Highlights of Qualifications

MBA with a concentration in Healthcare Administration

12+ years experience in self funded risk

Selected to attend United Leadership Academy - six sigma training

Strong analytical, verbal & written, and interpersonal skills

Exceptional team player with a passion to succeed

Professional Experience

VICINITI 10/10 -

Present

CO-FOUNDER

Viciniti creates hyper-local visitor guides, mobile applications and

content on San Francisco. Our content focuses on the experience of

actually being at your destination and includes extensive photo tours, as

well as a ton of old photographs and postcards. Primarily responsible for

research, writing, social media and marketing. You can download one of our

free apps from iTunes at: https://itunes.apple.com/us/artist/viciniti-

llc/id499190311.

UNITED HEALTHCARE GROUP, National accounts 07/05 -

10/10

SENIOR UNDERWRITING CONSULTANT

o Worked with customers to develop risk management programs (i.e.

cancer, cardiac, asthma, diabetes) that would mitigate future losses

and provide financial savings.

o Calculated Individual and Aggregate Stop Loss coverage

o Forecasted and evaluated customer savings through cost/benefit

analysis, ROI (return on investment), network effectiveness and

discount positions at participating facilities and physician

organizations.

o Performed pharmacy pricing and benefit savings modeling.

o Responsible for RFP pricing and strategy.

o Consulted on regulatory changes and impact to the customer.

Provided guidance and analysis for implementation of Healthcare

Reform.

o Liaison with general counsel on contract disputes and regulatory

implications.

o Managed workflow between departments (i.e. billing, banking,

Optum, claim processing) to identify key issues and develop

appropriate plan of action.

o Analyzed and reported to Finance on the revenue, expense and

margin levels of each account.

o Calculated claim projections and IBNR (incurred but not

reported) for Board of Directors and annual budgeting.

o Ensured that UHG risk through audits, performance guarantees,

and overpayments was being mitigated and accrued for.

o Performed training and performance evaluations to the analysts.

o Managed self-funded book of business valued at $40 million in

revenue with over 250,000 members.

KAISER PERMANENTE 11/03 -

07/05

PRICING CONSULTANT

o Team lead for East Bay Large Group Underwriting. Responsible for

prioritizing tasks and allocation of workloads amongst team members.

Lead team meetings.

o Rated HMO, POS, PPO, OOA Indemnity, High/Low, High Deductible, and

Health Net/Kaiser Risk Adjusted Product plans.

o Facilitated a California-wide underwriting training week on

understanding managed care and evaluating risk.

o Partnered with Account Managers and Sales Executives to strategize on

accounts with membership growth opportunities and/or on accounts

needing rate concessions.

o Participated in external meetings with clients and brokers.

o Prepared financial data, exhibits, utilization, and cost data.

o Committee member on quality improvement measures. Recommending

alternative processes and ways to implement.

o Trained team members on new business underwriting.

o Evaluated large loss reports to determine prognosis and cost of

future treatment.

Iisi, subsidiary of Llyod's of London

06/98 - 11/03

EMPLOYER STOP LOSS UNDERWRITER

o Solicited and negotiated new business in assigned region with TPAs,

brokers, and consultants.

o Rated Individual and Aggregate self-funded products; maintaining re-

insurer integrity and underwriting objectives.

o Consistently ranked #2 amongst the top producing underwriters.

o Achieved best loss ratio (lowest) every year.

o Reviewed Case Management reports to assess possibility for

catastrophic claims and/or ongoing risk.

o Worked with VP of Managed Care to negotiate contracted rates at

Centers of Excellence and local facilities to ensure best possible

outcomes of care.

o Management responsibility for Underwriting Assistant and clerical

staff.

o Worked for one year as a Provider Stop Loss underwriter, developing

capitated contracts and pmpm pricing based on

Commercial/Medicare/Medicaid populations.

BENESHPERE 08/97 - 02/98

Marketing analyst

o Managed the Request For Proposal process - analyzing the scope of the

request, recommendations for fulfillment, and monitoring completion

status.

o Developed pricing for flexible/dependent care spending accounts, cobra

administration and consolidated billing & eligibility fees.

o Performed cost/benefit analysis related to prospective clients.

DUNCANSON & HOLT GROUP, A&H Reinsurance Managers 10/90 - 02/95

ASSISTANT UNDERWRITER

o Managed multi-million dollar book of Facultative accounts.

o Performed initial review of incoming business for Treaty underwriting

acceptability.

o Attended week-long training sessions in Profession Selling Skills (New

York City), Provider Stop Loss (Chicago), and Facultative Underwriting

(New York City).

Education

o MBA, Concentration in Healthcare Administration, Golden Gate University,

San Francisco, CA; 1997

o BS, Marketing, Golden Gate University, San Francisco, CA; 1996

o ULA Academy, Six Sigma Training, Minneapolis, MN; 2007

o Long Term Care Professional (LTCP) and Health Insurance Associate (HIA)

designations through the Health Insurance Association of America

(HIAA).

Computer Skills

o Microsoft Word, PowerPoint, SharePoint. Advanced Excel (VLOOKUP &

pivot tables).

o Internet Explorer, Lotus Notes, Microsoft Outlook.

86 Barcelona Avenue ( San Francisco, CA 94115 ( 415-***-**** (

accwcu@r.postjobfree.com

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