Dr. Shannon I. Decker, Phd., Mba, Mba, M.Ed., M.Ed. Email & Phone Number

Consulting firm providing operational support for risk adjustment and quality operations to health plans, risk bearing Medicare Advantage, ACO, Medicaid physician groups. Services offerings include analytics, reporting, data submission, documentation education, coding and CDI services, assessment and retrospective program management.

Minneapolis, MN, US

Serve as Chair for doctoral students in the social & behavioral sciences. Certified and served as chief methodologist on the committees of doctoral students choosing mixed, quantitative and or qualitative paradigms – trained in all 3 methodologies.

US

Certified and served as chief methodologist on the committees of doctoral students (PhD, Ed.D) choosing mixed, quantitative and or qualitative paradigms – trained in all 3 methodologies. Promoted to University Research Reviewer, conducting oversight of the quality of committee work for the university.

Oakland, California, US

• Managed a division comprised of five departments and 57 reports, including (1) Risk Adjustment; (2) Quality, Population Health & Patient Experience; (3) Patient Assessments & Screenings & Physician Education; (4).
• Led comprehensive COVID-19 Taskforce to address new challenges related to virus, including, testing sites, telemedicine implementation, new clinical practice initiatives and conversion to a remote workplace.
• Implemented telehealth program to screen patients for needed wellness exams and quality improving revenue via increased documentation and closing of care gaps.
• Sponsored and implemented new suspecting platform for risk, quality and social determinants of health improving revenue and fiscal integrity, including alignment of forecasting with total cost of care.
• Implemented data reconciliation process recouping more than $50M in lost revenue as crisis remediation effort over a 2-month span.
• Optimized Quality and Risk integration points driving improved quality and risk assessment scores.

Eden Prairie, MN, US

• Oversaw the Risk Division and owned end-to-end risk adjustment process, including the design of the annual coding program, all chart review (internal and 3rd party vendors), audits, physician education and compensation.
• Solved for and maximized profitability of all new acquisitions.
• Managed a team of 8 direct reports and an overall department of 20 and engaged with other key internal and external stakeholders as the leader of risk.
• Accumulated more than $950M in risk revenue with a network average RAF of 1.6. During tenure improved RAF by 20% and doubled IOI.
• Business/process owner for risk adjustment.
• Oversaw, coordinated, or performed data mining and data-driven analysis to forecast/evaluate the performance of the risk adjustment program and refine strategies to achieve optimal performance.

Woodland Hills, California, US

• Commanded national Medical Management and Clinical programs and operations related to risk adjustment including provider programs, call centers, distribution houses, marketing, training, vendors, and vendor contracts.
• Established and managed national Medicare walk-in clinic operations for promoting annual assessments with business partners such as Take Care Health Systems.
• Established and managed national in-home healthcare program for Medicare members; including the vetting, contracting & oversight of 3rd party health services vendors.
• Identified, proposed and executed new strategies given market need, e.g., vascular identification programs, diabetes maintenance, and other health promotional incentive programs.
• Leadership Development Discussion Group Facilitator. Designed, led and monitored the Enterprise Solutions Office’s leadership development cohort.

Tempe, AZ, US

Taught classes in research and design, philosophy, critical theory & literacy

St. Louis, Missouri, US

Created and managed wellness programs for businesses.

Ph.D., Multi/Interdisciplinary Studies

M.B.A., Finance

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

J.D., Law

Master Of Education (M.Ed.), Educational Leadership And Administration (Principal)

M.Ed., Curriculum, English, Public Administration

Gifted Education Certification, Education/Teaching Of The Gifted And Talented

Adult Education Certificate, Adult And Continuing Education And Teaching

I.T.C., Secondary Education

B.A., English, History

Psy.D., Clinical Psychology

Bachelor Of Science - Bs, Biological And Biomedical Sciences