Tim Byrne Email & Phone Number

Denver, Co, Us

United States, Us

Sioux Falls, Sd, Us

Menasha, Wi, Us

Executive who developed and led a strategic, analytic shared services unit for Network Health, a provider-owned health plan with annual premiums approaching $1 billion spanning Commercial and Medicare Advantage membership. Areas of accountability included: payer/provider strategic alignment and analytics, actuarial services and underwriting, population health management analytics, decision support and reporting.Selected Accomplishments:• Recruited, hired and on-boarded new Medical Economics management team (underwriting lead, actuarial services lead, health analytics lead).• Executed a 2015 pricing strategy that improved Network Health’s Commercial book of business gross margins by nearly 75% as measured on a per member per month basis comparing 2015 YTD actuals vs prior year YTD results. • Co-developed Network Health’s provider risk share program. Performed financial reconciliations of all risk share programs spanning both Commercial and Medicare Advantage agreements and implemented a forecasting tool to enable Finance to set adequate reserves.• Drove the financial analyses of several key contract negotiations across various health systems and emerging market ACO’s.• Led an actuarial collaboration between Network Health and a new ACO partner as part of a market expansion which led to final Health Insurance Marketplace pricing decisions and risk share agreements.• Developed, presented and implemented a multi-year reporting and analytics roadmap and launched a health analytics reporting platform migration to achieve reporting consistency.

Directed various operations in support of RedBrick Health’s value proposition to external and internal stakeholders including: data analytics and reporting, enterprise-wide research, pricing functions, incentive design consulting and other key wellness-related business processes and products.Selected Accomplishments:• Fostered market growth from start-up to 500k+ employee lives and $30M+ in annual revenue.• Instituted rigorous, annual return-on-investment (ROI) measurement methodology, in conjunction with University of Minnesota’s School of Public Health, to evaluate financial impact of overall wellness program. Cost effectiveness study across RedBrick Health’s book-of-business demonstrated an annual per participant savings of $612 and ROI of 3.8:1.• Developed proprietary Health EarningsSM behavior-based underwriting model to establish multi-year plan for equitable healthcare financing for members willing to engage in their health.• Served as de facto data architect and created end-to-end reporting and consulting functions from ground up and managed reporting team responsible for ongoing operations including: client reporting development and production support, data analysis in support of product roadmap, and key research initiatives to advance industry thought leadership.• Built and maintained financial model used for all pricing decisions as well as drove pricing-related processes from acquisition through renewal in order to meet RedBrick Health’s overall revenue and margin goals.• Led social dynamic research study, based on Alliance for Healthier Minnesota’s statewide Biggest Loser Summer Challenge™, examining the effects of group versus solo participation on program engagement and health outcomes.

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Consumer Products (2006)Led a cross-functional product development team through market research, product prototyping and user acceptance testing.Operations and Market Relations (2003-2006)Managed strategic client relations across a $50 million/45 employee business unit and drove day-to-day operations of a $15 million/15 employee consulting solutions team.Selected Accomplishments:• Achieved new business annual revenue growth target of 15%.• Retained and/or expanded on 90% of existing $50 million book-of-business through client relations focus, up-selling and service level re-negotiations.• Implemented operational improvements that increased staff productivity by 15%.• Ensured the on-time and accurate delivery of nearly 200 technical solutions annually.• Exceeded new business revenue growth by 100+% each year.

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As direct report to CFO, managed Healthcare Analytics Team for Medicaid Business Segment (annual revenue of $2 billion). Organized mid-month financial close calls to proactively identify and solve for significant variance to budget and drive accurate forecasting.Selected Accomplishments:• Delivered a favorable $10 million dollar bottom line impact and halted annual gross margin deteriorization through strategic market expansion and exit decisions.• Analyzed and allocated market and cost category reserves for the United-legacy book-of-business.• Worked with cross-functional Executive Team (both Corporate and Field) to establish a sustainable, proactive business strategy.

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Managed underwriting operation to drive financial results for a $1.5 billion (218,000 members) Medicare Business Segment.Selected Accomplishments:• Executed a “Zero Premium” underwriting strategy to maximize market position and remain financially viable. Increased both restated pre-tax earnings by nearly 100% (from $93 million to $183 million) and margins as a percentage of revenue from 4% to 12% within two years.• Delivered favorable financial results and improved gross margins despite 6-8% medical expense trends vs. limited revenue increases from the Centers for Medicare & Medicaid Services of only 2-3%.• Earned UHG Sales Pinnacle Award, a recognition of top performance based upon significant growth or financial turnaround.

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Executed strategic pricing and underwriting operations for UHC's Southeast Region, including Key Accounts and Small Business. Developed quarterly book of business reviews to analyze and set market pricing in coordination with national sales leadership. Mentored new hires for the underwriting department.

Master Of Science (M.S.), Statistics

Bachelor Of Arts (Ba), Mathematics

Bachelor Of Arts (Ba), Natural Sciences