* Friendly, energetic, and creative problem-solver with strong negotiating and planning skills.
* Developed strong technical, analytical, consultative skills delivering broad-based consulting with Towers Perrin and Watson Wyatt (now Towers Watson), an international consultancy.
* Created, expanded, led managed care networks in twelve states.
---Met financial goals (control cost trends, profitability).
---Ensured delivery systems were marketable, stable, with broad access.
---Built networks for Medicare, Medicaid, and Commercial markets.
---Payment methodologies included DRGs, Revenue Codes, APCs, RBRVS, Capitation, Carve-outs, Case Rates, ASC Groupers.
* Specialist in negotiating terms among insurers, providers, and large employer groups..
* Developed/managed provider-owned MCO's (IPA’s, PHO’s, PSO’s, PPO’s) in four states, precursors to Accountable Care Organizations (ACO's).
* Created two Credentialing Verification Organizations (CVO’s); met gold standards of NCQA, Joint Commission, URAC.