Peer Collective

Peer Collective's mission is to radically increase access to high quality mental health support through online peer counseling. I support Peer Collective on go-to-market strategy and partnerships.

GTM Advisor

Vida Health

I worked with health plans, systems, and PBMs as a strategic partner for disease management, integrating physical and mental health. 

My approach is to maintain authentic and collaborative relationships with deep industry knowledge to appropriately position person-centered, high-value digital health solutions with various pricing models, including value-based.

Vice President, Market Access

Pear Therapeutics

Pear's cross-functional team operated at the intersection of biology and software technology in the discovery, development, and delivery of clinically validated software to provide better outcomes for patients, smarter engagement and tracking tools for clinicians, and cost-effective solutions for payers. 

My responsibilities included development of payer partnership strategy and execution in a variety of contexts, including relationships with commercial, government, and self-funded payers. Go to market SME on Medicare Advantage, and collaborative creation of a strong ecosystem between payers and established as well as forward-facing healthcare providers.

Corporate Account Director, Market Access

Livongo

Build strategic relationships across a matrix of roles and areas of expertise to manage and grow Livongo’s relationship with health plan payers. Drive revenue growth, product expansion and market development by prospecting and identifying new opportunities. Work closely with internal partners – including Product, Clinical, Data Science, Implementation, Reporting, Legal and Finance personnel – to deliver on Livongo’s side of the strategic roadmap.

IPO July 2019.
Livongo was acquired by Teladoc Health, the global leader in virtual care, in November of 2020.

Senior Account Executive, Health Services

Livongo for Behavioral Health by myStrength is a digital platform that addresses mental health needs across the full spectrum of acuity in populations. Users have access to evidence-based  tools and guided programs targeting a host of conditions including depression, anxiety, substance use disorder, stress, chronic pain, and insomnia. myStrength overcomes issues of cost, lack of access, and stigma, to deliver mental health and well-being resources at scale. 

I was leader of the team responsible for implementation and retention of provider relationships, including health systems and behavioral health centers. I ensured successful integration of tools into workflows and delivery on strong clinical, financial and operational outcomes.  

myStrength was acquired by Livongo in January of 2019

Senior Director, Account Services - Behavioral Health

TMO Consulting

Consultancy specializing in strategy and implementation of new projects and programs for social services, healthcare and payer organizations. Experienced with managed care contracts including Medicare Advantage, Accountable Care Organizations, Medicaid, and Medicare Shared Savings Program (MSSP). 

In addition to assisting providers and payers with the transition to value based care and implementing population health strategies, I work with organizations that are developing products and services for healthcare. I can advise on all go to market requirements: positioning, evaluation metrics and financing models.

My portfolio has also included Electronic Medical Record deployments, Community Health Assessments and communications strategies for a variety of clients in Austin and New Orleans, including non profit organizations, integrated delivery networks and Federally Qualified Health Centers.

Principal

Sense Corp

Sense Corp is a management consulting firm that serves a number of industries including Healthcare, Finance, Telecommunication, Energy and the Public Sector.  I was the leader of the Healthcare practice, responsible for practice strategy, quality assurance and all go to market activity.
  
I worked on solutions for Documentation & Coding, Data Warehousing, Business Intelligence (BI)/Analytics, Data Governance, Risk Stratification, Patient & Provider Engagement, Population Health, and Cost & Utilization.

The work was focused on helping clients improve outcomes and reduce costs in a variety of models transitioning from fee for service to value based contracts and ACOs.

Experience included Population Health management analytics for diversified, multinational enterprise clients that provide healthcare services to government healthcare programs, providers of Medicare Advantage, fee for service care and integrated delivery networks (IDNs). Other engagements  focused on supply chain improvement and payer operations. 

Efforts included assessment, recommendations, and execution.

Selected Work

*Launch of Sense-Ability, helping hospitals achieve operational excellence -improve patient experience, reduce costs in the millions of dollars and impact population health- by leveraging their greatest resource: the staff themselves. The evidence-based approach helped hospital leadership identify, prioritize and track their unique opportunities to achieve the Triple Aim in a positive and accountable fashion with active engagement of staff to continuously improve operations. 

*Supply chain bench-marking for Integrated Delivery Networks

*High value, targeted improvement of provider performance on Value Based Contracts

Managing Director, Healthcare

Lumeris

Lumeris clients are seeking the services and technology required to be successful in population health and value-based health services. Lumeris implements and manages Medicare Advantage (MA), Medicare Shared Savings Programs (MSSPs) and a variety of Accountable Care Organizations (ACOs) and related initiatives to achieve the Triple Aim of improved quality, cost and outcomes along with provider satisfaction.  I was proud to work with so many smart, committed and thoughtful customers. 

As a Client Account Executive, I lead a cross-functional team of clinicians, technologists and consultants to develop strategies and execute at a sustainable but ambitious cadence. All of our work was unified around a key principle: that all those involved in patient care, including hospitals, provider organizations and payers reach their goal of changing for the better how health care is delivered (and paid for) in this country and to do so collaboratively, inclusively and with an outcomes based approach.

In 2014, I took on operational, relationship and P & L responsibility for all clients in the Western U.S. and oversight of Account Managers in each market to ensure mutual success and growth.

Director, Operations and Account Management

Louisiana Public Health Institute

Louisiana Public Health Institute was awarded $13.5 million over three years by the HHS Office of the National Coordinator for Health Information Technology to enhance primary care coordination through innovative health information exchange between private hospitals and community health clinics. 

As Senior Management Consultant to the organization, I was an interim operations leader and responsible for expediting multiple clinical, administrative and communications programs to impact community health, facilitate transitions of care and reduce the burden of chronic disease.

Interim Advisor

Convio

The intersection of two long-standing interests, non-profits and technology.  It’s a great idea: leveraging CRM for the non-profit space and helping social causes of all sorts connect with their constituents, all delivered via SaaS.  I managed many of the company’s largest customers, all well-known and respected and I was personally responsible for a significant share of the company’s revenue (~10%).  I’m proud to have been the lead of the account team that supported impactful campaigns and responded positively to disasters when they occurred.  

Convio also had one of the best leadership teams I have ever had the chance to work with and whose presence I still miss at times.  While I certainly didn’t agree with every decision, Senior leadership modeled the courage necessary to execute and was committed to client success.  

In addition to learning more than I ever thought I would about software development, especially SaaS, I became very well educated on fundraising, engagement and advocacy for non-profit organizations.  I also honed my prioritization and time management skills to Samurai-like qualities.

IPO: 2010

Lead Account Manager, Enterprise Client Services

INTEGRATED CARE COLLABORATION

The Integrated Care Collaboration is a consortium of healthcare organizations in Central Texas.  Its mission is to improve quality and access to care for some of Central Texas’ most underserved residents.  

Based on my experience at LPHI, I was able to add value to another Health Information Exchange by building capacity in its clinical research and data mining initiatives, developing a community wide ROI methodology for the organizations’ leadership and funders and managing all finances for the organization.  The role gave me the opportunity to work with the leadership of healthcare in Central Texas and delivered many lessons, some humbling, that shaped a more nuanced and pragmatic approach to effectively leading change in organizations.

I am most proud of the work that I did to launch a community owned health insurance program.  I was the program manager for this effort, which culminated in a successful round of fundraising and subsequent launch.

Director of Finance and Reporting

Digital Health Commercialization and Access

Results-oriented and focused on entrepreneurial, sustainable, evidence-based solutions that reduce suffering. 

Startup and growth executive, experience includes contributing to 5 successful exits. 

I am both a strategist and operator that builds strong relationships with all stakeholders. I have directed teams towards measurable clinical outcomes that maintained 95%+ client retention year over year. As an individual contributor, I have launched new products and services, developed new business, and grown revenue.

Background in Management Consulting, acting as a trusted advisor to and delivering services to support payers and providers in technology, value-based contracts, and population health initiatives. I have led engagements with Medicare Advantage, Medicaid, self-funded ASOs, ACOs and fully insured populations.

undefined undefined

Laurence Girard

"When Congress conceived of the Medicare Advantage program decades ago, the hope was that insurers would make Medicare more efficient. In traditional Medicare, doctors and hospitals get paid for each service they provide, an incentive to provide more. The idea behind Medicare Advantage was to pay private insurers a lump sum to cover all services, giving them an incentive to keep patients healthier. 

To protect insurers from the risk of winding up with sicker-than-average patients, the government allowed bigger payments for certain serious health conditions. 

Partly because of that, Medicare Advantage has cost the government an extra $591 billion over the past 18 years, compared with what Medicare would have cost without the help of the private plans, according to a March report by the Medicare Payment Advisory Commission, or MedPAC, a nonpartisan agency that advises Congress. Adjusted for inflation, that amounts to $4,300 per U.S. tax filer."

Taplio

Ed Melendez's Linkedin Analytics

Ed Melendez

Ed Melendez's Best Posts (last 30 days)

Want to drive more opportunities from LinkedIn?

Taplio

.css-1jgreyo{background-image:linear-gradient(284deg, rgba(39,43,72,1) 0%, rgba(33,47,183,1) 100%);color:transparent;-webkit-background-clip:text;background-clip:text;}Ed Melendez's Linkedin Analytics

Ed Melendez

Ed Melendez's Best Posts .css-qqfgvy{font-size:var(--chakra-fontSizes-md);}(last 30 days)

Want to drive more opportunities from LinkedIn?

Ed Melendez's Linkedin Analytics

Ed Melendez's Best Posts (last 30 days)