Erika M. Gibson, D.C., M.S.A., B.S.

** **** ***** ***** 678-***-**** home

Powder Springs, GA 30127 678-***-**** mobile

acg3t1@r.postjobfree.com

SENIOR LEADERSHIP PROFILE

Executive Director/Consultant/Medical and Clinical Services/Business Strategist

Fortune 500 Companies /High Growth Organizations/ Master and Doctorate Degree/Certified Coach, Teacher

and Speaker through John Maxwell

EXECUTIVE LEADERSHIP COMPETENCIES

High-integrity, energetic leader with proven success providing leadership to companies representing a variety of industries and

organizational cultures. Specialized expertise includes, process redesign, strategic planning and organizational transformation.

Managed Medicaid and CHIP, HMO, FEP, PPO, and Medicare Contracts for various states.

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Strategic Planning Managing Key Relationships Leading Change Initiatives

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Productivity and Performance Inspiring Team Performance Contract Compliance

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Redesigning Processes Designing Organizations Performance Metrics/ Hedis

? ? Measures

Medicaid and Medicare NCQA/URAC Experience

Experience

PROFESSIONAL EXPERIENCE:

Magellan Health Service ? Southeast/Tristate VP & General Manager

August 2012 - Present

? Provide leadership and oversight for 4 Care Manager Centers (TX, OH, MI, and GA) to ensure operational compliance

with business financial, quality and employee objectives. Partners with account managers to achieve a high degree of

customer services. Ensures cost effective member and employee responsive operations are developed and maintained

throughout the Care Management Center. Ensure retention of 18 Health Plan clients servicing over 14 Million members

with revenues over $150M. Ensure revenue goals are met, cost of care and administrative expenses are managed and

segment profit targets are achieved for all accounts

Key accountabilities include:

? Manages Care Management Center financial performance, operating budget and variance from plan to ensure cost

effective delivery of service.

? Ensures that the CMC call center and clinical staff provides appropriate, efficient and quality services

? Directs the delivery of high quality services within the CMC and ensures that quality management plans and

protocols are implemented and that services are delivered in accordance with Magellan Health Service policies

and procedures

? Manages high-risk case and utilization trends.

? Directs CMC administrative and infrastructure operation activities such as lease negotiations, staffing plans,

? Oversees all clinical and operations personnel with respect to recruitment, hiring, promotion and dismissal

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APS Healthcare ? Director of Operations /Director of Clinical Operations/Acting Executive Director

Director of Implementation/Contract Compliance ? 2010- April 2012 (Company Merger/ Acquisition)

Directed the execution of new business clinical operations for various contracts, Translate contract terms into specific business

performance requirements, Plans and executes on-site operational reviews for identification of contract performance and

compliance deficiencies, Evaluates and assigns projects, develop and supervise staff members within the implementation

department and assists in growing a project culture that promotes standardization and process improvement

Key accountabilities included:

? Led, planned and co-directed operations to ensure all deliverables and performance guarantees were met on a

timely basis

? Developed plans to mitigate any identified contract performance risks/gaps or strengthen compliance

? Developed and executed staffing plans to ensure excellent quality to achieve contract deliverables which included,

delegating, hiring, and training staff.

Director of Operations/Director of Clinical Operations/Acting Executive Director ? 2008 to 2010

Planned and directed the day-to-day clinical and administrative operations of the Program, and directly supervised all dedicated

program personnel including clinical services, call center staff, administrative, reporting, provider outreach, and technical

compliance. Ensured that APS met contractual obligations and achieved its objectives and accomplished its mission in

accordance with the strategic plan, current year budgets and approved policies. Enhanced the Achievement of Clinical Hedis

Measures, Managed Program Budget.

Key accountabilities included:

? Oversaw and managed all aspects of clinical staff, including training, job descriptions, staff meetings, performance

evaluations, office procedures and communications within the staff, including service, and product delivery

? Coordinated activities to improve process, services, and outcomes between the clinical, technical, quality and

support staff

? Educated and collaborated with community providers and other state designated vendors

? High level of interaction with client representatives, providers and community stakeholders to promote productive

working relationships and achieve and maintain performance standards

? Monitored revenue and expenditures to ensure program operated within defined budget

? Participated in the interviewing, selection, coordination, and development of the staff

? Established, reviewed and enhanced policies and procedures to ensure effective and efficient operational

procedures

Key Accomplishments

? Increased patient/member engagement rate 103% within 4 months

? Exceeded the net savings guarantee of 4.76% during PY2, PY3 and PY4

? Reduced preventable hospital admission and avoidable ER visits 3- 11%

? Developed Dashboards to track clinical outcomes and business operations

Matria Healthcare, Inc ? Director of Quality Programs Women?s and Children?s Health Division (2006 thru 2008) Company

Merger/Acquisition-

Provided consultative and leadership services throughout the organization in the areas of organizational change management,

process improvement, quality audits, business strategy development, compliance, organizational design, documentation,

implementation, complex project management, and issue resolution processes. Managed a $1.5M budget and a 6 person team for

Women?s and Children?s Health,

KEY ACCOMPLISHMENTS INCLUDED:

? Lead an organizational re-design and implementation initiative for 7 Monitoring Centers and 28 Home Care Sites

focusing on developing an organizational vision and strategy.

? Restructured and re-designed the entire core services division patient intake process and facilitated the

interviewing and hiring of new employees. Designed a new management and organizational structure, creating detailed

job descriptions with roles and responsibilities, assessing and aligning staff to the new process

? Introduced chart review, peer review, utilization review and quality assurance programs throughout all

departments.

? Created performance metrics throughout Operations to measure and communicate business performance

? Assisted with Clinical Transformations

The Coca-Cola Company ? Process Improvement Consultant

Process Improvement (2005 ? 2006) Revenue Shared Services

Oversaw a seven person team with responsibility for providing ongoing customer support, quality maintenance, and program and

project management expertise. Created a new portfolio of new business processes for revenue management. Developed improved

financial planning, analysis and reporting methodologies that tied performance directly to bottom-line results.

Key accountabilities included:

? Stewarded all Six Sigma Statistical efforts in the areas of metrics, process improvement and benchmarking that

focused on quality, cost and speed of process execution for the Coca- Cola North America Client.

? Participated as a process improvement Council Member to identify areas of improvement and gathered teams to

implement formal methodologies

? Identified and implemented continuous process improvements for Coca Cola North America Operations Project

Managers and the Quality Maintenance Programs.

? Trained and mentored employees in Statistical Methodologies and Business Analysis .

E.I DuPont-Director of Process Improvements (Company Closed)

Six Sigma Blackbelt/Director of Process Improvements (2000-2005)

Directed the planning, coordination, and staffing of departmental activities. Scope of responsibility was diverse and included

program evaluations, development of policies and procedures for various activities, quality assurance, client services and public

relation activities, supervising a variety of professional employees, Evaluated program operations for program effectiveness, cost

effectives and staff utilization,

? Supervised operational programs, including integrating the development of program policies, goals and objectives, and

monitoring the delivery of services

? Assessed current practices and policies of individual sites to create documentation standardization and best practice

guidelines across the enterprise.

KEY ACCOMPLISHMENTS INCLUDED:

? Increased revenue by 80% in 6 months, Created and Composed Policies and Standard Operating Procedures for over 42

Operations that reduced cost by 60%. Led the development, redesign and realignment of efforts for work stream project

providing a cost savings of 250K hard savings.

? Ensured projects delivered targeted revenue 1.5M, created annuity business growth for the organization.

EDUCATION:

Bachelor of Science Degree; Biology Pre-Medicine, Dillard University,

Master of Science; Health Science Administration, Central Michigan University

Doctor of Chiropractic Medicine; Neuromuscular Physiology, Life University

PROFESSIONAL CERTIFICATIONS AND ASSOCIATIONS:

? American College of Healthcare Executives; Clinical Advisory Panel APS Healthcare Disease Management Programs

? Certified in X-Ray Theory and Practice, Clinical Competency Bio-Physics, Spinal Biomechanics, Healthcare Pre-

cede/Proceed Modeling, Certified Six Sigma Green Belt,

? Certified Black Belt and Master Black Belt in Statistical Methodologies, Lean Six Sigma Trained

? Profession Leadership Advisory Committee (PLAC)

? Member Advisory Group (MAG)

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