Negotiate MA & Medicaid value-based care contracts with prospective payer partners.
Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements.
Build and manage relationships with payers and other key stakeholders to resolve issues and optimize performance.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country, operating with a collaborative, inclusive, and remote-first culture.
Assess population needs, analyze the highest-need dual-eligible subpopulations.
Design integrated care models suited to rural duals populations and assess feasibility.
Develop payment model recommendations with rural-specific adjustments for travel time.
Artemis Connection is a strategic management consultancy working across the for-profit, public and social sectors. We help clients around the world identify their most pressing strategic issues and we staff teams of strategy consultants to roll up their sleeves and deliver impact.
Develop and execute commercial reimbursement strategies aligned with company objectives and growth plans.
Lead engagement with national, regional, and local commercial health plans.
Provide direct people management and leadership for the Market Access Manager team.
Calyxo, Inc. is a medical device company that addresses the need for improved kidney stone treatment. They're a dynamic team with experienced leaders and investors who aim to commercialize devices to meet unmet needs within urology.
Own the development and maintenance of clinical and reimbursement policies, ensuring perfect alignment with CMS regulations.
Design and oversee a robust audit program that monitors adjudication system output against clinical policies, pricing, benefit rules, and provider contract terms.
Lead the implementation of AI initiatives to automate the monitoring of reimbursement policies and contract validation.
Clover Health aims to improve the health of its members by leveraging technology and data-driven insights to provide personalized, high-quality care. They are a mission-driven team of individuals, who are passionate about solving healthcare's most complicated problems, and strive to put members first.
Triage calls by understanding callers’ purpose, needs and urgency.
Collects and records client information in the customer relationship management system, Salesforce.
Provide exceptional customer service by listening and responding to client requests and building rapport with clients, their family members, and clinical professionals.
Acadia Healthcare is a leading provider of behavioral healthcare services across the United States. Acadia operates a growing network of behavioral healthcare facilities and is the largest stand-alone behavioral health company in the U.S with over 23,000 employees.
Lead and manage multi-level Clinical Specialists for clinical support and case coverage.
Develop and deliver clinical education to sales, clinical specialists, and OR staff.
Work cross-functionally with Quality, Regulatory, Marketing, and R&D to develop clinical education.
Calyxo, Inc. is a medical device company that addresses the profound need for improved kidney stone treatment. They are led by executives and investors with a proven track record of commercializing paradigm-shifting devices to meet unmet needs within urology.
Oversee the Commercial segment within the Strategic Payer Partnerships team ensuring performance goals and objectives are met.
Collaborate with Executive Leadership to shape Aledade's strategy for value-based contracting on behalf of independent primary care practices.
Lead, direct, and evaluate a team of senior leaders ranging from Manager to Sr. Director.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Oversee and/or perform an accurate medical record review for all RISK.
Conduct training related to ,RISK, platform usage, update any training materials, and function as RISK SME.
Manage RISK coding projects when needed- including project status and completing chart reviews for coding projects as needed.
Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. They are trusted by 80+ customer organizations nationwide and work to advance care quality, strengthen documentation integrity, and sustain operational readiness.
Serve as the primary operational lead for assigned studies.
Partner with sponsors and CROs as a key point of contact.
Proactively identify operational risks, including enrollment challenges and protocol-related issues.
M3 Wake Research is an integrated network of premier investigational sites meeting the clinical research needs of global biopharmaceutical, biotechnology, medical device, pharmaceutical and clinical research organizations. With close to 30 owned and managed research sites across the country, M3 Wake Research is one of the largest independent, multi-site clinical research companies in the US.
Design and execute AI safety testing protocols for clinical AI modules.
Review and validate AI-generated clinical content against evidence-based guidelines.
Partner with the Sales team as a clinical SME during demos, prospect calls, and pilot evaluations.
Avo is a clinical AI platform used by healthcare enterprises to infuse trusted knowledge into clinical copilots, integrated directly into the EHR. It helps clinicians deliver higher-quality care without the documentation burden and is in a growth stage.