Healthcare is hard.
I have spent more than 20 years primarily in the payer space starting as a data scientist and leveraging that skillset throughout the course of my career.
I have held senior level finance roles with various payers however I would call myself the COO of CFOs! I am a financial business partner who understands the financial statements, the drivers of financial performance and who can work as a financial business partner to help other areas of the organization become successful.
Areas of Expertise
Financial Planning & Analysis
Data Analytics/Medical Econonics/Data Science/Informatics
Value-Based Arrangements
Delegated Risk
Risk Adjustment
STARS/Quality
“Cost of Care”/Clinical Utilization
Network Pricing/Strategy
Claims
Medicare/Medicaid Reimbursement Methodologies
Medicare Bids
To fill in a key role on an interim or full-time basis
To provide assistance in setting up value-based care contracts and DOFRs (division of financial responsibilities), and understanding financial and utilization results
To assist in M&A, de novo geographies or new product offerings
Why might you need a consultant?
Creating risk arrangements
Negotiating reimbursement strategies
Optimizing analytics capability to assist in strategic decision making
Understanding budget variances, finding drivers, and establishing tactics with operational and clinical business partners
Spearheading risk score optimization efforts
I can help with the following: