Digital Management

Marybeth Regan, PhD, DBA

*** ****** **** • Libertyville, IL 60048 • 312-***-**** • ****************@*****.***

Senior Healthcare Executive and nationally recognized healthcare payer/provider subject matter expert, managed care contracting and operations executive. Results focused on in-depth understanding of healthcare and an expert across healthcare segments. Innovation in devising solutions for Payers including innovative contracting and operations, Network Development, Value Based Methodologies, Accountable Care Organizations (ACOs) and Bundled Payments. Proficient in Network Development and negotiating terms. Focused on Specialty Care and Disease and Care Management. Newest Articles: A Paradigm Shift: Shifting Resources for Success and Clinical Pathways: Paving the Way to Improve Patient-Centered and Cohesive Cancer Care. Demonstrated strengths:

Supported payer and provider contracting for IBM, Optum Insight and Deloitte Consulting. Client Executive for High Profile Clients. Devised new service delivery model with specialty care for large BCBS organization, encompassing prevention and wellness into current delivery, contracting and communications model;

Consulting / Subject Matter Expertise / Product / Project Management—Subject Matter Expert (Contracting and Operations) for payer clients such as Self-Insured Employers, Managed care Companies, HealthNet, Tricare, HealthPartners (Integrated Delivery System) and Tennessee Oncology; defined and implemented introduction of bundled payments and care management for a nationwide PPO; implemented three specialty PPO's for cardiovascular care (Texas Instruments) focused on results. Extensive Program/Project and Software management skills. Known for Managed Care Contracting, Innovations and Care Management.

Accomplishments—Project manager for multi-stakeholder insurance payer organizations for statewide WHIO (Wisconsin Health Information Organization's) data repository creation; Included member responsibility for engagement. Global Managing Partner for clients such as HealthNet, Tricare and HealthPartners (Integrated Delivery System). Spearheaded Project Lifecycle/ Product Development. Negotiated with payers/physicians on contracting for bundled pricing methodology; led development of Accountable Care Organizations (ACO) software.

A Career of Driving Process and Innovation for Quality

Deloitte Consulting, Chicago, IL

“Big Five” Accounting and consultancy company 2014 - current

SPECIALIST LEADER - SUBJECT MATTER EXPERT - INDEPEDANT CONTRACTOR

Expert managed care and specialty care contracting for client engagements in Clinical Transformation Practice. Provided expertise to CIGNA for Value Based Care Program and Narrow Networks. Provided contracting and operations expertise. Development of Payer/ACO Analytic software for Converge Health, a new Deloitte company. Client Executive for Converge Health. Established Digital Programs to enhance Customer satisfaction for members.

IBM, Chicago, IL 2010 – 2013

Healthcare solutions division of $104.5B publicly held (NYSE: IBM) multinational consulting and technology.

HEALTHCARE SUBJECT MATTER EXPERT: BUSINESS SOLUTIONS PROFESSIONAL

Consulted with executives of healthcare payers (including Self-Insured Employers and Unions) and provider organizations as Subject Matter Expert (SME) including Managed Care Contracting and Implementation. Advised Medicare/Medicaid on transformation including Exchanges, Consumerism and Business Intelligence solutions to achieve compliance and process improvement. Provided product development for oncology (Watson) software. Client Executive for Humana. Focused on Humana’s Digital Programs. Developed and communicated and oversaw the design, development, approval and execution

Delivered consulting engagements on engagement strategies and sustainability for ACO’s and Medical Homes (contracting and operations). Identified Shared Services options. Regular reporting of project status.

Published articles: “Clinical Pathways: Paving the Way to Improve Patient-Centered and Cohesive Cancer Care.”

OPTUM INSIGHT (formerly Ingenix Consulting), Minneapolis, MN 2007 – 2010

United Healthcare consulting subsidiary providing information and technology solutions to leading healthcare organizations.

GLOBAL MANAGING PARTNER

Provided thought leadership, developed software products and served as project lead for oncology informatics software. Lead for Request for Proposal (RFP) for Tricare for team - UHG and HealthNet.

Selected as project lead on multi-stakeholder Wisconsin Health Information Organization's (WHIO) creation of a statewide data repository, including contracting, provider engagement strategies and operations. Client Executive for WHIO and HealthNet.

Expanded initial $1M data aggregation engagement with WHIO to $5.9M three-year contract. Managed 150.

Developed software solutions focused on benchmarking for specific diseases, physician referral and supply and demand Planning software.

Completed PhD Dissertation 2007

“Disruptive Innovation: The Reluctance of New Technology Acceptance by Physicians;” Focused on EMRs, PHRs, ePrescribing and Telemedicine.

CAPGEMINI/ACCENTURE, Chicago, IL 2005 – 2007

French multinational corporation, headquartered in Paris, France; provider of IT and consulting/outsourcing services. North American healthcare consulting practice was sold to Accenture in 2005.

SENIOR MANAGER

Identified contracting issues and solutions for payer engagements (both strategy and IT) with leading healthcare organizations.

Devised new service delivery model for large BCBS organization, encompassing prevention and wellness into current contracting and delivery model. Included operational focus.

Spearheaded successful $17.5M RFP to Federal Health and Human Services Agency on interoperability

Reviewed and benchmarked Humana’s care management capabilities and infrastructure.

MAYO COLLABORATIVE SERVICES INC., Rochester, MN 2004 – 2005

Profit arm of not-for-profit Mayo Clinic—world’s largest integrated not-for-profit medical group practice.

Education

PhD—International School of Management, Paris, France

Dissertation: Disruptive Innovation: The Reluctance of New Technology Acceptance by Physicians.

DBA, International Business—International School of Management, Paris, France

Dissertation: Utilizing the Internet in Disease Management.

MS, BSBA, Business and Marketing, Northern Illinois University—DeKalb, IL

Addendum to Resume

Professional Affiliations / Certifications / Board Leadership

Women Business Leaders of the US Health Care Industry Foundation

International School of Management, Paris, France—Board Member

Commission for Case Manager Certification—Research Committee

Healthcare Access Initiative—Board Member

University of Chicago, TMJ Association—Board of Directors

Healthcare Information and Management Systems Society – Topic Coordinator (seven years)

Disease Management Association of America

Healthcare Information Technology Standards Panel (HISP)

Academic Experience

Adjunct Faculty Member—University of Chicago

Adjunct Faculty Member – University of Phoenix

Selected Publications (Authored 20+ articles):

Book: Disruptive Innovation: The Reluctance of Technology Acceptance - ISBN number is 978-3-659-87003-3

Clinical Pathways: Paving the Way to Improve Patient-Centered and Cohesive Cancer Care (2017),

Is your “Big Data” strategy like the Flintstones or the Jetsons?

The Eight Dimensions of Care Management – Version 2.0

Is ICD-10 the Holy Grail for Disease Management, For the Record (2012)

ICD-10: Crunch Time, Health Leaders Online (2010)

Selling a Physician Practice to a Corporation – Hard Lessons Learned, Health Leaders Online (2010)

Oncology Management: Benchmarking for Quality, Health Leaders Online (2008)

Collaboration: The Power of Data Aggregation, Health Leaders Online (2008)

Regional Health Information Organizations: The Keys to Sustainability, Health Leaders Online (2008

Integrated Information Management: the key to Improving Patient Thru put, Health Leaders Online (2007)

Personalized Medicine and Care Management, Health Leaders Online (2007)

Patient Throughput: The Forgotten Element in revenue Management, Health Leaders Online (2007)

Disruptive Innovation: The Acceptance and Adoption of New Technologies, Health Leaders Online (2007)

The Impact of the Laboratory on Disease Management, Disease Management (2006)

Presentations (Delivered over 15 presentations):

The Good, the Bad and the Ugly! Partnerships that work! —Association for Medical Imaging Management (2009)

Oncology Benchmarking—Association of Continuing Cancer Centers Annual Meeting (2009)

Oncology: Management: Benchmarking for Quality—Texas Association of Health Plans (2008)

The Impact of the Laboratory and Disease Management—3rd Disease Management Summit, Boston, MA (2005)

HIPAA Regulations and Their Impact on Your Organization—University of Chicago (2002)

Determining the Benefits of Carving-In and Carving-Out Diabetes—Managed Diabetes Care, San Diego, CA (1997)

COMMITTED TO IMPROVING THE NATION’S HEALTHCARE DELIVERY SYSTEM AND FACILITATING COLLABORATION BETWEEN STAKEHOLDERS

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