Experience

• 

  Emerson PHO and IPA

  • Executive Director, Emerson PHO and IPA

    • Jan 2001 - Feb 2011

    Successfully managed performance of commercial and Medicare Advantage managed-care risk-contracts for 220 physicians, maximizing incentive payments to providers.Returned 100% of physician incentive funds for achieving 2005-2009 EHR adoption targets.Developed and implemented an incentive distribution process and reporting structure of performance results at the individual physician level to support and encourage greater provider participation in managed care initiatives.Consistently met or exceeded P4P measures, resulting in over 90% return of overall incentive funds to providers. Implemented Radiology programs and policies, reducing inappropriate high-cost radiology and nuclear studies; recognized as a PCHI best practice.Improved pharmacy performance through education of providers and patients and increasing the use of generic and OTC medications, resulting in reduced prescription drug costs and improvement of patient compliance.Communicated pertinent information regarding strategic, financial, and clinical operations to IPA/PHO providers and the hospital.Designed secure PHO Intranet for communicating with PHO/IPA members and practice support staff.Developed plan and provided oversight of Electronic Health Record (EHR) implementation for 135 physicians and their support staff in private ambulatory practices.

• 

  EMERSON PHYSICIAN-HOSPITAL ORG., INC

  • Executive Director

    • Jan 1997 - Feb 2011

• 

  Emerson PHO

  • Provider Support Specialist

    • Jan 1997 - Jan 2001

    Responsible for development, implementation, and management of referral program in order to deliver high quality healthcare in the most cost-efficient (community) setting as clinically indicated under capitated and P4P risk contracts. Provided oversight and central management of quality and efficiency measures in pay-for-performance risk contracts in 100 ambulatory practices.Over 70% of referral services were managed within the network.

• 

  Solo Practice

  • Primary Care Practice Manager

    • Jan 1995 - Jan 1997

    Provided oversight of daily operations.Created policies and procedures for support staff for continuity of patient care. Developed job descriptions and employee benefits to establish fair practices for all.

• 

  Winchester Hospital

  • Manager, Quality Improvement and Risk Management

    • Jan 1992 - Jan 1995

    Managed and reported quality improvement activities and risk issues for the medical staff and all clinical departments of the hospital, hospital leadership, and Board of Directors. Implemented (QSM) quality assessment software program, improving efficiency and significantly reducing coding time of inpatient medical records to 24 hours post discharge and improving accounts receivable.

• 

  new Workers Compensation pilot program

  • Case Manager

    • Jan 1990 - Jan 1992

    Managed and monitored the delivery of occupational care and progress of employees in outpatient rehabilitation pilot program for Anheuser Busch truck drivers. Saved the company over $1M the first year. Cardiac Liaison Nurse for inpatient cardiac service and high-risk arrhythmia program

• 

  Spaulding Rehabilitation Hospital

  • Cardiology Liaison Nurse

    • Jan 1984 - Jan 1992