Susan Perry Email & Phone Number

Canton, MA, US

• Develop annual strategic & business planning process to advance vision of Chief Medical Officer (CMO). Create/revise long-range strategic plan and quarterly dashboard. Manage budget, including monthly reporting.
• Set vision and strategy for cross-functional Medical Cost Trend Management Steering Committee. Lead group in identifying and driving medical cost savings initiatives, overseeing development of high-value UM projects.
• Championed turnaround of high-visibility project to achieve NCQA Health Equity Accreditation and gain position as first health plan in New England to be accredited.
• Liaise between Harvard Pilgrim Health Care and The Harvard Pilgrim Health Care Institute (Harvard Medical School Department of Population Medicine). Facilitate financial discussions and operational issue resolution..
• Foster employee retention by cultivating relationships, resolving issues, advocating for needs, and recognizing successes.
• Championed change management efforts for business unit merger activities focusing on team migration, integration, and office relocation. Communicated changes and maintained seamless operations during transitions.

Canton, Massachusetts, US

• Facilitated planning and development of CMO/Health Services strategic plan; prepared and led planning meetings and compiled plan components. Managed staff of 5 supporting implementation of cost savings initiatives..
• Launched patient-first oncology utilization management (UM) program period. Led RFP process, business case development, program launch for oncology programing, and expansion of medical drug prior authorization program.
• Planned, designed, and implemented medical drug data base to drive medical drug strategy and future formulary.
• Contributed to $30M/year cost reduction by managing Cost Savings Initiatives Committee, process, and pipeline. Reviewed trend data, news, provider performance data, and employer requests. Conducted competitor analysis.

Canton, Massachusetts, US

• Delivered high-priority initiatives that advanced corporate strategy and goal achievement by providing leadership, consultation, facilitation, insight, and support to Cost Savings Initiatives Committee and.
• Collaborated with cross-functional teams to align resources and advance complex, large-scale projects from strategy to implementation, including initial medical drug prior auth, claim editing, NICU, cardiac, genetic.

Boston, MA, US

• Evaluated provider relations, credentialing, and enrollment department operations, technology, and staffing. Prepared and implemented extensive optimization plan.
• Executed assessment, performed diagnostics, and prepared recommendations for CEO involving operations for first year of 3-year strategic plan. Enhanced initial Balanced Score Card, defining measurable metrics.
• Planned and implemented companywide operations calendar and dashboard used by leadership for proactive planning.
• Assessed and optimized BIDCO new client implementation and onboarding process, including project plans for Executive, IT, Clinical, Quality, and Professional Relations teams. Created structure and focused process by.
• Managed project to overhaul EMR data collection, programming testing, and reporting of updated Pioneer ACO and AQC quality measures in BIDCO data repository.

Canton, Massachusetts, US

• Directed budget operations for health services, network services and product business units with combined budgets of 100M+. Managed budget planning and development process for each business unit, creating.
• Advised executive leaders in development and reconciliation of annual budget targets for each business unit, reconciling dollars owed between units and providing expertise on discretionary and non-discretionary expense.
• Prepared monthly aggregate budget reporting for business unit executive leader, identifying anomalies and highlighting drivers of variances, potential trends/issues, and saving/spending opportunities.

East Boston, MA, US

* Provided consulting services for the following time periods: 7/02-12/02, 4/03-8/03, 10/05-6/06* Coordinated the ESP Admin staff in the preparation of their required CMS PACE Application* Evaluated and rewrote all ESP policies, procedures & operations to meet CMS PACE Regulations* Developed preliminary training requirements to transition current.

Canton, Massachusetts, US

• Developed and maintained quarterly utilization reports combining the data for several delivery systems.
• Designed and loaded sophisticated utilization data models used for business development and group negotiations.
• Evaluated the First Seniority Intake Process and made recommendations to automate and streamline department operations resulting in the elimination of temporary staff and outside system consultants.
• Led and managed the development of the Geriatric Assessment System incorporating the First Seniority system needs including: writing functional and system specifications, data clean-up, and system and user acceptance.

Canton, Massachusetts, US

• Develop and maintain core resource library consisting of Supplier Quality Monitoring & Improvement strategies, tools and internal and national benchmarks which was used for 1995 NCQA inspection.
• Coordinate delivery system data collection and produce division wide analyses to support lead teams: Ambulance, Physical Therapy, and Home Infusion Therapy.
• Provided delivery system data collection and produce division wide analyses for first HPHC Disease State Management Lead Team (Congestive Heart Failure).
• Serve as IS business analyst between Provider Contracting and their outside systems consultant in the redesign and improvement of Provider Contracting Data System.

Boston, MA, US

• This was a new division of Fidelity specializing in the administration of Health and Welfare Benefits outsourced by large corporations.
• Conduct system analysis to evaluate vendor software against Health and Welfare business requirements.
• Create standards for Product Development area to document Health & Welfare system requirements.
• Manage the development of a vendor prototype Health and Welfare administration system.
• Develop the system Plan Design client implementation process.
• Manage the client functional testing of the Health and Welfare administration system.

• Responsible for planning and developing systems and operations procedures for a national startup company, ecuCare, which will broker and administrate managed care services to Insurance Companies and Third Party.
• Responsible to administrate the operations and systems of TotalCare managed care products in order to produce accurate utilization and financial data to many audiences including clients and investors.
• Created and managed TotalCare managed care data base, account set up and billing system.
• Produced monthly and YTD product savings reports.
• Evaluated and recommended managed care program vendors; (pharmacy and home infusion providers).
• Presented sales demonstrations to prospective self funded employer groups.