Management Health
Resume:
Diane (Dee) Brown
Reisterstown, MD 21136
Cell - 443-***-****
Summary
A senior executive with extensive expertise in operational responsibilities including; not for profit fiscal management and for profit budget management with profit and loss accountability; executive operational oversight and program management; consulting to C-suite staff; policy development; legislative and legal compliance requirement; Contract negotiations and contract development; RFP review, response, award and appeal; business development; strategic planning; human resources; account management and project and new business implementation. Strengths include visionary leadership through transparent communications; mentoring staff for success; public sector board management, non-profit and public/private financials and fund administration; successful project implementation; information system conversions using cross functional teams; marketing strategies and research aligned to organizational vision; and organizational function and design that lead to improved workflows, efficient processes and reduced administrative cost structures.
Experience includes:
Large and small for profit, private, public, not for profit and quasi-government organizations
Working with federal and state financial regulations, procurements and judiciary audits
Fortune 500 insurance, managed care, public sector, provider organizations
Publicly traded and privately held entrepreneurial start-ups
Work Experience
11/23/11 to 9/24/15 SVP Business Administration & Chief Operating Officer – Integra Health Management, Inc. (now Integra ServiceConnect, LLC)
Privately Held Health Care Management Organization using Community Health Worker Model
Responsibilities and competencies include:
Organizational and business oversight
Capital raise due diligence
Leadership to multi-functional management team
Profit and Loss responsibility ($3M), grown to ($6M), projected 2015 ($11M)
Obtained Health Information Trust Alliance (HITRUST) certification for first vendor of its kind in the US
Strategic management with CEO to grow the organization
New business implementation
Secured National Master Service Agreements with 4 of the 5 largest National Insurers in US
Facility operations
Policy development, process improvement and scalable solutions
Regulatory compliance and market research
All contracting (Vendor, client negotiations, legal communications, regulatory compliance, broker and coverage for business and employee benefits)
Oversaw HR, Finance, legal compliance, IT, vendor management, account and program management
11/23/09 to 11/21/11 Chief Operating Officer – Baltimore Mental Health Systems, Inc.
Quasi-government Non-profit Agency – Responsible for Public Mental Health System Baltimore City
Responsibilities and competencies include:
Oversight of CFO and fiscal operations ($22M);
Oversight of human resource functions, policies, procedures and benefit
selection;
Management of state block, federal block and private foundation fund
contracts;
Management of 127 contracts with 60 provider organizations;
Information Systems oversight;
Facility operations and office management;
Quality Management oversight for complaints, provider site visit audits and
annual quality management plan; and
Organize, plan and manage state report submissions, quarterly audits and legislative audit responses.
8/4/08 – 11/20/09 Senior Associate - Open Minds
Private National Behavioral Healthcare Consulting and Publication Organization
Responsibilities and competencies include:
Lead consultant for client projects including
oStrategic Planning;
oRFP solicitations – research, market analysis and response;
oSystem of Care Design – process workflows, barrier analysis and reengineering;
oInnovative Technology implementations – new business and system design, root cause analysis and system process improvement;
oManaged Care services/systems – claims, call centers, provider services, marketing, RFP response, system redesigns to current market trends, workflow efficiency process mapping;
oPharmaceutical research and messaging for community reentry and managed care marketing; and
oTelehealth, Medical Home and Accountable Care Organization (ACO) research, industry education and training.
6/18/07 – 8/1/08 Chief Administrative Officer – Clearpoint Business Resources, Inc
Public National Temporary Staffing Organization
Responsibilities and competencies include:
Management of multiple teams in the corporate and field staff in more than 70 locations;
Payroll responsibility for 9,000 employees weekly
Strategic plan implementation;
Organizing the company during multiple organizational restructuring events;
Budget development and management;
Leading the IT technology operations division with the CIO that brought a unique revolutionary solution to the global staffing business; and
Overseeing the following departments: payroll, billing, human resources and the local finance administrative team.
6/6/06 - 6/17/07 Senior Director of Network Development – Harmony Behavioral Health
Public Managed Behavioral Health Care organization wholly owned by WellCare Health Plan serving members in CT, NY, IL, IN, OH, MO, LA, FL, NY, NJ, GA, SC, TX
Responsibilities and competencies include:
National responsibility for network development and provider data integrity and website functionality;
Innovative solutions included a provider evidenced based best practice pay for performance model, new business implementation in two new markets with successful network builds (OH and NY), expansion network builds in 69 counties this year in support of existing markets; and
Member of the Medical Advisory Committee, Co- Chair of the Network Quality Review Committee and Executive Leadership team member reporting to the CEO/COO.
1/17/05 – 6/1/06 Vice President of Administration – Comprehensive Behavioral Care
Public National Managed Behavioral Health Care serving members in CT, TX, MI and FL. Tampa, FL, Corporate Office
Responsibilities and competencies include:
National responsibility for provider services, data management, credentialing, call center, MIS reporting; and
Successful implementation of process improvement activities to support new IS system implementation, improve claim processes with auto adjudication improvements, client reporting and automated processes to better service clients, members and providers.
10/01/04 -6/1/06 Independent Management Consultant (Comprehensive Behavioral Care and Open Minds – Senior Consultant and Advisory Board member)
Responsibilities and competencies include:
Workflow design (Claims, Clinical Service Delivery, Call Center, Network Management);
Policy and Procedure Development and Revision;
Provider Network Management, Contracting and Profiling;
Account Management Plan Development;
Client Reporting Quality Review;
New Business Response and Implementation; and
Program Administration and Management.
11/01 to 11/03 Senior Vice President of Provider Network Services - Magellan Behavioral Health
Public National Managed Behavioral Health Care Serving over 70 Million Lives
Columbia, Md. Corporate Office
Responsibilities and competencies include:
National responsibility for all provider services (contracting, rate setting, data management, credentialing, network management and outreach).
Served over 50,000 individual practitioners, 3,000 facilities and 6,000 group practices growing the network from 26,000 in 2 years (92% increase).
Direct management responsibility for over 300 staff. Reduced administrative costs by improving workflows and system infrastructures and staffing to 115 staff saving the company $6 million in 18 months.
Led national unit cost task force to reduce cost of care impacts. Projected savings through 2006 targeted at 6 million based on unit cost initiatives begun in 4th quarter 2003.
Managed multiple system migrations to achieve a single provider database capability that eliminated administrative costs ($6M) and 36 related systems company wide.
Successfully managed company through Chapter 11 re-organization
11/99 to 10/2001 Chief Operating Officer - Foster America, Inc.
Start-up Managed Care Child Welfare Title IV-E Waiver Project
Chalfont, PA.
Responsibilities and competencies include:
Overseeing direct service site in Baltimore City, business development and strategy, industry projections, and oversight of company operations and budget of $8 million annually.
Built company from ground to reality (hired staff, space, infrastructure, procedures, training, vision, culture) creating a low turnover environment in a high turnover industry.
Demonstrated early family permanency achieved for children placed in the program. 194 children adopted compared to 77 in the city program.
10/97 to 11/99 Director of New Business Development - Devereux Foundation
Non-Profit behavioral healthcare provider organization in 14 states.
Villanova, PA. Corporate Office
Responsibilities and competencies include:
Operation of new business opportunities for non-profit nationwide network of programs for individuals of all ages who have a wide range of emotional and developmental disabilities.
Awarded key child welfare managed care contract for District Five in Florida totaling $18 million in annual revenue.
Created merger and acquisition guidelines utilized in purchase of the Cleo Wallace Center (230 bed facility) in new Colorado market.
Stabilized outpatient services in Pennsylvania from loss to profit run rates.
1/91 to 10/97 Merit Behavioral Care (now Magellan Behavioral Health)
Newtown, PA.
Multiple positions including Associate Executive Director, Area Director of Operations, Regional Implementation Manager, Claims Manager, and Claims Supervisor.
6/86 to 11/91 Massachusetts Mutual Life Insurance Company
Horsham, Pa.
Multiple positions including Claims Supervisor, Corporate Trainer, and Claims Examiner
1974 to 1986 Various positions in hospital and doctor's office environments. Strong medical/surgical background including operating room and labor and delivery and surgical technician experience.
Education
Masters of science in Management
Rosemont College, Rosemont, PA. 1998 – 2000
Bachelor of Science in business management; magna cum laude
Rosemont College, Rosemont, PA 1993-1998
Other Educational/Industry Activities:
Union College, Union, New Jersey - 1978 (Nursing)
Health Insurance Association of America Group A, B, and C - certified
Insurance Claims Association Part I and II
Advisory Board member for Open Minds
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