Manager Development

Executive Summary

Creative, energetic professional with a broad financial, operational and

business development background in healthcare services. A hands-on

leader, with a history of driving significant growth and improvement

initiatives including strategic and operational planning, operational

process change, automation and product/pricing development.

Direct functional leadership in the following areas: Financial Reporting,

Accounting, Accounting Operations (A/R/A/P, Payroll) Contracting, Claims,

Information Technology, Administration, Network Development, Business

Analytics, Actuarial, Underwriting, Treasury and Tax.

In addition to functional leadership, demonstrated core competencies in

the following areas: strategic and operational planning, budgeting,

activity based cost analysis and benchmarking, benefit development,

information systems analysis and procurement, healthcare informatics,

analytics, KPI development and implementation, mergers & acquisitions,

business development and ROI analysis.

Excellent communication skills. Communication responsibilities have

included internal and external parties such as: Boards of Directors,

provider and vendor partners, regulatory agencies and financing partners.

Experience & Selected Accomplishments

Mercy Health Plans, Inc. - St. Louis, Missouri - A provider sponsored

regional health plan generating $600M in annual revenues and offering

Commercial group, Individual, Medicare, CHIP and ASO products in 5 states

to over 250,000 members

Executive Director, Strategic Financial Planning & Analytics 2006 - 2009

. Established, designed and executed administrative cost allocation and

reporting policy and procedure which led to the identification and

correction of over $6M in under funded administrative charges.

. Coordinated the development and execution of pricing and benefit

strategies on existing and new product lines including ASO, Medicare

Advantage, CHIP and Individual product lines which led to standardization

and consolidation of product offerings and reduction of administrative

support.

Correctional Medical Services, Inc. - St. Louis, Missouri - A national

healthcare services and Pharmacy Benefit Management organization serving

inmate populations in 13 states and over 40 municipalities generating

annual revenues of $700M and servicing over 250,000 members.

Vice President/Chief Financial Officer, 2001 - 2006

. Led the development and execution of financial strategy of this national

healthcare staffing/managed care provider improving annual revenues from

$500M to $700M and earnings growth from $6M to $45M.

. Improved cash flows $75M through A/R process improvement, pharmacy

inventory management and contract risk restructuring.

. Actively involved with Board of Directors in evaluations of potential

liquidity transactions including sale, debt leveraging and IPO.

Instrumental in completion of $135 million recapitalization.

. Restructured departments (Network Development, Claims, IT, and Financial

Accounting) to streamline administration, improve contracting and

increase automation of processes thereby maintaining and/or reducing

administrative cost trends under 3%.

. Drove the creation and implementation of an operational "Balanced

Scorecard" and established a Management by Objectives process which

included monthly operational reviews with each service area using key

performance indicators. These key performance indicators were used to

effectively measure, monitor and improve operational, financial and

clinical performance.

. As Secretary to the Audit Committee of the Board, directed annual risk

assessments and internal and external audit activities. Drove project

development for Sarbanes-Oxley review and remediation testing.

OSF Healthplans Inc. - Peoria, Illinois - A provider sponsored regional

health plan generating $250M in annual revenues and offering Commercial

group, Medicare and ASO products to over 100,000 members

Vice President/Chief Financial Officer, 1997 - 2001

. Developed and executed strategic operating plans which addressed

financial and capital requirements of this $150M start-up MCO, a

subsidiary of a $1B regional Integrated Delivery System accomplishing a

+$20M improvement in earnings over an 18 month period.

. Designed, developed and executed contractual relationships for

administrative, joint-marketing and risk-sharing arrangements (Physician,

Facility and Pharmacy). Developed initial Medicare + Choice and FEHBP

program proposals and executed contract implementations.

. Led physician practice development including development and execution of

provider reimbursement and risk sharing arrangements including discounted

fee for service, withhold and capitation based agreements.

Director of Finance, 1994 - 1997

. Developed financial accounting and reporting systems necessary to

transact and manage product lines and contractual relationships for ASO,

PPO, POS and HMO services and a regional Medicare HMO.

. Planned, prepared, and reviewed statutory insurance reports ensuring

compliance and accuracy of financial statements. Managed the financial

statement preparation and analysis for monthly, quarterly and annual

reporting and analysis.

. Established product pricing strategies and Rating and Underwriting policy

and procedure related to various insurance and managed care products

including HMO, PPO and Point of Service, for commercial group, Individual

and Medicare supplementary products including medical, pharmacy and

ancillary cost.

. Established and implemented company 401(k) defined contribution plan and

employee benefit programs, investment and cash management policy.

Humana, Inc. - Louisville, Kentucky - A national health plan generating

$1B in annual revenues and offering commercial group, Individual, Medicare,

Medicaid and ASO products.

Manager of Acquisitions and Development, 1994

. Participated in due diligence activities performed for acquisition

candidates that included directing the compilation and review of

regulatory filings, external audits and actuarial certifications.

Group Health Plan, Inc. - St. Louis, Missouri - A regional subsidiary of a

national health plan generating $250M locally in annual revenues and

offering Commercial group, Individual, Medicare, Medicaid and ASO products.

Manager - Finance (1992 - 1994)

Senior Financial Analyst (1991)

Compiled and reviewed operational and financial information and performed

subsequent analysis and review against operating plans and industry trends.

Responsible for the rating and underwriting on all lines of commercial

HMO/POS offerings.

Compiled and reviewed regulatory filings and actuarial certifications.

Directed financial accounting activities to include development of incurred

but not reported (IBNR) claims liability and reinsurance reporting.

Additional Experience - St. Louis, Missouri

Edison Bros. Stores, Inc. (Manager of Accounting) 1987 -1991

Arthur Andersen (Staff Accountant) 1985-1987

Education

B.S.B.A. Accounting; University of Missouri; St. Louis, Missouri

National Center for Managed Healthcare Administration - UMKC, Graduate

Certifications

Certified Public Accountant (AICPA)

Certified Healthcare Financial Professional (HFMA)

Fellow, Academy of Healthcare Management (AHIP)

Affiliations

Knights of Columbus, 3rd Degree Knight Council 9981

[pic]

Contact this candidate