Mike Clift Email & Phone Number

Nashville, Tn, Us

Reporting to the President of Evernorth Care Delivery, I am responsible for strategic planning & execution of Evernorth's Care Delivery assets, including development and management of a strategic roadmap, management of a $45M project portfolio, and oversight of a Program Management, Change Management and Training organization.

United States

Reporting to the Managing Director of Stars and Risk Adjustment, with a dotted line to the President of Medicare, I oversaw Cigna's Medicare Risk Adjustment operations nationally. During this time I also led a multi-year IT program and Cigna's second largest Medicare Portfolio investment to support the operational redesign of Cigna's Medicare Risk Adjustment program through agile delivery.

Nashville, Tennessee

Initially reporting to Cigna's Vice President of Medicare Quality, then eventually to the Senior Vice President of Health Services and Revenue Management with a dotted line to the President of Medicare, I set strategy and led national operations for Cigna's Medicare Stars program resulting in the percent of Cigna Medicare Lives in a 4+Star plan improving from 62% in 2017 to 89% in 2022. As a part of this role I oversaw Medicare's H-Contract strategy and partnered closely with Government Affairs on advocacy efforts to help shape Stars policy.

Reporting to the Medicare Market President, I led strategic planning and execution efforts for Cigna's Mid-Atlantic & Pennsylvania Medicare markets including management of the market scorecard to ensure attainment of key financial and operational metrics. I oversaw a local Project Management Office which drove operational projects to meet market performance objectives. During this time I also managed key strategic physician partnerships locally, and on a national basis led compliance oversight of Cigna's First Tier, Down Stream and Related Entities (FDRs).

Reporting to the Vice President of Contracting, I oversaw contracting efforts for hospitals and ancillaries in Cigna's Mid-Atlantic & Pennsylvania Medicare markets. While in this role I led Service Area Expansion efforts into eight new counties in the Pennsylvania Lehigh Valley and Maryland Eastern Shore, meeting all CMS filing and network adequacy requirements.

Reporting to the Medicare Market President, I led the implementation of a clinical quality program that incentivized network physicians to perform against various clinical quality metrics, including preventive care, clinical outcomes, and clinical documentation. I built a high performing team consisting of 45 clinicians, managers, and business analysts that oversaw program contracting and growth, physician partnerships and clinical support, and outcomes reporting and management.

Baltimore, Maryland Area

Reporting to the Market Stars Leader, I developed, implemented, and managed initiatives aimed at increasing Bravo Health's CMS Star ratings.

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

Bachelor Of Science, Business Administration - Entrepreneurship

Aa, Avionics Technology