Lee Rowe Email & Phone Number

www.benroweproject.org

Provides process, project, and change management methodology & consulting support to both local and company wide initiatives; Trusted expert advisor and provides strategic direction in large scale projects; Proactively identifies opportunities for improvement; Researches, develops, and implements related best practices; Identifies and develops plans to improve performance enterprise wide.

East Region

Responsible for ensuring the overall success of all Prospective Revenue Management programsManages the activities related to CMS Medicare Risk Adjustment and Provider Outreach and Education.Develop metrics, policies and procedures in support of required deliverables and validation of programs ROI while ensuring the programs are in compliance of CMS program requirements.Create and maintains databases to track business performance. Oversees and assists in data analysis, reporting, and formulating recommendations and providing guidance to other team members and providers. Develops and analyzes business performance reports (internal and external) and provides notations of performance deviations.Hires, trains, coaches, counsels and evaluates performance of direct reports.

Relationship owner and point of contact for large Accountable Care Organizations (50,000 plus attribution each) participating with Value Based Care arrangements.Responsible for consulting with practice leadership to improve efficiencies of provider practices and clinical processes leading to shared savings ($2.7M payout to one ACO in 2018).100% success rate in shared savings earning among 3 ACOs, member attribution 116,000.Leads face to face and virtual encounters with executive leadership teams.Obtains and analyzes organization specific cost utilization and quality data and reports for cost of care and quality opportunities.Assists practices to target elevated risk members and stratify gaps in care.Develop, maintain and strengthen relationships among payer and provider. Identifies action plans for providers to implement to improve cost, quality, and the patient experience.Creates and hosts tailored learning opportunities to support the deployment of program interventions.Collaborates with all program stake holders to meet organization service needs.Manage high-profile and sophisticated provider groups engaged in value-based payment model.Train, mentor, and coach Care Consultants (9) to ensure success and growth.Audit staff (9) on core competencies and programmatic elements.Develop and lead educational sessions internally and externally.Pilot new programmatic features and serve as a SME on population health strategies and transformation topics to internal and external stakeholders.Collaborate with CDT Manager to review market level performance data and identify outliers.

Relationship owner and point of contact for large Accountable Care Organizations participating with Value Based Care arrangements.Responsible for consulting with practice leadership to improve efficiencies of provider practices and clinical processes.Promote efficiencies and identify actions to achieve shared savings (all assigned groups successful, 3 with total 116,000 member attribution).Obtains and analyzes organization specific cost utilization and quality data and reports for cost of care and quality opportunities.Assists practices to target elevated risk members and stratify gaps in care.Develop, maintain and strengthen relationships among payer and provider. Identifies action plans for providers to implement to improve cost, quality, and the patient experience.Creates and hosts tailored learning opportunities to support the deployment of program interventions.Collaborates with all program stake holders to meet organization service needs.

Responsible for clinical operations across the care continuum.Oversee case management and utilization management duties, maintaining quality and reducing costs associated with complications.Lead role in setting direction and development of program which yields annual revenue of $8.9M.Coordinates and collaborates with others to gain efficiencies and enhancements within the program and organization.Identifies and corrects client and member issues to maintain membership and growth.Communicates interdepartmentally to gain resolution and satisfaction of member and client/customer needs. Implements new accounts and determines operational needs. Sets team direction, resolves problems, and prioritizes while managing a team of 25 Registered Nurses.Utilization of quality measurement tools such as HEDIS and STARS.Participation and preparation in client audits and accreditation audits such as NCQA, URAC and ISO.Implemental in department growth, team of 12 RN’s in 2013 to current number of 25. Membership 4M 2013 to 7.7M 2105. Growth forecast for 2016 is 8.6M.Interviews and hires to bring the best talent to the program. Reviews, audits and coaches nurses on performance and areas of improvement.Develops and edits policies and educational aids.

Supports management team in daily operations of busy and growing program. Performs and trains team in case and utilization management. Reviews, audits and coaches nurses on performance and areas of improvement.Participation and preparation in client and accredidation audits such as URAC, NCQA and ISO.Develops and edits policies and educational aids.

Albany County Department Of Health

Responsible for providing in home nursing care to a diverse population.Maternal-Child care specialist.In home assessments and education.Synagis prior authorization and administration to at-risk infants.Assess physical and psychosocial needs of clients, and perform nursing duties as needed.Teach and demonstrate healthcare techniques to clients and families.Coordinate community services to meet clients’ needs.Develop and present wellness programs in health, safety, asthma, and lead poisoning prevention.Serve as Nurse Liaison for Health Department at family practice clinic.

Niskayuna, New York

Responsible for care of infants in a level III NICU.Served as Charge Nurse, overseeing staff of five to eight RN’s.Attended all high-risk deliveries and cesarean sections.Neonatal Resuscitation as needed.Lactation support.Served as preceptor for new employees and graduate nurses.Participated in QA/CQI programming.Audit preparation and participation (JCAHO).

Master'S Degree, Health/Health Care Administration/Management

Bsn, Nursing Science

Activities and Societies: President's List, Highest Honors Diploma conferred June, 2015

Associate'S Degree, Nursing

English Language And Literature, General