Professional Summary
Healthcare executive and value-based care strategist with 15+ years across payor, provider, and technology roles. Track record of negotiating multimillion-dollar payor and provider contracts across fee-for-service, risk, and specialty arrangements; building financial and analytics infrastructure; and leading provider organizations through value-based care transformations. Proven to thrive in established health systems, health plans, and early-stage health-technology ventures, with a founder's bias for creating and a passion for transforming data into insights that improve patient outcomes.
Leadership philosophy: A servant leader dedicated to developing people, aligning diverse stakeholders, and creating sustainable business improvement.
Professional Experience
Founder
- Founded a value-based care technology and analytics venture; authored the business plan, strategic roadmap, and investor pitch deck for a platform that reduces provider administrative burden, strengthens data integrity, and improves patient outcomes.
- Built and launched the MSSP ACO Explorer, a public interactive analytics platform covering 12 years of Medicare Shared Savings Program data across more than 1,000 ACOs, demonstrating capabilities in healthcare data visualization, standardization, and population health insight (trynytyhealth.com).
- Delivered client consulting engagements and early-stage fundraising outreach, including Python and Streamlit dashboard prototypes for MSSP ACO data, ACO LEAD model support, and value-based performance optimization.
- Published thought leadership on CMS risk adjustment policy, the appropriate use and limits of AI in healthcare, and barriers and solutions in value-based care delivery.
Director, Managed Care & Financial Analytics Consulting
- Negotiated a guaranteed $120M in incremental revenue over five years on a value-based contract for an Independent Physician Association (IPA) covering 30,000 patients.
- Built integrated financial models for Provider Sponsored Health Plans (PSHPs) and other clients, aligning strategy across multiple geographies and lines of business to advance client strategic and operational goals.
- Led the redesign of financial modeling tools, migrating legacy Excel models to the proprietary ARC technology platform.
- Authored an early industry analysis of CMS's proposed risk adjustment transition (v24 to v28) that surfaced provider and payor risks and opportunities and prompted broad industry discussion.
- Directed multiple concurrent high-value engagements, including PSHP expansion strategies and interim finance leadership for a provider client:
Great Lakes Integrated Network · Vice President, Finance (Interim) · February 2022 to March 2023
- Led a financial turnaround that converted a $2M annual loss into an $8M surplus through renegotiated payor contracts and operational restructuring.
- Conducted a comprehensive readiness assessment and restructured the Management Services Organization (MSO) to support value-based arrangements, streamlining processes and operational efficiency.
- Developed a three-year payor contracting roadmap and secured an ACO REACH award through a competitive application process.
- Directed due diligence and reorganization and chaired the Board Finance Subcommittee across multiple simultaneous initiatives.
Director, Managed Care
- Developed the strategy to shift physical therapy services toward concierge and value-based reimbursement models.
- Conducted market assessments and financial modeling to support M&A and de novo expansion strategies.
Value-Based Payments Manager
- Implemented value-based arrangements, including a COPD bundled payment program that delivered measurable cost savings and improved patient outcomes.
- Drove performance improvements across joint replacement bundles, oncology care, the Medicare Shared Savings Program (MSSP), and Medicare Advantage risk contracts.
- Negotiated and managed value-based contracts aligned to system strategy across the university and the hospital.
- Built KPIs, a predictive risk model, and reporting that improved transparency and accountability across value-based programs.
Progressive Roles in Provider Engagement, Contracting Finance & Analytics
Provider Engagement Manager, Chicago, IL · August 2016 to May 2018
- Led Humana's Provider Simplicity initiative for the Illinois market, driving a 20% improvement in risk adjustment and a 4.5 Star rating through collaboration with internal teams and providers.
- Co-managed a $2B P&L with the regional CFO and delivered $400M in revenue growth.
- Created a risk adjustment reporting package to optimize clinical documentation for providers including Advocate Health Care, Oak Street Health, and ChenMed.
Network Contracting Finance Manager, Chicago, IL · March 2014 to August 2016
- Modernized contracting finance processes, cutting monthly workload by more than 50% and enabling deeper insight into provider relations and performance.
Provider Analytics & Transparency Analyst, Louisville, KY · April 2012 to March 2014
- Optimized provider networks using episodic groupers, generating cost savings through data-driven performance evaluation.
- Advanced Humana's value-based capabilities by developing analytics for Care Decision Insights, bundled payments, and narrow networks.
- Built a reporting tool that mitigated $2B in potential sequestration liabilities across U.S. markets.
Customer Reporting Analyst, Louisville, KY · July 2010 to April 2012
Areas of Expertise
Value-Based Care
VBC strategy & operations, ACO / MSSP / ACO REACH, Medicare Advantage risk contracts, bundled payments, population health analytics
Medical Economics & Finance
Medical economics, financial modeling & P&L, risk adjustment & Stars, predictive risk modeling
Managed Care
Payor & provider contracting, provider enablement, IPA management, MSO operations, PSHP development
Technology & Data
SQL, Tableau, Power BI, Excel; SAS, VBA, beginner Python; healthcare data visualization, population health reporting
Leadership
Servant leadership, change management & M&A integration, executive consulting, Board engagement, stakeholder alignment
Policy & Regulatory
CMS risk adjustment methodology (v24 to v28), Medicare / Medicaid policy, regulatory compliance
