KPMG US

As a Principal at KPMG, my role revolves around using my management consulting skills to provide financial analysis and strategic business planning guidance. I work closely with healthcare executives, empowering them to navigate the complexities of budgeting within the evolving landscape of healthcare payments. By cultivating leadership development and leveraging my analytical skills, I help these professionals sustain and grow their organizations effectively.

Principal

Managing Director

Director

American Heart Association

As a member of the executive leadership team for the American Heart Association's Heart Walk, I leverage my skills in management consulting and leadership development to drive fundraising efforts, community engagement, and awareness campaigns. I am deeply involved in budgeting and financial planning for fundraising activities, utilizing my analytical skills to maximize efficiency and reach. My role is focused on raising awareness about the impact of heart disease and stroke in Maryland, forging strong connections with the community, and providing strategic guidance to optimize our mission's impact.

Heart Walk Executive Leadership Team Member

Healthcare Financial Management Association (HFMA)

In my previous role as President of the Maryland Chapter of the Healthcare Financial Management Association (HFMA), I led a professional network of financial executives in the healthcare sector. I applied my management consulting expertise and financial analysis skills to oversee educational development and foster leadership development within the organization. A significant part of my work involved guiding members in comprehending and navigating the intricacies of healthcare payments, budgeting, and analytical techniques, thus contributing to their individual growth and the overall advancement of the chapter.

President of Maryland Chapter of HFMA

I am a Principal at KPMG, where I use my management consulting skills to provide financial analysis and strategic business planning guidance to healthcare executives. With a Masters of Health Science from The Johns Hopkins University, I have a strong background in health finance and management, which enables me to navigate the complexities of budgeting within the evolving landscape of healthcare payments.

My role is focused on empowering healthcare professionals to sustain and grow their organizations effectively, by cultivating leadership development and leveraging my analytical skills. I have delivered keynote speeches at healthcare conferences, trained professionals at Johns Hopkins Bloomberg School of Public Health, and advised executives on payment policy design for maximum community impact. I am also a member of the executive leadership team for the American Heart Association's Heart Walk, where I drive fundraising efforts, community engagement, and awareness campaigns. I am passionate about collaborating for a sustainable future.

James Case

Evernorth Health Services

Strategic Planning | Sales | Account Management | Contracting & Negotiations | Client Account P&L | Relationship Building | Product & Bid Strategy | Affordability

—> General Management role (individual contributor) with P&L responsibility for an assigned health plan client book of business including leadership accountability for:
    - Client Relationship Management & Satisfaction
    - Strategic Planning
    - Contract/Pricing Negotiations
    - New Solutions Sales
    - Financial Performance
    - Growth Strategy consultation (GTM, Value Proposition, Benefit design)
    - Operations Execution

—> Current portfolio includes xxxk members across all major LOBs (Commercial, HiX, Medicare, Medicaid)

Sr. Account Executive - Health Plan Division @ Express Scripts ► Strategic Planning | P&L | Sales

> Growth Executive for Cigna/Evernorth’s fully owned primary/multi-specialty care medical group and retail pharmacy chain, employing 200+ clinicians across 15+ specialties and services, including: 
   - 20 family practice/internal medicine practices
   - 4 urgent care centers
   - 1 ambulatory surgery center
   - 17 retail pharmacies
   - 7 advanced imaging centers
   - 10+ additional specialties, including: Pediatrics, Optometry, Ophthalmology, Retail Optical, General Surgery/Gl Endoscopy, Podiatry, Audiology, Dermatology, Clinical Pharmacy, Behavioral Health, Population Health/Clinical Programs

> Evernorth Care Group is one of the oldest and highest performing value focused healthcare organizations in the country and is an innovation proving group for Evernorth Care, consistently delivering exceptional patient experience scores (87 NPS, 96% patient satisfaction, 98.2% MA retention).

> Dual reporting relationship to the President/GM and the Chief Transformation & Integration Officer

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> Business Development
          - Patient Acquisition + Sales Enablement
          - Client (Agent / Employer) Account Management
          - Community Engagement + Brand Awareness
          - GTM Strategy (Marketing collaboration)
> Health Plan / PBM Contracting
          - Negotiate FFS and VB relationships
          - Existing contract optimization
          - New payer partner prospecting
          - Health plan relationship management
> Strategic Program Development & Service Line Assessment
          - Home Based Primary Care Integration Pilot (via Evernorth Home Based Care)
          - Integrated Behavioral Health (CoCM via evolvedMD)
          - Mayo Clinic AZ (Mayo Employees & Community Patients) collaboration
          - Employer Onsite Wellness Visit Program
> Executive Sponsor, JHU Administrative Residency Program

VP / Growth Officer @ Evernorth Care Group ► Business Development | Contracting | Strategic Programs

*Role Expanded Feb 2022
> Senior Advisor to the Chief Growth & Performance Officer
> Expanded role, primarily focused on:
     - Rebranding and initial migration/integration (Cigna to Evernorth)
     - Multipayer Strategy (Pitch, Contracting, Implementation, and Partnership)
     - Value Based Care (Delivering on payer contractual performance programs)
> Continued leadership of Evernorth Care Group’s Growth Operation
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> CMG Leadership Development Program Participant
> Reported to Chief Operating Officer / SVP, Business Performance & Improvement / Chief Growth & Performance Officer

> Responsible for building de novo Growth/Strategy department/functions and driving business value through cross functional collaboration
> Growth Operations (patient acquisition)
> Growth Analytics
> Patient Experience & Retention
> Network Management / Operations 
> Real Estate footprint optimization (New / Relocation / Refresh: $60M+ project)

Director, Growth Operations & Strategy @ Evernorth Care Group

Cigna Healthcare

- One-year leadership development program, providing comprehensive exposure to Ambulatory Care Operations & Strategic Business, as well as Payor-Provider Partnerships. Completed in partnership with the Johns Hopkins Bloomberg School of Public Health and Cigna Healthcare of Arizona. 
- Reported to VP, Operations & Analytics
--------------------
> Growth Reporting
> Process Improvement
> Product Strategy

Senior Consultant, Operations & Analytics @ Cigna Medical Group

Johns Hopkins Bloomberg School of Public Health

Master of Health Administration (MHA) Candidate

Kindred Healthcare

SKILLED NURSING | LONG-TERM ACUTE CARE HOSPITALS | INPATIENT REHAB | HOME

- Reported directly to the Enterprise Chief Medical Officer

HIGHLIGHTS:
- Developed enterprise wide quality reporting, inclusive of key clinical, regulatory, quality, and customer service outcomes from all Kindred clinical divisions
- Worked across clinical divisions, departments, and various levels of the organization to partner with subject matter/technical experts in medicine, nursing, case management, IS/analytics, operations, and finance
- Generated dashboards and reports to maximize performance improvement on key clinical quality indicators and reduce variability across sites of care
- Authored an annual report for the medical affairs division from the office of the Chief Medical Officer, which included updates on the enterprise clinical strategy performance and progress towards upcoming milestones
- Undertook a comprehensive assessment of enterprise clinical education resources and their strengths, weaknesses and opportunities
- Collaborated with senior leadership on quality improvement project design, data collection, tracking and analysis, reporting, and special projects related to Medical Affairs

Medical Affairs Consultant - Enterprise Medical Office

Strategy & Business Development executive with 10+ years of healthcare experience: 
   > Relationship Building Expert
   > Culture Cultivator
   > Strategic Planning / Go-To-Market
   > Contract Negotiations
   > Customer Growth (Sales/Marketing/Community Engagement)
   > Regulated Markets / Government Programs
   > Value Based Performance & Risk Adjustment
   > Clinical Program Development
   > Client Management
   > Patient Experience
   > Analytics & Data Visualization / Storytelling 

- Accomplished strategic and analytical thinker with a passion for enabling data-driven customer growth, retention, and performance solutions in value based partnerships. 
- Uniquely experienced in payor/provider collaborative growth and market development strategies. 
- Proven track record of building/leading/mentoring high performing teams and effectively leveraging cross-functional collaboration to deliver on corporate strategy in large, highly matrixed organizations
- Strong financial acumen and understanding of healthcare financing models

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The Battle

James Case

Blake Manion, MHA

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