Experience

Metro Community College

• Higher Education
• 1 - 100 Employee

• Adjunct Professor

  • Jan 2022 - Present



H4 Technology

• United States
• Information Technology & Services
• 1 - 100 Employee

• Strategic Account Executive

  • Feb 2019 - Jun 2021

  One Platform For All Your Healthcare Data COMPASS, a single cloud-based data management, integration and analytics platform. Designed specifically for Hospitals, Behavioral Health, and State & Federal Agencies. Data Warehouse Improve your data's quality and consistency with data cleansing, standardization and configurable business rules. Health Analytics Measure and drill down to performance, outcome, operations, financial, and utilization metrics. COMPASS CONNECT Easily connect to any EHR or Data Silo with our cloud-based data integration engine. Population Health Identify key metrics to improve healthcare performance. Show less



Ensocare

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Director of Payer Strategy

  • Dec 2017 - Jan 2019

  Ensocare provides care coordination solutions to help manage patient care transitions, reduce length of stay and reduce readmissions. Unique technology enables Ensocare to help health plans and payers make proactive decisions that optimize care and positively affect their members’ health. Ensocare’s software solutions are backed by an industry-wide, no-cost post-acute care network and 24/7 customer support to transition patients to the most appropriate next level of care. Ongoing and proactive care coordination helps guide health plan members through the care continuum, giving them the information and support they need to stay healthy and out of the hospital. Robust analytics enable payers and health plans to evaluate the effectiveness of post-acute networks, capture patient outcomes and make strategic decisions about operational effectiveness and quality. Show less



UnitedHealth Group

• Hospitals and Health Care
• 700 & Above Employee

• Director of Population Health Management Consulting

  • Jul 2016 - Dec 2017

  United Health Care (Chicago, IL & Northern California) • Subject Matter Expert Primary Lead for Population Health Management on competitive Market Assessment in regards to Total Cost of Care • Conducted analyses and provided recommendations on utilization, prevalence, network performance, out-of-network penetration and identified opportunities to reduce utilization and contain costs Santa Clara County, CA “Whole Person Care Initiative” (Medi-Cal Population) • Whole-Person Care is the coordination of physical health, behavioral health, and social services in a patient-centered manner with the goals of improved health outcomes and more efficient and effective use of resources. • Subject Matter Expert Primary Lead for Population Health Management on the Care Delivery of targeted high utilizer population • Conducted analyses, identified Gaps and provided Recommendations for Future State and Roadmap Show less



Sanford Health

• Hospitals and Health Care
• 700 & Above Employee

• Vice President

  • Jul 2015 - Apr 2016

  Sanford Health Plan is a 180,000 member NCQA accredited health plan. Responsible for providing Leadership, Strategic Direction and Actionable Solutions. -Restructured department of 50 staff by line of business (commercial, Medicaid Expansion and TPA) Established seamless workflow in the management of patients from Prior Authorization through Chronic Case Management. -Implemented Triple Aim Impact Report to document cost savings and patient experience.-Introduced benchmark standards for admission and length of stay.-Implemented Value Based Care shared savings model to include quality standards for screening, disease management and Total Cost of Care for attributed population. Show less

• Health Strategy Officer

  • Jul 2012 - Jun 2015

  Facilitate cross-market initiatives to foster innovation in Population Health. -Installed Verisk Health predictive analytics software to risk stratify patients and establish Care Plans for catastrophic, high and emerging risk population.-Implemented EPIC Tapestry Care Management module that is embedded in patients's electronic medical record. -Direct contract with the State of South Dakota Employee Health Plan & JBS Swift for a dedicated primary care clinic. -Direct contract for tiered bundled pricing for cardiology, orthopedics and bariatric services for State of South Dakota Employee Plan. -Developed and Implemented high risk Medical Home program for the State of South Dakota Medicaid Population. -Developed and Implemented Defined Contribution Employee Benefit Plan for 27,000 Sanford Health employees Show less

• Vice President

  • Apr 2005 - Jul 2012

  Sanford Clinic is a 1600 multi-specialty physician practice operating in SD, ND, MN and IA. The Clinic is part of Sanford Health, an integrated health care delivery system that includes 43 hospitals, 250 clinic locations and a 180,000 member health plan. -Manage 100 million dollar budget of 500 employees, 100 physicians 5 critical access hospitals and 15 clinic locations in the state of South Dakota. -Lead merger and acquisition activity of 6 physician clinics that expanded the clinic by 35 physicians and that lead to the building of a 48 bed hospital in Aberdeen, SD. -Developed and Implemented Patient Centered Medical Home program. -Implemented first clinic to "go live" on EPIC EMR. Show less



Avera Health

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

• Executive Director

  • Jan 1998 - Mar 2005

  Avera Tri-State is a Physician Hospital Organization (PHO) representing over 500 physicians, an acute care hospital, a heart hospital, specialty hospital and ambulatory surgery centers. Provide Strategic Leadership of a start-up organization. Responsibilities include contract language, contract execution, rate negotiation and operational issue resolution. Implemented a Health Care System tiered network product for self-insured employers. Avera Tri-State is a Physician Hospital Organization (PHO) representing over 500 physicians, an acute care hospital, a heart hospital, specialty hospital and ambulatory surgery centers. Provide Strategic Leadership of a start-up organization. Responsibilities include contract language, contract execution, rate negotiation and operational issue resolution. Implemented a Health Care System tiered network product for self-insured employers.



Mutual of Omaha

• United States
• Financial Services
• 700 & Above Employee

• Director, Health Care Reimbursement

  • Aug 1994 - Dec 1997

  Developed, implemented and administered provider contracts for PPO, POS and HMO product service line Developed, implemented and administered provider contracts for PPO, POS and HMO product service line