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Sr. Director/VP of Finance

Location:
Ramona, CA, 92065
Posted:
November 26, 2015

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Resume:

DENISE AWREY

PROFESSIONAL SUMMARY

MBA, VP of Finance, Senior Financial Executive. Over 15-years of experience managing Financial Planning and Analysis functions for multi-billion dollar corporations. Recognized for delivering insightful analysis and demonstrating strong personal character. A “problem solver” by nature with the ability to see the “big-picture,” including the end to end business impacts. A driven, and responsive leader who meets challenges head-on and has attained credibility for getting results. Team player adept in both hands on and leadership roles as dictated by corporate circumstances and resources.

Management / Operations - Lead finance representative in the merger between US Behavioral Health Plan, CA and Pacificare Behavioral Health, CA, tracking systems integrations, contract agreements between segment and corporate, and work with corporate treasury and Controller to ensure smooth transition of banking and claims payment processing. This was completed on time and without any customer disruptions.

Budgeting / Forecasting (FP&A) - Working with the Sales and Operations teams to develop annual budgets and quarterly forecasts which we were able to increase revenue by an average of 20% annually while reducing Operating expenses and FTE's. Providing updates and variance explanations by region and customer to track all deviations to budget and forecast. Providing ELT with explanations for stockholder meetings as needed.

Presentation Skills - Part of the executive Public Policy team (OptumHealth) meeting quarterly with providers and members to review the state of the Plan (USBHPC) where I presented the financial position. Oversaw preparation of quarterly DMHC financial results and presented results at the quarterly Board meetings for USBHPC and PBHC when CFO was unavailable.

Financial Analysis - Partnered with actuarial and underwriting (OptumHealth) to successfully reopen and negotiate the final year of a three year contract to gain over $3M in additional revenue on a loss account. Brought account to 12% IOI (Internal Operating Income).

DSA Financial Consulting 2014 - Present

Principal Financial Consultant

Provide budgeting, forecasting and general accounting services on a part time basis. Working directly with owners and /or executives in aligning the accounting functions and reporting with the strategic direction as outlined by leadership.

Current project: Engineering firm needing budget development, forecast reporting and setup of reports for tracking job costing and profitability on projects to assist in the invoicing process. Created accounting, payroll and financial reporting standard operating procedures. Assisting with recruiting and interviewing of applicants to replace accountant.

OPTUMHEALTH BEHAVIORAL SOLUTIONS (subsidiary of United Healthcare) 2005 –2014

OHBS is part of OptumHealth and has revenues of $3.9B and 3,900 employees. OHBS is part of a Multi-National Specialty network offering Mental Health and EAP services, to Employer groups, HealthPlans and internal United Healthcare members in the US, Europe, Australia and Latin America.

Senior Director for Commercial Business (additional duties added to prior position) 2009 – 2014

Led a finance team that partnered with Commercial Internal & External General Managers, providing first stop contact between the business and finance for strategy development and full P&L forecasting and budgeting on $1.4B in revenue, while maintaining a monthly close on workday 3. A member of the team responsible for organizing and preparing the annual rate reviews for each Legal Entity and state showing rate filed for commercial, MediCare and Medicaid products. Also assisted in, providing guidance and review of Cost Benefit Analyses ensuring correct financial elements are included in evaluating costs and savings on potential projects. And assisted with quarterly presentation of financial results to Board of Director.

Led Intersegment rate negotiations and worked with sister segment Employer and Individual finance team to negotiate internal rates on Behavioral Health business in excess of $800M in revenue annually. Gained 5% rate increase based upon factual presentation of cost vs. pricing assumptions.

Assisted in development of standardized contract renewal process with sister segments to meet audit requirements, which improved our audit outcomes and increased operational efficiency.

Finance Director for External Payer & Employer Group (additional duties added to prior position) 2007 – 2009

Led finance team as liaisons between Sales Organization & Finance. My team developed and presented all external business revenue and membership forecasts and budgets for our external Payer & EG accounts, with revenues totaling over $400M annually. Partnered with account management to prepare rate negotiations and financial presentations for external payer agreements.

DENISE AWREY *******@*****.*** Page Two

Designed Top 40 & external Loss Accounts for Executive Leadership and strategic planning on rate negotiations/terminations. Report allowed executives to make strategic rate negotiation decisions on account renewals. Use of the report brought the overall Payer (Health Plan) division from a profit margin of 6% to over 12%.

Finance Director for Blue Shield & Payer Division 2005 – 2007

Lead finance liaison between Sales and Finance for all external Payer business and all areas within finance (accounting, FP&A, UW, contracts, PMO). The finance SME for the dedicated Blue Shield site with over 160 FTE’s. Prepared and presented financial results at the Knox Keene Entity Public Policy meetings held quarterly. Senior finance leader on the Blue Shield account, the single largest external customer for OHBS at the time.

Provided all financial forecasts, budgets for the stand alone office in San Diego for the Blue Shield business including revenue, membership, SG&A. Prepared regular P&L and profitability reports to Executive leadership. Through detailed analysis and review was able to increase revenue and profitability on the annual rate negotiations.

Key player in the successful negotiation of a three year renewal on a $120M annual revenue contract.

QUADRAMED CORPORATION Full Time 2002 -2005

Financial Services Division, which identifies and collects accounts receivables for hospitals and medical groups and provides other Chancellor products and services. Revenue in excess of $40M and over 150 employees.

Director of Operations, Managed Care Services and Administrative Services

Managed and directed the Managed Care Payment Review Unit, responsible for budgets, forecasting, IS development and operations. Provided overview and support on contract interpretation for contract analysts and recovery specialists and consulted with hospital contracting departments for clarification. Managed the Administrative and clerical AR departments including all off-site field representatives located at facility sites.

Researched and recommended a MedRec Chart Locator program for purchase to help eliminate misplaced files, program accepted and installed in April 2003, improving efficiency and average turnaround times by over 10%.

SO. CAL. PHYSICIANS MANAGED CARE SERVICES Full Time 1999 –2002

Manager, Revenue & Reimbursement 2000 – 2002

Managed Accounting/Finance department, staff included two Financial Analysts, two Benefit Analysts, and one Reimbursement Analyst. Responsible for accuracy and timeliness of financial statements for ten Independent Physician Associations (IPAs) and the San Diego County Community clinics. Provide management summaries and variance analysis as part of monthly financial package for each IPA.

Reengineered reimbursement department, increasing quality and timeliness for internal and external clients.

Implemented tracking and audit protocols for journal entries, cash receipts and disbursements.

Senior Financial Analyst 1999 – 2000

Modified and Updated current Access program to track and record inpatient bed days for ‘at risk’ contracts, and to identify specific areas of concern.

UCSD MANAGED CARE DEPARTMENT Full Time 1997 –1999

Capitation Manager/Senior Accountant

Managed and restructured the capitation department, responsibilities included, reengineering of departmental process flows, development of job descriptions, recruitment and training of capitation specialists, monthly capitation payments to providers, journal entries, accounts receivable and payables.

EDUCATION

Bachelor of Business Administration, Finance – San Diego State University, San Diego, CA

Masters of Business Administration (MBA) – California State University, San Marcos, San Marcos, CA

CERTIFICATIONS AND PROFESSIONAL DEVELOPMENT

Certified Healthcare Financial Professional, HFMA (December 2005)

President, San Diego/Imperial Chapter, Healthcare Financial Management Association (2009 – 2010)



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