Vice President Population Health

ROCKY EDMONDSON

*******@*****.*** 208-***-**** Arrington, TN 37014 WWW: Bold Profile

PROFESSIONAL SUMMARY

Senior Healthcare Operations Leader and Influential, Top-Producing Business Executive, with strong qualifications in guiding corporations in identifying and capitalizing on market opportunities to drive revenue and profit growth. Highly analytical with verifiable accomplishments delivering record setting results. Excels at guiding companies through uncharted waters—leading rapid implementation, transforming performance, and driving profitability. Expertise in critical phase restructuring and realignment of operational efforts to achieve the desired outcome. Ability to build consensus across the whole system, motivate and maintain teams and develop partners to achieve system wide goals. Successfully manage relationships across all levels of leadership and among both internal and external partners. Willing to relocate.

SKILLS

Managing Cross Functional Teams

Leadership and People Development

Change and Growth Management

Corporate Strategy and Development

Approachable and Outgoing

Market Analysis—ROI, Executing Business Plans

P&L Optimization

Performance Monitoring and Evaluation

Process Improvement

Operational Oversight

Program implementation

Performance improvement

WORK HISTORY

Corporate Vice President of Payment Innovations (Population Health) / Community Health Systems (CHS) - Franklin, TN / 12.2017 - 06.2025

Responsible for the design, implementation, and ongoing performance of the Value-Based Care and Population Health strategy for CHS

Oversaw clinical and business operations, patient care delivery, quality, patient safety, and patient and provider satisfaction for 15 Accountable Care Organizations (ACO), and 2 Clinically Integrated Networks (CIN) caring for over 200,000 covered lives in 12 states with 84 hospitals and over 500 physician practices.

Responsible for guiding development, payor contracting, implementation and performance of an additional 4 CINs.

Achieved more than $100 Million in shared saving revenue disbursed over the past 7 years through various Value-Based programs by developing care pathways, processes, and practices that reduced total cost of care for patients while ensuring quality and safety standards were achieved.

Directed development of reporting analytics that ensures performance monitoring and accountability

Responsible for quality reporting, monitoring, and improvement activities for over 4500 employed and independent staff and providers.

Achieved MIPS exceptional quality bonus for all practices

Spearheaded budget analysis and forecasting to align operating costs with business strategy, saving more than $2 million per year.

Serve as a corporate liaison and subject matter expert (SME) between staff, case managers, nursing, hospital executives, post-acute providers, and physicians, providing support and guidance on care delivery, patient satisfaction, quality, and best practices.

Developed and refined the long-term vision and objectives, resulting in the addition of numerous CINs designed to improve contract terms, generate additional revenue, and increase network utilization.

Achieved a 10% decrease in GMLOS across 84 hospitals by working with Case Management to standardize discharge criteria and utilize a preferred network of PAC providers.

Conferred with board members, organization officials and staff members to discuss issues, coordinate activities, and resolve problems.

Implemented corrective action plans to solve organizational and departmental barriers.

Analyzed legislation, laws, and public policy and recommended changes in Value Based Care, MA, and commercial programs to promote and support interests of all stakeholders.

Represented organization and promoted objectives at networking events.

Supported upper management operations to proactively address and resolve challenges, resulting in an increase in Network Utilization by 10%

Interpreted and enforced policies and regulations to maintain alignment with corporate objectives.

Presided over and served on boards of directors, management committees, and other governing boards.

Analyzed operations to evaluate performance and to determine areas of potential improvement.

Corporate SME on business intelligence, market growth, innovative programs, value-based contracting, vendor contracting, program implementation, and metric development to evaluate performance

Developed high-performing teams by recruiting top talent and fostering a culture of continuous improvement.

Managed cross-functional teams to drive organizational growth and achieve key objectives.

Senior Director, Healthcare Consulting / XG Health Solutions, Management Advisors - Columbia, MD / 01.2016 - 01.2017

Developed strategic Population Health direction for national and regional health systems by revamping business operations through innovation, process improvement, operational excellence, product development, marketing, and client relations

Deliver target driven performance in areas of building high performance nursing, physician and hospital teams and introducing strategic and tactical thinking throughout various channels

National speaker and sought after SME on Value-based care, population health, care delivery systems, change management, and performance improvement activities, resulting in consulting arrangements with multiple national and regional health systems

SME and driver of the development and implementation of commercial bundle programs, and direct to employer programs.

Provided

leadership in advancing the capacity and capabilities of the services and products offered

Delivered 6.5% or $1073 savings per episode for xG clients

Reduced readmission rates from 24.0% (2009-2012) to 18.0% in (2016Q3), 24.9% reduction

Decreased Post-Acute utilization by 15.7% across all covered lives

Optimized project timelines by effectively delegating tasks and prioritizing workload among team members.

Cultivated a culture of innovation by promoting creative thinking and encouraging employees to take calculated risks in pursuit of solutions.

Director of Clinical Operations / Remedy Partners - Darien, CT / 01.2015 - 01.2016

Served as the key member of the Operational Leadership Team for CMS Bundle Payment for Care Improvements (BPCI) largest CMS Bundle Payment Convener

Full operational and P&L responsibility for $225 million in BPCI program

Identified and developed new market segments, created business strategies and communicated corporate vision for the entire business

Spearheaded the development, commercialization and product positioning within the emerging markets

Developed and managed budget—resource planning and allocation of funds

Served as Nursing/Clinical Subject Matter Expert and liaison between Remedy staff, case managers, nursing, hospital executives, post-acute providers, and physicians

Directed program implementations across multiple sites. Educating, monitoring, and holding accountable staff, nursing, providers, and hospital executives

Responsible for staffing, development, and performance evaluation.

Enacted strategic business plans to foster growth in revenue, sales and market share.

Ensured regulatory compliance by staying informed of industry standards and maintaining thorough documentation practices.

Championed patient advocacy initiatives, upholding ethical principles in all aspects of clinical practice management.

Clinical Supervisor - Nursing / Eastern Idaho Regional Medical Center - Idaho Falls, ID / 01.2003 - 01.2015

Full management responsibilities over 70-80 nursing FTE's with staffing, training development, and performance evaluation responsibilities

Served as Nursing Subject Matter Expert for all nursing related requirements, gatherings, and dissemination of information to functional areas

Implemented policies, procedures, and controls which resulted in 95% scanning compliance for the entire staff

Collaborated with multidisciplinary teams to coordinate care for clients with complex needs, ensuring comprehensive support was provided across all domains of life functioning.

Assessed patients, determined needs, and managed care.

Responded to crisis situations with calm and professional approach to optimize support.

Monitored, analyzed, and corrected staff performance and worked with nurse manager to raise standards of practice.

Charge Nurse – ICU / Maui Memorial Hospital - Wailuku, HI / 01.2001 - 01.2003

Staff Nurse - ICU / Providence - Portland, OR / 01.1998 - 01.2001

EDUCATION

Boise State University - Boise, ID

Master of Business Administration: MBA

Boise State University - Boise, ID

Bachelor of Science in Nursing: BSN

University of Hawaii - Wailuku, HI

Associate of Science in Nursing: ADN

CERTIFICATIONS

Registered Nurse

MILITARY EXPERIENCE

Recon Team Leader, United States Marine Corps

#HRJ#32966eb6-1986-4932-ade2-e76abbeea5f9#

Contact this candidate