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Leading all aspects of network management for the central and southeast regions of the United States.

Responsible for pharmacy operations, clinical pharmacy services, vendor management, oversight of delegated provider operations, enterprise affordability initiative execution, virtual health strategy and execution, and operational compliance oversight. Accountable for a $1.3B pharmacy budget, and a $12M internal budget. Leading a team of 1 Vice President, 2 Sr. Directors, 4 Directors, and 109 Associates. Reporting to the Chief Operating Officer.Headquartered in Woodland Hills, CA, HealthNet is an almost 3 million member and $13B annual revenue managed care organization operating Medicaid, Medicare, and Commercial business. It is the largest region of Centene Corporation.Instituted transparent pricing with PBM and affordability initiatives that yielded over $100M in Rx cost reductions in 2019.Established a clinical pharmacy services team as part of a modernized population health initiative that has improved quality and the member experience through integration and outreach.Created a model for managing high-cost precision drugs from pipeline to payment.Establishing an infusion drug Center of Excellence Strategy.

Series A start-up think tank focusing on reducing opacity in healthcare through data science.

Responsible for enterprise functions of Network Strategy, Provider Contracting, Provider Relations, Network Development, Provider Credentialing, and Network Operations including a $5.5M internal budget and a $2.5B contracted provider budget. Led a team of 6 Directors and 60 Associates. Reported to EVP Health Plan Division (Head of Health Plan). Headquartered in Seattle, Group Health (now Kaiser Permanente Washington) is an integrated system of care and coverage, operating two licensed health plans (HMO and Choice Plan) and 25 medical centers, covering 680,000 members in Washington and Northern Idaho. 2016 operating revenue of $3.84B.• Rated 2016 top performing commercial health plan in the US by National Business Coalition on Health (Evalu8). • Part of health plan executive leadership team that profitably grew enrollment by 16% (2016 and 2017).• Led network strategy on Access PPO, a high performance directly contracted commercial choice plan offered through Group Health Options, Inc. 90,000 members (2014-16). Total GHO choice plan enrollment 230,000 (2017).• Led network engagement on quality initiatives achieving Medicare 4.5 Stars for 2016 and 2017.• Successfully delivered enterprise unit cost and total cost targets for 2016 and 2017 across all lines of business. Including a negative unit cost trend.• Successfully delivered internal operating budget under target in 2015 and 2016.• Successfully created and implemented value-based payment agreements with two of the largest hospital systems in the State of Washington driving improved quality, utilization, and total cost of care.• Led a divisional re-organization aligning strategy, execution, and personnel.• Key role in management presentations and strategy helping facilitate the $1.8 billion Kaiser Permanente acquisition.• Leadership role in supporting market-driven network value story to major accounts and consultants.

Head of strategy for commercial markets

Directing the market-facing value proposition for network management and health management. Straddling commercial markets and operations, and driving strategy creation and market positioning.

Provided insight to clients around network development, innovation, and contracting. Including operational and market facing decision support.

Directing the Network Differentiation and Strategic Value Proposition including: Network Development, Transparency, Consumerism, High Performance Networks, Patient Centered Medical Home, Accountable Care Organizations, Blue Distinctions, Commercial Markets and Government Programs Network Strategies, and Policy implications.Responsibile for creating and delivering the strategic model including financial and clinical impact to the network as well as supporting and influencing the product creation and pricing.Accountable for delivering strategy models that support integrated relationships, and drive financial trend impact.

Directed the provider relationship and contracting strategy.

Led the provider network negotiations with integrated care delivery systems, Independent practice associations, and specialist practices.

Performed the financial analysis and negotiations analysis in support of network management decision making.