Resumé

Experienced Global Health Care Service Operations Leader/Consultant for Start-up and Mature Businesses

Summary of Experience

Experienced and accomplished global health care operations leader and independent health care consultant. Leader of global, multi-sited (offices on four continents) health care payer businesses for two Fortune 20 companies. Utilized industry knowledge and a deep set of relationships and experiences to build and run a successful independent consulting practice for more than 10 years.

As a leader, directed multi-cultural business and operations teams with a time-tested record of achieving concierge level of service results while exceeding financial performance targets.

As a consultant, achieved excellent outcomes whether working with start-ups, business turnarounds or mature healthcare businesses. Significant expertise with integrating acquired businesses and solving for the numerous business and operational nuances associated with global healthcare services and delivery. Deep set of consulting skills as an individual contributor and able to move seamlessly between strategic and tactical solutioning.

Professional Experience

RMDT Consulting, LLC

Founder/President – Independent consulting firm specializing in global health care services.

• After leaving United HealthCare International, restarted independent consulting practice and immediately awarded contracts with telehealth and EMR start-ups to help them scale their services to healthcare payers and providers.
• Awarded consulting contract with partner to analyze, recommend and implement a consolidation of offshore operations and business practices for a global medical travel/assistance company. Recommended structural, process and technology changes which were starting to be implemented prior to a leadership change.
• Other engagements for the consulting practice (partner) included integration of global network services following an acquisition by a global health care company. Integration by partner is completed.
• Healthcare Operations Subject Matter Expert for Alpha Sights (company that links consulting expertise with healthcare payers and providers).

Active contributor to Patina Solutions healthcare practice initiatives (sourcing, candidate review, etc.).

Previous (2005 – 2012)

• Grew successful health care consulting practice with focus on delivering customized best practice operational solutions for international health care payers. Generated leads and achieved $.5M annual revenue as an individual contributor.
• Sold and delivered solutions to industry leading clients including Aetna International, Cigna International, United HealthCare International, World Access/Mondial, Medex, Harvard International, etc.
• In 2012, added an employee to the practice to further strengthen the solutions offering regarding global provider networks.

• Hired as consultant by United HealthCare International to build service and operational support for their start-up expatriate product. Hired by UHCI full-time in March, 2010 (see below).
  Lead the project to integrate Operations as part of a cross-functional project team following a business acquisition (Aetna International).
• Key participant on a Business/IT Project Team charged with developing a technology solution to support expatriate payer’s critical back room operations. Developed business requirements and ROI used in presentation to Sr. Mgt. to obtain project funding support for $5M capital investment. Recommendations delayed by business acquisition (Cigna International).
• Completed detailed analysis of aberrant claim and call patterns for an expatriate healthcare company by using trend data, user interviews and timing studies. Recommendations developed for improving customer service operations implemented (Cigna International).
• Assisted a global assistance company executive throughout a project management cycle to implement a web site focused on global healthcare information provided by Harvard Medical.
• Project implemented on-time and on budget (Medex, Harvard International).
• Developed RFP to assist in selection of claim/benefit administration system and medical management vendor for global assistance company. Recommendations not implemented due to change in corporate strategy (World Access/Mondial).

Aetna PayFlex Service Operations

Director/Senior Program Manager – Aetna’s Consumer Health Payment Business.

• Recruited back to Aetna/PayFlex to lead key Service Operations initiatives and led Service Operations relationship with PayFlex’s largest client/partner (One Exchange-Willis Towers Watson).
• Turned around Service Ops KPM’s in three months that were plan laggards and achieved consistently better than plan metric results for 11 months in a row.
• Developed a dedicated Call Team for key subsidiary (OPERS) in six weeks from RFP to implementation that has achieved extremely positive outcomes and feedback from client.

• Directed efforts to implement omnichannel solutions for PayFlex . Visual engagement/co-browse, member email and member chat solutions all completed inside an aggressive 12 month window.
• ABX Yellow Belt and supported PayFlex wide ABX claim and contact center initiatives as SME.
• Mentored Head of Service Ops on use of vendor partners, staffing optimization, culture development, Service Ops strategy, etc.

United HealthCare International – Tampa, Florida

Vice President, Leader of Global Operations – Global business division of United Health Group.

• First hire and lead operational, product development and business technology efforts to build service support for introduction of expatriate offering; go live efforts completed in 18 months following approval by senior management.
• Built and staffed start-up 80+ person operations team in Tampa (functional teams include client implementation, eligibility, client management, claim processing, 24x7 customer service, clinical support and network operations).
• Lead business development of homegrown $2M+ administrative platform (Global Hub) in support of UHCI expatriate business.
• Responsible for directing international provider network growth to 1,000+ medical providers and six business partner alliances. Insurance Fronting Partner Operations Lead accountable for three new relationships in three global regions (ME, Australia and Czech Republic).

• Established personalized service offering philosophy which led to significantly exceeding industry leading service metrics during first two years of operations.
• Key M&A operational subject matter expert. Vetted key acquisition targets identified in ex-pat and assistance space. Performed operational due diligence for assistance (FrontierMedex) and in-country (Amil) health care acquisitions. Responsible for integration of travel assistance (FrontierMedex) assets into UHCI organization.
• Provided leadership support for established US-inbound “travelers” business segment by functioning as interim leader for Cross Borders business segment.
• Lead team developing product and operational support for Business Travel Product including developing B2C business requirements for medical assistance and self-service digital platform for ex-pat plans.

Aetna Global Benefits – Tampa, Florida

Vice President and Head of Global Service Operations – Global business division of Aetna.

• Recruited back to Aetna by President of AGB to lead global service integration efforts in 2007 as a result of a business acquisition.
• Directed 400+ employees of eight locations in seven different countries along with outsourced vendors in four other countries; $20M annual budget supporting 400,000+ members.
• Responsible for delivery of concierge service to AGB’s global client base. Services included claim administration, customer service to members, providers and global clients, as well as quality assurance training program delivery for global service employees.
• Expanded AGB’s global operation footprint by opening an additional service office in Manila and significantly expanded the size and scope of AGB’s Ireland and Seattle operations. Inherited service/contact centers in Hong Kong, Shanghai and Dubai as a result of the Goodhealth acquisition.

• Successfully integrated Goodhealth Worldwide acquisition operations. Integration included people (new leadership team), processes (new service delivery model), systems and transition of functions between the multiple service locations.
• Developed and implemented 24x7 contact center support for members/providers as part of a global “Follow the Sun” strategy.
• Increased claim output and call handling efficiency by 35% vs. prior year.
• Successfully implemented AGB’s largest customer during the integration period with no negative fallout.
• Implemented a highly successful teleworker program for US based staff that improved productivity while supporting a 20% YOY staff increase.

• Recruited back to Aetna by Senior Vice President to lead start-up operation.
• Scope of position: $7M annual budget and 115 employees based in two offshore and two onshore locations.
• Managed all aspects of operations and customer service for rapidly growing and profitable product line including developing 24x7x365 service delivery model for claim, call, web and global network while managing 800+ clients and 125,000 global members.
• Managed project to select global medical assistance vendor/partner that improved service and lowered costs. Developed International Health Advisory Team as a value added component of AGB’s product offering.

• Successfully executed a service turnaround for this business line (i.e., reduced claim turnaround time from 40 days to 10 days in six months). Mentored staff to achieve two best in class service/leadership awards given out annually to only two employees (out of 28,000 company-wide).
• Developed start-up operations in Seattle, Ireland and Manila.
• Participated as a speaker at numerous sales conferences and client advisory meetings.
• Instilled a concierge level of service culture in the organization that achieved 98%+ satisfaction ratings from clients and members as well as less than 10% annual turnover of employees during my four year tenure.

Independent Contractor – Lakewood Ranch, Florida

• Consulting services for flexible spending accounts and consumer directed health plans.

• Contract engagements fulfilled from off-site location based in Lakewood Ranch, Florida.

Ceridian Benefit Services – St. Petersburg, Florida

Vice President/Product Director, Benefits Services – Global record keeping provider.

• Managed team of 250 employees responsible for delivering flexible benefit services to 27,000 clients and their employees during a period of mergers and acquisitions for Ceridian.

• Scope of position: $11M annual budget, operations, system liaison, sales support and compliance.

Aetna, Inc. – Hartford and Middletown, Connecticut

National managed care company.

• Managed all core operations (claim, client services, member services, systems, vendors, sales and sales support for the FSA and COBRA businesses).
• Scope of position: accountable for P&L, $28M in annual revenue, $14M in annual budget and all related services for 1100 clients (more than 1 million members). Directed a staff of 215 employees.
• Directed e-commerce initiatives that supported the strategic goal of reducing paper and increasing member self-service for this product. Diversified product line following the addition of new government regulations (i.e., Retiree Reimbursement Accounts, Qualified Transportation Benefits, etc.).

• Doubled the revenues of this business in 4 years; developed Aetna’s FSA business as the premiere FSA administration business in the marketplace.
• Developed strategic plan for FSA business that served as precursor for development of consumer directed health plan product line for all of Aetna.
• Developed and implemented new mainframe FSA administration system (SPARKS) on-time and under budget ($3M expenditure). This system is still being used by Aetna for their consumer driven health plan administration.

• Accountable for all marketing and strategic planning for fee for service health and welfare consulting business.
• Recommended the introduction of the FSA product as an additional service to sell to Aetna clients which increased department revenue in first year by $3M.

• Managed six consultants responsible for selling fee for service health care cost management products and services to Fortune 100 employers.
• Personally achieved annual sales of $1M in consulting fees.