Core Capabilities
Payer Operations & Performance
- End‑to‑end operational redesign
- Claims operations optimization
- Prior authorization modernization
- Contact center and member experience improvement
- Quality and performance management
- Delegated risk readiness and oversight
Medicaid & Public Sector Strategy
- Medicaid program advisory
- RFP strategy, procurement support, and implementation
- Vendor management and accountability frameworks
- Cross‑agency coordination and stakeholder engagement
- Policy translation into operational models
Managed Care Transformation
- Operating model design and transformation roadmaps
- Network strategy and provider engagement
- Utilization management redesign
- Data‑driven performance dashboards
- Change management and workforce alignment
Innovation & Ecosystem Development
- Healthy aging and community‑based care models
- Digital health integration and partnership strategy
- Human‑centered design for member and provider experience
- Market analysis and future‑state scenario planning
Differentiators
- 15+ years leading payer and Medicaid operations across federal, state, and commercial environments
- Deep expertise in Medicaid, delegated risk, and operational turnaround
- Executive‑level operator who has led multi‑state implementations and large cross‑functional teams
- Proven ability to translate policy into practical, scalable operational models
- Arizona‑based with national experience and a strong understanding of regional dynamics
- Known for clarity, operational rigor, and human‑centered design
Representative Engagements
- Led delegated risk readiness for a regional Medicaid plan, improving compliance and operational performance
- Redesigned prior authorization workflows for a multi‑state payer, reducing turnaround times and improving provider satisfaction
- Supported a statewide Medicaid agency in procurement redesign and vendor oversight
- Built a caregiver innovation strategy for a major nonprofit organization
- Designed the largest healthcare innovation and diffusion of best practices program in the country
- Directed multi‑state health plan implementations serving over 1M members