcare & PublicService industries -Advise clients on how to integrate machines and software intelligence into their organizationsin order to bring new skills and help their people do new jobs in order to invent a new futurefor their organization. -Co-create with clients to shape and sell project work; architect how to use AppliedIntelligence capabilities to drive client transformation for industry or functional use cases -Do data-driven storytelling through quant analysis, dashboards and data viz -Help C-suite executives use data analysis to grow their companies -Guide teams on analytical and AI methods and developing proposals -Lead projects, define their goals, manage budgets and risk and get buy in from seniorclients -Encourage creative and innovative thinking on large and diverse teamsProject: CalVax -Lead a team of application developers to build solutions to consolidate or disambiguate patient data -Administer project tracking, time, budget, and overall progress. Ensure projects are on schedule. -Analyze and solve for application errors, bugs, and new development.

Saint Louis, Mo, Us

Led startup, implementation, stabilization functions for analytics at the health plan and corporate level; change leader. Developed and executed data/analytics related aspects of partnership arrangements with external partners: Population Health, Value Based Purchasing, Competitor transition of care, Social Determinants of Health, MLR/HBR interventions. Drove evidence based support for innovation, enterprise strategic planning, new product implementation. Integrated state & national data into plan decision making solutions including Evidence Based Medicine, SDOH, others. Lead staff development to include: analytic staff training, management enablement, executive evangelism. Advised health plan leaders on intricacies of New Mexico nuances, general Medicaid Managed Care, local and national trends related to government sponsored health care finance, Best practices, Operational alignment. Guide state government Human Services Department with input and national experience regarding policymaking; inform state legislators via expert support for lobbying team at both state and national levels. Served on state Advisory boards support development of state Value Based Contract development, innovation, and implementation. Direct support for CEO, CFO, CMO, COO day to day insights and strategic target management. Led analytic development for sensitive and otherwise non-public projects. M&A, legal / criminal, and IP protection.

Albuquerque, Nm, Us

Led a team of 30+ analysts and consultants with a $4MM+ operating budget in all aspects of Managed Care and health plan analytics for the largest integrated health plan in New Mexico. Coordination and collaboration to support >450K insured lives, >800 physicians, 8 hospitals in multiple states. Develop and lead analytics in areas focusing on Clinical Operations / Population Health, Finance / Actuary, Business Operations and development, and Regulatory Operations. Responsible for identifying potential new revenue sources >$20MM and reduction of Medicaid encounter based rejection risk of >$10MM. Simplification of tools to eliminate over $720K in annual licensing fees and more than doubled team efficiency with new tools / processes.

Brea, Ca, Us

Responsible for all Operations and Payor Solutions analytics including non-claims finance, clinical operations, compliance, pricing, leakage, and analytic automation. Business owner of the Business Intelligence Stack, including all data warehousing and BI toolsets as well as organizational data governance. Direct day to day relationships with Executive Committee and Managed Care / Provider leadership. Developed FTE analytics team as well as 2-season internship program. Planning, budgeting, and goal setting for analytics team as well as large scale analytics projects. Management of licensing requirements and training initiatives. Delegation and oversight of critical requirements to subordinates and project facilitation with critical stakeholders. Mentoring relationships with team members and a strong focus on cross-functional development, automation, and administrative simplification.

Brea, Ca, Us

Responsible for providing clinical knowledge within the Data Analytics team and broader organization. In conjunction with the Chief Medical Officer works with clients as a partner in development of IT and reporting solutions the meets industry clinical requirements. External client needs identification, analysis, and relationship support via direct contact with current and potential clients. Responsible for business-side ownership of Data Warehouse development including element development, prioritization, validation, and final sign off. Business intelligence evangelism, project management, requirements determination, and member of the approval team for BI Initiatives. Industry insight, regulatory and other compliance awareness, as well as ensuring consumable communication at all levels of internal and external customers are a significant component of this role. Ability to quickly grasp and act on new ideas and initiatives. Team motivator with a lead-from-the-front mentality and a strong desire to overcome barriers with creative solutions utilizing existing resources.

Saint Louis, Mo, Us

Responsible for a multidisciplinary team charged with sensitive / time compressed / strategically critical analyses to Centene Corporate and Plan clients. Projects include ad-hoc smaller scale production management, ongoing consulting, and long term research efforts with the ultimate goal of producing actionable information for senior leadership as well as evidence based strategic guidance. Long-arc efforts focused on project development and ownership to the point of full production, at which point the project would be handed off to various relevant operational groups. Predominant clientele include senior corporate and plan executives, externally facing compliance and ratesetting entities, investor relations, and Board of Directors. Strong flexibility and adaptability to shift focus with respect to changing project materiality using alternative tactical approaches is a hallmark. Strong effort to design and lead projects across the spectrum of operational groups and facilitate efforts between business and IT related to analytics and reporting. Highly effective under pressure with strong team-oriented approach. High ability to compartmentalize, determine critical path, and organize teams to achieve goals in critical deliverables.

Saint Louis, Mo, Us

Focused primarily on supporting the financial analysis of Centene corporate, plans, and subsidiaries, Advanced Business Analytics (part of the Business Intelligence group) is uniquely positioned to interact with the entire spectrum of operational groups at Centene. My team within Advanced Business Analytics is focused primarily on Data Analysis and Research with specific work on ratesetting, RFP support, financial compliance, scenario building, estimation (GAAP accrual support), operations insight, and act as a business-side SME in partnership with the data warehouse and other IT teams. Minor responsibilities in training (business and technical), documentation, and mid-size project management. The work is a challenging blend of short term ad-hoc projects, smaller scale production management, ongoing consulting, and long term research efforts with the ultimate goal of producing actionable information for senior leadership as well as evidence based strategic guidance. Most projects originate and are sponsored at VP-level or above and have high criticality, sensitivity, or compressed timeframes. Though our teams are flexible I’ve directly managed as many as 4 high-skill professionals, with indirect management of many more.

Saint Louis, Mo, Us

Responsible for development, management, and support of critical financial analysis, compliance analysis, and troubleshooting. Act as a subject matter expert in a number of areas related to health care finance and Centene, and provide support both to corporate staff as well as plan staff nationally. Travel to plans and provide high level support, training, and skills enhancement to teams. I am also involved in all Business Intelligence implementation efforts for the company.

Saint Louis, Mo, Us

Responsible for reporting for several health plans in Arizona and Massachusetts as well as support for corporate initiatives. Scope of work includes financial analysis of primarily specialty companies including Medicare, Long Term Care, and Medicaid populations. Heavy responsibilities in decision support for senior leaders as well as statuatory reporting. Additional heavy responsibilities in business intelligence platform standardization and conversion. Platform conversions include Oracle->Teradata conversion as well as movement to a standardized enterprise reporting platform (Business Objects / WEBI). Main reporting path includes Finance, Actuary, and Operations teams. Additionally focused on strong relationship building between Corporate and Field operations with emphasis on communication, staff development, and relationship management.

Chesterfield, Missouri, Us

As a member of the MHP Analytics team I'm responsible for the development of reports and analysis to support the day to day operations of MHP as well as to provide decision support and strategic planning guidance for the senior leadership of the company. In addition I directly support several departments and their embedded Technical Analysts, including Care Management, Medicare Risk Adjustment, Care Coordination, Pharmacy Services, Quality Management, and several other key operational committees.

My primary responsibilities include dedicated analytics support of 10+ Key client companies with membership in excess of 40,000 lives and peripheral support of several other accounts with another 50,000 lives. This support includes development of clinical and financial metrics and the subsequent measurement of the metrics. I also coordinate efforts between the Account Executive responsible for day to day operations of the client and other critical stakeholders including the senior leadership as well as other operational leaders to ensure effective management of the group and efficient communications. Analytics responsibilities include both scheduled analysis as well as ad-hoc reporting and participation in executive and operational level strategic development teams for analytics.

As a Marketing Analyst my responsibilities were focused on two core competencies: CRM and Process Improvement. For CRM I was tasked with complete administration and strategic development of all Customer Relationship Management software including system administration, staff development, and campaign management. For Process improvement I was tasked with development of effective sales metrics relevant to both our industry and strategic objectives as well as constant auditing of all sales related processes. Both responsibilities led to the singular goal of providing the 50+ sales professionals in 5 offices & 3 states I served all of the tools and skills they needed to provide optimal service and increase sales success rates.