SKILLS SUMMARY Accomplished results-proven healthcare professional with 15+ years of professional experience in managed care with proficiency in government programs such as HIX, Medicare and Medicaid. Strategist and a demonstrated change leader who demands excellence and inspires by example. Versatile management profPessional offering solid history of improving client relationship and managing multi-year multi-million dollar relationships. Recognized for offering deep functional content knowledge and competency in account management, community relations, program management effectiveness, operational efficiency, customer service, and sales. Progressive experience directing multiple projects from conception through full life cycle to post implementation. Combine recognized Content/Technical knowledge, professionalism, competency, communications skills, and negotiation to forge enduring relationships, drive change, and establish win-win solutions. Recognized for providing exceptional customer service, driving many concurrent client facing programs and activities, business to business relationships, developing successful products and effectively managing staff. CORE QUALIFICATIONS * Implement products/programs to enhance revenue growth * Build and manage collaborative, multi-disciplinary teams of more than 40 team members * Manage business needs analysis and deliver program vision and strategy * Build high performance teams through selective recruitment, training and mentoring * Influence business partner and vendor relationships * Build extensive network of community contacts and possess outstanding relationship cultivation abilities PROFESSIONAL SUMMARY Specialists On Call Reston, VA 2015 - Present VICE PRESIDENT, CLIENT ENGAGEMENT * Lead the SOC Client Engagement team * Ensure SOC Physicians provide specialty telemedicine services to facilities and hospitals across the US * Manage personnel in distributed workforce * Define goals and objectives for each individual * Translate corporate goals promulgated by senior leadership into effective client engagement program * Provide analysis of high-impact and high-risk client relationships * Define goals for management of all hospital clients * Effectively renew client contractual relationships * Monitor client clinical services in cooperation with CMO and clinical teams * Assess financial strength of client relationships and lead strategies to optimize financial outcomes * Proactively assess need for client engagement resources based on review of service pipelines * Oversee program that results in successful cross-sell of new services to existing clients * Report on client management outcomes to senior leadership * Directly engage effectively with high-priority or problematic clients Inovalon (formerly MedAssurant) Bowie, MD 2008 - 2015 PROMOTION SR. DIRECTOR, CLIENT GENERAL MANAGER * Responsible for the leadership and strategic direction of an Emerging Client team. * Responsible for P&L ownership of the productlines * Direct future growth strategy through product design, client interaction, and regulatory awareness. * Provide industry-leading, exceptional customer service to key clients in order to build long-term relationships, facilitate and Ensure retention, up-sell and cross-sell opportunities. * Build, maintain and provide oversight and leadership of a team consisting of data analytic, clinical, operations, and product experts, as well as client services professionals. * Oversee the effective identification, recruitment, review process, retention, training, daily coordination, and management of team members to achieve a successful balance of service provision and associated financial fiduciary responsibility * Develop and maintain "expert-level" knowledge of all of Inovalon's current and potential product lines, including associated regulations, processes, timelines, and general clinical approach underlying each product * Create strategies to ensure the accurate and timely delivery of the Company's services on key accounts for the respective client (s) * Drive the client delivery strategy, beyond the day-to-day oversight * Identify the need for comprehensive business requirements and provide direction to Inovalon's product teams regarding product planning and design * Be accountable for the strategic leadership of assigned client accounts, client satisfaction and the creation of valued senior level business relationships with clients * Proactively identify potential and existing issues in client service relationships, address these directly and intervene when necessary to ensure client satisfaction * Ensure approved business contracts are executed by taking responsibility for the completion of all requirements * Cultivate and expand existing business relationships through frequent communication, including formal and informal meetings and client visits * Lead team goals of the division by participating in strategy meetings, including discussing business development pipeline, marketing strategies, and current challenges. DIRECTOR, CLIENT SERVICES AND ACCOUNT MANAGEMENT * Lead, support, and take ownership of the planning, design, strategy, maintenance, and success of the Company's product offerings across the client services department and teams. * Develop and manage multiple client projects. * Responsible for assessing and advising upper management on Client Services issues, including both emergent and systemic. * Responsible for determining several projects' schedule, scope and budget, and directing appropriate team members in fulfilling the specifications to meet client and company objectives. * Support the development and enhancement of training programs to Company staff and client staff regarding Risk Adjustment Products. * Responsible for defining departmental operating budgets, and resource, risk and scope management. * Develop and maintain "expert-level" knowledge of various risk adjustment methodologies (e.g. Medicare Advantage, Medicaid, commercial capitation programs, and other such programs impacted by risk adjustment), regulations, processes, timelines, and general clinical approaches underlying the Company's current and potential product lines. * Lead client service teams, comprised of Sr. client service managers, client service managers, data analytic, clinical, operations, and product experts in the accurate and timely delivery of the company's services. * Plan, facilitate, coordinate and direct implementations of multifaceted operations, products, and services roll-out, ramp-up, and expansions of client services departments. * Closely monitor project plans and communicate progress through creation of internal and external status reports and other client communication. * Drive new business opportunities, including identification of organic growth within existing accounts, development of proposals (including estimated budgets), and development of new business presentations aiding sales when appropriate. Key Achievements: * Lead teams including: Sr. managers and Client services managers to support client contract, goals and initiatives. * Lead client projects of over $50 million and achieved client ROI of over $400 million. PROMOTION SENIOR MANAGER, CLIENT SERVICES * Lead client service teams, comprised of client service managers, data analytic, clinical, operations, and product experts in the accurate and timely delivery of the company's services. * Provide detail and dashboard reporting of client status with regards to satisfaction, product deliverables and custom requests. * Lead and oversee execution of client integration processes per contract requirements, to ensure efficient and effective project launch while properly managing client expectations. * Actively work with marketing and business development in the cultivation of key client relationships. * Maintain detailed knowledge of company product offerings to include: Retrospective and Prospective Risk Adjustment Comprising of both Medicaid and Medicare populations STAR Advantage, HEDIS Advantage, BI and CCS Advantage. * Identify and assist in the development of product or process enhancements which may improve process flow, client use, and/ or business function. * Maintain working industry knowledge of the Encounter Data as well as the 5010 transition mandated by CMS. * Lead and support the execution of Risk Adjustment Data Validation/RADV projects across company's client base. * Assist in the delivery and monitoring of weekly client conference calls to address service delivery expectations, progress, panning, review of deliverables, service delivery outcomes, education regarding products, and issue resolution, etc. * Resolve client questions, concerns and service issues, including undertaking appropriate efforts to become aware of any such questions, concerns or service issues. * Participate in the quality review process of company's deliverables such as reports and custom analyses. * Mentor and develop junior team members comprising of client services managers and project coordinators. * Maintain compliance with company's policies and procedures. Key Achievements: * Lead teams of 4-6 Client services managers to support client contract, goals and initiatives. * Lead client projects of $30 plus million and achieved client ROI of over $200 million. * Increase customer's use of existing and new products and services by 10% PROMOTION RISK ADJSTMENT PRODUCT SOLUTIONS MANAGER (PRODUCT MANAGER) * Develop and maintain in-depth product knowledge and expertise regarding MedAssurant risk adjustment products utilized by MedAssurant clients, and serve as the product "expert" and "mentor" to clients and other team members. * Directed business and product requirements definition and verified customer needs throughout product development lifecycle. * Identify business opportunities through competitive market research, customer retention analysis, segmentation and feedback review for market. * Provide documentation to Executive Vice President and Sr. Director of Risk Adjustment Products regarding pertinent client needs and opportunities for product expansion. * Verify incorporation of Executive Vision in new products and services and actively assist Senior Management in the cultivation of key client relationship (s) including the translation of client needs into new service offerings. * Maintain knowledge and understanding of CMS regulations and guidelines for Medicare Advantage and Medicaid Risk Adjustment processes. * Conduct regular client project reviews lead client support teams comprised of data analytic, clinical, operations, and product experts in the delivery of services. * Maintain frequent client communication to address service delivery expectations, progress, risk mitigation planning, review of deliverables and provide ongoing education regarding products. Key Achievements: * Lead client projects ranging up to $30 million and achieved client ROI of over $200 million. * Lead the execution of client integration process to ensure several efficient and effective new project launches. CLIENT SERVICES MANAGER * Support, nurture, and expand positive and successful client relationships for both new and repeat clients. * Managed projects and products for up to 8 health plan clients. * Manage assigned Health Plan clients across the Company's services, including HEDIS Advantage, Capitation Risk Adjustment ChaseWise Medical Record Review, Claims Processing solutions, CMS Risk Adjustment Processing solutions (RAPS), Disease Management and other products/services. * Create and maintain client implementation plans and schedules. * Maintain a knowledge base and understanding of NCQA hybrid measure specifications and processes. * Demonstrate knowledge and understanding of CMS guidelines for Medicare Advantage and Medicaid Risk Adjustment processes * Conduct weekly client conference calls to address service delivery expectations, progress, planning, review of deliverables and education regarding products Point of contact for issue escalation and resolution. * Lead and oversee execution of client integration process to ensure efficient and effective project launch. * Maintain an expert level of knowledge regarding the assigned products and services of the company. Assess client needs and communicate those needs to management, operations and product development teams. * Demonstrate knowledge of CPT, ICD-9 and HCC coding. Key Achievements: * Facilitated process that enabled Health Plan clients to reduce acute care cost in Emergency Room by 25% * Lead process that maximized Health Plan clients rate of reimbursement from CMS by over 50% * Effectively manage Health Plans ranging in size from 6000 to over 100,000 member lives * Prepare directives, manuals and guidelines for new and existing clients and product lines.

Highlights:

• Client Services
• Client Engagement
• Account Management
• Medicare/Medicaid
• Telemedicine
• Risk Adjustment
• HealthCare
• Management
• Account Management
• Adobe Photoshop
• Business Development
• Business Requirements
• CCS
• Cms
• Coding
• Integrate
• Management
• Cms
• Medicare
• Account Management
• Adobe Photoshop
• Business Development
• Business Requirements