Experience

Ponaman Healthcare Consulting

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Chief Operations Officer

  • Oct 2016 - Present

• Senior Vice President

  • Aug 2013 - Present

• Director of Operations

  • 2013 - Present

  Responsible for managing all organizational operations, consulting practices, and support teams (human resources, administrative, and finance). Budget and P&L responsibility. • Coordinates project/engagement resource and provides project management support for all PHC client related activities• Leadership role for all business development efforts including client meetings, project/engagement proposals, RFP responses, and vendor participation conferences.• Supports all regulatory compliance filing, monitoring, education, and other related requirements.• Direct reports with delegated responsibilities include Consultants, Senior Analysts, Executive Assistant, and Finance and Special Projects Coordinator.• Responsible for monitoring and reporting for all consulting practice efforts• Provide 340B Program consulting and technical services to hospital systems and federally qualified health centers (FQHCs)



UnitedHealthcare

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

• Associate Director, Clinical Support Operations

  • 2012 - 2013

  • Oversight responsibility for the implementation and ongoing operation of the Clinical Support Operations (CSO) Business Unit, a nonclinical team comprised of 120+ staff located in 10 states and built to support 9 clinical programs. Budget and P&L responsibility.• Led cross-functional team and oversaw project management effort which resulted in successful transition of 9 programs to the CSO and ongoing operation of this unit.• Set strategies to improve efficiency and customer and employee satisfaction.• Met and exceeded Operational Efficiency targets for 2012.• Championed service coordination between Commercial and Medicaid clinical and nonclinical services for the customer, ensuring continuity and quality of care. Customer satisfaction surveys reflected high level of quality, and customer complaints were reduced.

• Associate Director, Healthy First Steps

  • 2011 - 2012

  Led team through a program redesign of a Medicaid Maternity Program nonclinical operation. • Redesigned program to eliminate redundant processes and identified opportunities for process improvement including enhanced reporting resulting in elimination of a 4 month backlog and ongoing ability to meet and exceed contractual metrics.• Developed strategies to improve engagement of Medicaid members in the Healthy First Steps program, a high risk population, resulting in an improvement in member engagement from 16 percent to 44 percent over an 8 month period of time.• Participated in new business development activities including new program design, budget development, and development of technical proposals resulting in winning proposals for Louisiana and Hawaii.

• Director of Operations & Quality

  • 2006 - 2011

  • Provided strategic guidance along with assistance in the design, development, and implementation of Managed Service Organization (MSO) programs and served as a disease management technical resource. • Recipient of UHG Public Sector Market Program (PSMG) Innovation Award for 2007 for the utilization of predictive modeling n a Medicaid population.• Responsible for implementation activities for the MSO including development of, and managing key relationships, with clients, subcontractors, and identified vendors.• Managed client expectations regarding project timing and budget and communicated regularly with the management team. Recognized as a technical resource.• Participated in new business development activities including program design and development of technical proposals resulting in wins for in the states of Washington and Texas.• Utilized expertise in specialty program operations to increase growth opportunities for the MSO.• Served as the technical resource in the submission of the National Committee for Quality Assurance (NCQA) Disease Management Accreditation resulting in full accreditation and re-accreditation for 6 conditions.• Collaborated with team on the implementation of a Disease Management Program for the State of Georgia within 60 days and which resulted in program savings of $40 million.

• Director, Implementation & Special Initiatives

  • 2005 - 2006

  •Completed specialized consulting and project management activities including direct interactions with consulting clients and stakeholders, the creation of strategies and solutions, development of detailed work plans and audit tools, conducted onsite audits, and prepared reports.• Responsible for all phases of implementation for AmeriChoice MSO projects including the development of key relationships with clients, subcontractors, and identified vendors.• Participated in new business development activities such as new program design and development of winning technical proposals — particularly in specialty healthcare programs such as HIV/AIDS, Developmental Disabilities, and 340B Programs.• Utilized expertise in specialty program operations to increase both consulting and operational growth opportunities for the MSO in areas including, but not limited to 340B, specialty care management, and HIV/AIDS.

• Manager, Health Policy and Consulting

  • 2004 - 2005

  Responsible for managing a variety of projects in all areas of the MSO business – Business Development, Project Implementation, Consulting, and Operations. • Performed ad-hoc tasks to support critical business objectives, spanning the continuum of low to high-level tasks supporting the management team. • Provided specialized consulting and project management support including the development of project plans and accurate estimates of time and budget required for the execution of various projects. • Managed client expectations regarding project timing and budget and communicated regularly with the management team. Served as a recognized clinical technical resource.

• Senior Development Specialist

  • Jun 2003 - Nov 2004

  • Responsible for research and development of Medicaid opportunities that promoted cost effectiveness and the efficient delivery of health care services.• Provided ongoing project management for business development proposal responses, in addition to providing technical support for the implementation of key initiatives.• Served as a technical resource for regulatory and policy issues.



Mercer Government Human Services

• Consultant

  • Dec 1999 - May 2003

  • Responsible for clinical technical support and project management for awarded Clinical Quality Team contracts, including supporting for External Quality Review projects in Delaware, Ohio, Arizona, and the Commonwealth of Virginia. • During 2003 managed Clinical Quality projects totaling $700,000 and during 2002 managed Clinical Quality and Behavioral Health projects totaling $1.6M. • Developed operational review guides and tools to conduct readiness reviews and focus studies with an emphasis on discharge care planning, coordination of perinatal care, network adequacy, grievance systems, and member services in the District of Columbia, Tennessee, Delaware, and the Commonwealth of Virginia. • Provided strategic guidance along with assistance in the development and implementation of alternative care delivery systems including primary care case management in Delaware. • Participated in performance monitoring and outcome analysis, needs assessments, strategic planning, capacity building, and development of quality assurance and monitoring for various clients with an emphasis on special populations including HIV/AIDS and long-term care.



Scottsdale Healthcare

• United States
• Hospitals and Health Care

• Assistant Manager/Supervisor

  • Jul 1982 - Nov 1999

  • Participated in the task force for the development and implementation of the Scottsdale Healthcare Medical Education Department. • Provided administrative oversight of the Scottsdale Healthcare Medical Education and Family Practice Residency Program. • Responsible for ensuring compliance with accrediting and regulatory bodies including Centers for Medicare and Medicaid (CMS), Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and Accreditation Council for Graduate Medical Education (ACGME). • Responsible for credentialing physician extenders, medical students, residents, and fellows. • Conducted hospital system orientation for residents and other provider trainees.