Experience

AIM Specialty Health

• United States
• Hospitals and Health Care
• 500 - 600 Employee

• General Manager, National and Strategic Accounts

  • Oct 2018 - Present

  AIM is the leading specialty health benefits management partner promoting quality of care improvements and effective cost reduction options for many complex tests and treatments. My role is to collaborate with our health plan clients across the country to find creative solutions for national employers that will improve the health and well-being of their employees. In addition, I provide strategic direction and support for this segment and related organizations looking to help their associates receive the right care, in the right setting and at the most competitive price. Generating actionable opportunities around provider network management engagement and design, value-based reimbursement programs and business development are also areas of focus.



McKesson

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Vice President, Managed Care Strategy and National Accounts: |Business Growth|Leadership|Strategy

  • 2016 - 2018

  •Led a team responsible for negotiating innovative value-based care arrangements on behalf of the 1,400+ community oncology providers in over 24 practice locations nationwide; in 2017, over 20 alternative payment models implemented resulting in an annualized revenue increase of $25 million.•Created radiation contract strategy and corresponding practice playbook.•Negotiated a $250,000 contract extension with a national payer to support practice closure (FL). •Led a team responsible for negotiating innovative value-based care arrangements on behalf of the 1,400+ community oncology providers in over 24 practice locations nationwide; in 2017, over 20 alternative payment models implemented resulting in an annualized revenue increase of $25 million.•Created radiation contract strategy and corresponding practice playbook.•Negotiated a $250,000 contract extension with a national payer to support practice closure (FL).



Ameritox

• United States
• Biotechnology Research
• 200 - 300 Employee

• Vice President, Payor Relations: |Business Development|Strategic Planning|Negotiations|Leadership

  • 2012 - 2016

  National leadership role, responsible for aligning Ameritox services with quality and cost initiatives of target national/regional health plans. Developed and implemented strategic direction with managed care organizations as well as pursued new business opportunities with health systems and government entities. Created marketing materials and strengthened analytical outputs to enhance existing payor relationships and grow business across the United States. Finalized over 150 new contracts in less than a 3-year period.



Blue Cross NC

• United States
• Insurance
• 700 & Above Employee

• Vice-President, Network Management: |Business Development|Strategic Planning|Negotiations|Leadership

  • 2000 - 2010

  •Led the management of BCBSNC's provider network, with over 30,000 hospital/physician/ancillary providers representing nearly $9 billion in provider payments.•Motivated a team of l00 employees, committed to excellence in the areas of contract negotiations, provider service and network operations. Managed department budget of nearly $11 million.•Achieved medical expense savings of over $60 million from 2006-2010.•Created innovative provider reimbursement models (i.e. Blue Quality Physician Program).•In support of new dental products, grew BCBSNC's dental network by 60%.•Decreased non-participating provider payments from 10% to less than 3%.



WakeMed

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Vice-President, Managed Care & Provider Networks

  • 1998 - 2000

  •Built WakeMed's Managed Care Contracting Department, focused on payer strategies, contract negotiations, market/financial analysis and contract administration.•Coordinated first outreach program to target employers and local Chambers of Commerce for direct contract opportunities and overall hospital awareness initiatives.•Grew managed care portfolio by over 250%, estimated at $135 million, maximizing hospital revenue and increasing patient volume through new payer contracts. •Developed and implemented strategy for forging alliances and enhancing relationships with other hospital systems/physicians throughout WakeMed's referral region.•In response to a national employer's Request-for-Proposal, created a unified hospital/physician proposal for cardiology services, winning that exclusive contract.

• Corporate Director, Managed Care Contracting

  • 1996 - 1998

  See information for Vice-President position under WakeMed.

• Manager, Managed Care Contracting

  • 1993 - 1996

  See information for Vice-President position under WakeMed.



Blue Cross Blue Shield of Massachusetts

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Account Executive/Account Representative

  • 1987 - 1993

  •Managed market analysis, sales projections, and member growth strategies in over 20 Massachusetts cities, interfacing with over 300 employers.•Recognized as the top Account Executive (Northern Region) in 1991, with 113 new accounts sold, generating an estimated $4.8 million in premium revenue. •Managed market analysis, sales projections, and member growth strategies in over 20 Massachusetts cities, interfacing with over 300 employers.•Recognized as the top Account Executive (Northern Region) in 1991, with 113 new accounts sold, generating an estimated $4.8 million in premium revenue.