Proven strategic and operational leader with success building and delivering great products and services by listening to the market.
Grounded innovator who combines strategic thought leadership with operational execution.
In-depth knowledge of the Healthcare Insurance and Integrated Payments ecosystems.
High-energy business professional who launched a successful healthcare payments platform business in the infancy of HIPAA compliance and helped lead its growth through ACA and beyond.
Focused on creating long-term and profitable recurring revenue relationships through exceptional delivery and service.
Passionate professional with a talent for taking innovative ideas from concept to launch.
Comprehensive experience in business management, finance, and sales.
Areas of Expertise
Health Insurance
Electronic Payments (ACH, Card)
SaaS
Platform & Network Software
Alternative Payment Models
Risk Contracting
Strategic Planning
Financial Planning
Product Management
Operational Execution & Delivery
Ideation & Prototyping
Business Architecture & Integration
Professional Experience
04/2015 - Current
Payspan, Inc. － Atlanta, GASenior Vice President & Chief Product Officer
Responsible for product strategy and management, strategic integration and innovation
Refocused product portfolio with CEO and Chief Growth Officer
Provided strategic design guidance to business requirements development for the company's Patient Financial Engagement solution, including auto-collection, future settlement, and payment plan features
Assisted requirements elicitation for the company's multi-application configuration and servicing portal, known as Paypoint
Business Architect of Payspan Direct agreement that combines card processing and consumer-ACH
Strategic planning oversight for the Premium Collection solution's present & pay capability
Leading strategic integration discussions with alternative payment solution providers and non-traditional healthcare payers
Leading the analysis of future technology-enabled finance initiatives for medical practice lending, advance claim funding, and patient lending
Business Architect of an "off-rail" solution for a Medicaid MCO solution to financially engage Medicaid recipients
Collaborative roadmap planning with Chief Operating Officer
08/2011 - 04/2015
Payspan, Inc. － Atlanta, GASenior Vice President & Chief Knowledge Officer
Responsible for strategic market intelligence, knowledge management, intellectual property, prototype development, and ideation
Led design of the company's private rail (fee-based ACH) capability
Business Architect of Payspan Direct; "PayPal-esque" capability
Oversaw termination of the company's ISO relationship with Bancorp Bank for merchant services, which was inherited via acquisition; negotiated the company's ISO Sponsorship with Vantiv
Business Architect of a differentiated merchant funding model for pre-payment of medical services, incorporating an escrow account for custody of funds
Established and implemented the company's first technology-enabled finance (TEF) partnership for medical practice lending
Business Architect of a unique prefunding debit model for virtual cards; including just-in-time virtual card issuance
Led business development efforts to partner with commercial banks as resellers of the company's Patient Financial Engagement solution
Led the incubation of the company's Provider Economics business unit from October 2012 until December 2014
Charged to establish a Program Management function in January 2015, which became Product Management in April 2015
Responsible for Development, Quality Assurance, IT, Delivery, Service, Product Management, and Marketing
Published Accountability Maps for Senior Management transparency
Obtained EHNAC HNAP-EHN certification
Authored the company's Healthcare Payment Exchange strategy
Completed initial work on PCI-DSS certification
Moved SDLC to Agile Methodology, JIRA for Ticketing, Enterprise Architect for UML Modeling
Implemented automated testing in Quality Assurance
Led special EFT/835 Professional Services engagement at BCBS FL
Sold and Delivered 2 of the company's Top 5 clients during this time (16% of current revenue); cumulatively since 2005, 7 of the company's Top 8 (64% of current revenue)
Responsible for Sales, Marketing, Service, Operations, Delivery, and Product Management
Established PMO and Account Management functions
Published employee digital magazine NETMA
Implemented organizational operating controls, resulting in SAS 70 Type II certification; including detailed business continuity & disaster recovery
Certified compliance with the HIPAA transactional standard for healthcare payment and remittance
EFT/ERA platform chosen by BCBS as preferred solution
Sold and Delivered 5 of the company's Top 10 current clients during this time (48% of current revenue); including 3 of its Top 5 (39% of current revenue)
Recruited to launch the healthcare division at Payformance
Business architect of the company's healthcare product strategy
Developed and documented requirements for the EFT/ERA platform
Established standard operating controls, including HIPAA PHI policies and financial account verifications
Developed standardized service Task Order
Designed standardized Business Requirements Document (BRD)
Recruited healthcare talent to staff the division
Subject matter expert in support of sales efforts, landing first clients (including BCBS MA and Amerigroup)
09/1999 - 04/2004
Health Alliance Medical Plans － Urbana, ILDirector, Finance & Accounting
Responsible for the Accounting, Statutory Accounting, Financial Analysis, and Decision Support functions of the health plan
Accountable for budgeting and reporting of Revenues, Medical Expenses, and Administrative Cost
Automated the production of GAAP, Statutory Basis, Cash Basis, LA&H, HMO Blue, HMO Orange, and Consolidated Basis financials
Reduced the monthly closing process from 27 days to 5 (81% reduction) using automation and process improvement
Responsible for risk-based contract accounting, including global reimbursement models and joint ventures
Business Architect for development and launch of pioneering solutions for EFT/ERA (2001), Electronic Premium Collection (2002), Medical Economics/Population Health (2003), CDH (2004)
Developed and managed annual revenue budgets exceeding $1.2 Billion and medical expense budgets exceeding $1.0 Billion
Boosted company efficiency and profitability through technology upgrades and process improvements including: a new General Ledger System, Data Warehouse, Enterprise Ad-Hoc reporting solution, IP Telephony, and Contract Management
Primary contact for IRS, GAO, State DOI audits
01/1995 - 09/1999
Health Alliance Medical Plans － Urbana, ILManager, Financial Analysis
Modeled and negotiated provider risk contracts and global reimbursement models
Led the modeling, planning and execution of all financial processes
Automated 100% of the claims reserving process
Moved all administrative expense budgeting to a web-based system
Created detailed financial models to account for the company's joint ventures with other provider-sponsored health plans
Automated monthly medical expense and administrative variance reporting
Analyzed complex GAAP, NAIC, State, and Federal regulations with respect to revenue recognition, risk-based capital requirements, and liability accruals
Developed creative strategies to reach company and shareholder goals relating to parent and subsidiary accounting, as well as profit-sharing
Responsible for creation and presentation executive analysis reports highlighting financial performance and business risks
07/1992 - 01/1995
Health Alliance Medical Plans － Urbana, ILFinancial Analyst
Joined the company (<40 employees,="" ~$20="" million="" in="" revenue)="" as="" it="" accelerated="" growth="" from="" a="" small="" primarily="" aso="" shop="" into="" fully-insured="" plans="" and="" state="" and="" federal="">
Implemented its first budgeting and forecasting systems for Medical Loss Ratio, Claim Reserve Calculation (RBNP & IBNR), Utilization Management, and Reinsurance/Stop-Loss filing
Responsible for Risk-Pool Accounting, Specialty Carve-Outs, Capitation, and Out-of-Network utilization monitoring
Responsible for NAIC Statutory Accounting & State DOI Reporting
Education
1991
University of Illinois at Urbana-ChampaignUrbana, ILBachelor of Science: Finance Recipient of Illinois General Assembly Scholarship
