Shane Sumner Email & Phone Number

 Informing the development of health and productivity management (HPM) strategic and tactical initiatives. Managing the integration of medical and pharmaceutical claims data, plus absenteeism, disease management, wellness program, EAP/behavioral health, workers compensation, FMLA and disability data. Applying evidence-based medicine guidelines to assess opportunities to improve benefit plan design to better support member health and control healthcare costs. Engaging corporate leadership, internal clinical resources (physicians, occupational health, et al.) and external vendors to create a successful, coordinated HPM model. Responsible for measurement of benefits and services from return-on-investment and value-of-investment perspectives at the systemic, regional, and departmental level.

 Focus on sales of Employee Assistance Programs (EAP), work/life, wellness, e-health and managed behavioral health carve-out services to employers with 3,000 to 15,000 employees and health plans with a minimum of 50,000 members.  Consultative responsibility for sale of Medical-Surgical Case/Disease/Population management services to large health plans and TPAs, including leading sales presentations interpreting data mining results and ROI of APS’ ability to identify and intervene with high risk/high cost members.  Definition and longitudinal oversight of all aspects of service implementation based upon negotiated contract requirements, including intensive collaboration with operations and account management staff.