Michele Causley Email & Phone Number

Waterford Township, MI, US

Portland, Oregon

Burton, MI

Lead a population health analytics team supporting 100+ primary care physicians and a Medicare Shared Savings ACO.- Utilize Milliman MedInsight software tool to analyze paid claims data- Data governance- Value based contract negotiation- Prepare and present reports to multiple stakeholders including Board members, physicians and C-suite leaders.- Establish.

Greater Detroit Area

Managed a team of analysts responsible for all analytics and financial modeling to support provider reimbursement and contract negotiation for a regional Health Plan.- Provider payment dispute resolution- Provider reporting to support value-based risk contracts- Provide strategic direction and modeling to the Provider Contracting team to support.

Flint, MI

Manage several diverse teams providing support throughout the company including:- Provider reimbursement- Contract rate modeling- Financial analysis- Population health analytics- Data warehouse structure- Corporate reporting- HEDIS reporting- Internal audit of claims payment processes- Medical Audit

Flint, MI

Managed a multi-functional team within the Business Intelligence Department providing analytics and corporate reporting for numerous departments in the organization.- Contract rate analysis, modeling and negotiation support.- Manage internal audit functions- Development of corporate payment policies- Government healthcare regulation monitoring and impact.

Flint, MI

Project lead for Accountable Care Organization (ACO) services working directly with a Medicare Pioneer ACO Participant.- Financial Analysis- Population Health Metrics- Corporate Report development

Fenton, MI

Director of a department consisting of three service lines related to hospital reimbursement and regulatory issues with a primary focus on Medicare.- Responsible for meeting strategic goals and service line profitability.- Medicare cost report appeals with numerous successful outcomes- Client development- Marketing activities including newsletters and.

Fenton, MI

Project manager and lead consultant of the Medicare Low Volume Adjustment division. - Assisted rural hospitals nationwide to receive substantial additional Medicare reimbursement.- Coordinated multiple projects and clients at a given time- Wrote all appeals and negotiated final settlement with various Medicare Audit Contractors

Auburn Hills, MI

Controller of an electrical controls design company and tier 1 supplier to the automotive industry.- Managed all finance, accounting and human resource functions- Financial reporting and analysis- Annual budget- Cash flow, sales forecast reporting

Master Of Business Administration (M.B.A.), Management

Bachelor Of Arts (B.A.), Economics