Health Manager

CHRISTINE SEXTON

**** ******** ***** **. ******, OH 45458 937-***-**** *******************@*****.*** www.linkedin.com/in/chris-sexton-ms-rn

EXECUTIVE-LEVEL PROFESSIONAL

Accomplished, metrics-driven leader with experience guiding organizations through transitions to reenergize approach to organizational mission and vision. Successes include producing $1.2 million in savings via incentive program platform implementation, new market expansion leading to 1 million new program members, and slashing ED utilization by up to 18%. Skilled in managing non-profit financial resources, including working with board of directors on budgets and finances. Enhance organizational image through active presence and visibility in community. Ability to communicate organization mission to donors, partners, and community stakeholders. CORE COMPETENCIES

Annual Strategic Planning Organizational Vision Mission Planning

Operational Development Product Line Development Best Practices Deployment

Staff Development/Retention Marketing and Communications Brand Visibility

Program Development Nonprofit Reporting Board Governance

Clinical Programs Startup/Turnaround Donor Stewardship/Cultivation

Corporate Partnerships Fundraising Strategies Product Introduction CAREER HIGHLIGHTS

DIRECTOR OF CLINICAL PROGRAMS AND INTERVENTIONS CARESOURCE

Played key role in enhancement of clinical programs including tobacco cessation, adult and child obesity, disease management, behavioral health, Early Periodic Screening Diagnosis and Testing (EPSDT) Medicaid program, women and children specific programs, and health risk assessments. Identified/implemented programs that secured Medicaid, Marketplace, MyCare, and Medicare Advantage business/provider contracts in Ohio, Georgia, Indiana, Kentucky, West Virginia, and Arkansas. DIRECTOR, HEALTH OUTCOMES AND MATERNAL CHILD SERVICES FOR OHIO MARKET CARESOURCE

Managed over 30,000 Medicaid births annually throughout Ohio. Successfully improved identification, care coordination strategy, and resource allocation to high risk maternal population members receiving care. DIRECTOR, SERVICE LINE AND CLINICAL OPERATIONS, WOMEN AND CHILDREN’S SERVICES MIAMI VALLEY HOSPITAL

Helped secure funding to begin renovations to Women’s Berry Center at MVH that included labor and delivery rooms, post- partum rooms, nurseries, patient waiting areas, physician lounges and sleeping quarters, ensuring local market competitiveness.

Led strategy, planning and oversight for construction of new Level II Birthing Center at Miami Valley Hospital South; exceeded 1st year delivery projections by 100% (1,200 vs. 600), with excellent quality and physician satisfaction ratings. BARIATRIC PROGRAM MANAGER-WEIGHT LOSS SURGERY KETTERING MEDICAL CENTER AND SYCAMORE HOSPITAL

Developed and launched multidisciplinary program that delivered nationally recognized, inpatient, pre-surgical and post- surgical care. Obtained Bariatric Center of Excellence (COE) accreditation through Surgical Review Corporation (SRC) for Kettering Medical Center and KMC-Sycamore within 6 months of start-up. Secured revenue producing insurance provider status and contracts with insurance companies such as UHC, AETHA, CIGNA, Med Mutual and Anthem BC/BS. Achieved regulatory compliance with zero deficiencies under Joint Commission and SRC. PROFESSIONAL EXPERIENCE

CARESOURCE – Dayton, OH 2012 to 2020

Non-profit managed care organization $10 billion in annual revenue and 2 million members in 5 states, leading industry in providing member centric health care coverage. Rated in top 20 health care plans and received 4-star rating within Glassdoor awards. DIRECTOR, CORPORATE POPULATION HEALTH PROGRAMS (2015-2020) Provided strategic leadership in areas of disease management, wellness programs, behavior health programs, women and children healthcare, health risk assessments, and rewards and incentives programs. Reported to VP and COO and oversee 4 managers with 10 staff reporting up through teams within department. Navigated strategic programing supporting model fidelity for population health initiatives and interventions to drive quality outcomes and lower overall cost of care. Developed, implemented, and monitored existing clinical programs to ensure positive impact on member health and wellbeing. Ensured adherence to state requirements and provider contracts. CHRISTINE SEXTON

9844 Southern Belle Ct. Dayton, OH 45458 937-***-**** *******************@*****.*** www.linkedin.com/in/chris-sexton-ms-rn

Championed establishment of benchmarks, goals, and outcomes for all programs, with focus on managing high costs, volume, and risk conditions identified through analytics. Ensured strategic alignment of population health model, utilizing analytic models and predictive indicators to deliver best practice through outcome-based strategy across continuum of care. Managed operating budget.

• Consolidated vendors and contracted with new vendor; implemented rewards and incentives program platform that generated

$1.2 million in savings. Ensured alignment and eliminated duplication of services.

• Assisted with securing state contract bids for Ohio MyCare, Medicare Advantage, Arkansas Marketplace, Indiana Medicaid, and Georgia Medicaid.

• Led Women’s and Children program development, ensuring its scalability.

• Collaborated in efforts to expand CareSource's footprint to new markets in Indiana, Georgia, West Virginia, and Arkansas, ultimately increasing membership by 1 million members.

• Updated and monitored Babies First rewards programs for all markets, incentivizing members to keep appointments to provide key milestone health checkup and vaccinations for children.

• Assisted in development and implementation of Care4U, CareSource’s new population health model of care, becoming standard for how CareSource managed member care, as well as benchmark for others.

• Implemented adult preventative program (Spirit of Health). Broke down key screenings by gender and age groups and provided reminders and incentives to members to ensure screening completion.

• Participated on committees that include ED Utilization, Case Management, Quality, COVID-19 work group, and Telehealth workgroup. Represent CareSource on board of March of Dimes.

• Partnered with kiosks supplier (Pursuant) in Walmart stores in Indiana that facilitated members completing HRA documents onsite and receiving Walmart gift card as reward.

DIRECTOR, HEALTH OUTCOMES AND MATERNAL CHILD SERVICES FOR OHIO MARKET (2013-2015) Supervised 6 direct and 19 indirect reports while leading Ohio market maternal child service line development and quality improvement efforts for Medicaid population through implementation of focused quality initiatives and clinical interventions. Ensured adherence to requirements through continual review, audit, and monitoring of quality improvement, performance improvement, and accreditation activities. Participated in data and root cause analyses and ensured effective presentation. Established and maintained standards and procedures for communicating areas of strengths and developing gap closure plans for improvement opportunities.

• Oversaw major strategic initiative targeting reduction in infant mortality, with project strategies recognized as best practice. Implemented 3 new strategies in metropolitan hot spots that included neighborhood-based strategy, opening of pregnancy medical homes, and implementation of technology platform that interacted with high risk pregnant members.

• Decreased ED utilization by 15%-18% and increased OB visit compliance by 12% in 8-month period. Provided analytical research targeting members in specific areas. Designed outreach strategies for each member population to educate on conditions, medication compliance, and urgent care vs. ED.

• Implemented quality initiatives that placed CareSource in 75th percentile in key HEDIS measures, resulting in enterprise receiving 110% of bonus in 2015.

• Launched technology platform targeting pregnant women by utilizing digital landscape to drive self-care and deliver personalized messaging to high risk pregnant women based on evidence-based practices.

• Partnered with Text4baby to launch pilot national campaign app used to send targeted messages to mothers during after delivery to relay healthy tips for delivering healthy babies.

• Worked with community resources such as local HUBS, city school systems, and United Way to partner on key initiatives such as well child visits/vaccines, pre- and post-partum visits, safe sleep/spacing education, and substance use education. CHRISTINE SEXTON

9844 Southern Belle Ct. Dayton, OH 45458 937-***-**** *******************@*****.*** www.linkedin.com/in/chris-sexton-ms-rn

DIRECTOR, PRODUCT DEVELOPMENT AND COMMUNITY MARKETING (2012-2013) Supported markets and assisted with growth and retention planning. Oversaw processes to optimize market-focused product design. Supervised 58 community education representatives providing support and education regarding CareSource and services provided. Administered department operating budget. Led team in tracking and reporting of member volume for all markets and products to entire enterprise. Managed cost benefit analysis process to inform and build ROI and business case documentation.

• Assisted with marketing design for Marketplace product that successfully went live in state of Ohio and remains successful product line offered in all states in which CareSource operates. Ensured strategic development and design for launch of new product lines, incorporating data and feedback from key consumer groups. Managed cost benefit analysis process. MIAMI VALLEY HOSPITAL/MIAMI VALLEY HOSPITAL SOUTH – Dayton, OH 2007 to 2012 Miami Valley is a large tertiary medical center with Level III Regional Perinatal Center (5,000 births annually). Miami Valley Hospital South (MVHS) campus has a Level II nursery, supporting 1,200 births annually. Part of Premier Health hospital system. DIRECTOR, SERVICE LINE AND CLINICAL OPERATIONS, WOMEN AND CHILDREN’S SERVICES Provided strategic service line leadership and oversight for multi-site system, with accountability for implementing strategies to ensure development of care model creating coordinated Women’s Service line across multiple sites. Developed and implemented business plans and quality initiatives/strategies that included market audits, root cause analysis, and data analysis operational monitoring to ensure execution for service line. Oversaw process change control related to clinical workflow, compliance, and accomplishment of business objectives. Secured grant funds and philanthropic support.

• Secured physician partnership for MVHS OB/GYN campus and implemented on-call contracting for 24/7 coverage with participating physicians.

• Led/implemented successful transition of Center for Women’s Health Clinic to FQHC model at Miami Valley Hospital.

• Developed, launched, and secured benefactor for Brethen Center for Surgical Advancement; secured additional grant funds for equipment at Miami Valley Hospital.

• Maintained quality metrics and led risk assessment for all established and new processes and programs for service line, including accreditation and recognition/certification by Health Grades, Ohio Department of Health, The Joint Commission, HCAHPS, CMS, and Magnet. Collaborated with organizational leaders to support strategic development and knowledge transfer from care model operations, resulting in Magnet designation. KETTERING MEDICAL CENTER/KMC-SYCAMORE HOSPITAL – Kettering, OH 1996 to 2007 BARIATRIC PROGRAM MANAGER-WEIGHT LOSS SURGERY (2003-2007) CLINICAL NURSE MANAGER/IN-HOME CARE (199-2003) CLINICAL NURSE TEAM LEAD AND CASE MANAGER (1996-1999) EDUCATION TRAINING

Master of Science, Management Indiana Wesleyan University – Marian, IN Bachelor of Science, Nursing Capital University – Columbus, OH Associate Degree, Nursing Kettering College of Medical Arts – Kettering, OH Telehealth Summit-Webex Global Leadership Summit – Dayton, OH Internal HEDIS/Stars Training Case Management Society of America (CMSA) National Conference PROFESSIONAL ORGANIZATIONS

Ohio Organization of Nurse Executives 2005-Present Dayton Area Nurse Executives 2006-Present

Association of Women’s Health, Obstetric and Neonatal Nurses 2008-Present Ohio Collaboration to Prevent Infant Mortality 2011-Present Dayton Collaboration to Prevent Infant Mortality 2012-Present BOARD MEMBERSHIPS

March of Dimes 2019-Present Bridget’s Path 2014-2016 Cradle Cincinnati 2014-2016 Ronald McDonald House 2010-2013

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