Creating, Leading and Turning a strategy into results. While connecting collaborations, activating employees, and using advanced technologies @ Reẖovot, Central
Principal at Health Management Associates
Passionate around managed care management and operational excellence.
Lead the Medicare programs for AmeriHealth Caritas including 2 Medicare Medicaid Financial Alignment Initiatives.
Developed staff and operational process guidelines, and policies and procedure and introduced quality measures for a new provider sponsored Medicare Advantage Plan. Have a 4 Star rating. Have increased income by 20% in 2009 over 2008 through focus on accurate risk reporting.
Formed a management services organization (MSO) a major New York Hospital System, to manage a risk contract for 6 HIP Health Plan sites in Manhattan. Expanded to other hospital primary care sites. Developed budgets, hired operational staff for utilization management, customer service and claims oversight. Formulated strategy and negotiated capitated specialty and fee for service hospital and ancillary contracts.
Developed managed care strategy for a complex hospital system including medical and psychiatric services, and a nursing home. Contracted with all major health plans on behalf of the hospital and voluntary and staff physicians. Revitalized a physician oversight body to ensure a common understanding of managed care principles and to determine the strategy for contracting and delivery system management.
Designed and implemented an innovative program in Massachusetts to align the financial incentives of independent physicians, organized into risk bearing groups, with quality measures, including selection of measures, reporting and formulation of improvement plans.
Specialties: Leadership, Thought Leader, Team Development, Accountability, Strategic Planning, Medicare Managed Care, Operations, Quality, Risk Management, Reporting, Compliance, Healthcare, Process Improvement, Policy & Procedures Optimization