Clinical Affordability Director @ •Work with Health Analytic Consultant and Chief Medical Officer to propose realistic annual medical cost trend goal for key initiatives to deliver against trend goal •Propose and prioritize Customer solutions to reduce trend (programs, processes, benefit design, network) and outline realistic Customer expectations for the Optum Sales Executive to present to the Customer •Work with the Strategic Client Executive to ensure Customer recommendations are aligned with service delivery capabilities •Develop Medical Cost Action plan in concert with the Virtual Health Plan Consortium (VHP C2) Healthcare Analytics Consultant and Medical Director and lead the meetings. •Ensure scalability and sustainability of Customer specific recommendations. Identify process gaps and work with appropriate product and operational owners to address gaps specific to Virtual Health Plan Consortium recommendations. Works with Product owners and Finance to ensure profitability •Lead the team in the creation and execution of at least one affordability initiative and charter. Drive accountable owners performance against charters. Keep up to date on and leverage affordability initiatives managed by other Virtual Healthplan leads •Assist in preparation of customer specific presentation and analyses for recommendations •Provide oversight and analysis of a group of clients with Chief Medical Officer and Healthcare Analytics Consultant •Coordination with Account Management Team regarding Medical Cost Action Plan initiative action items/deliverables •Analysis of outcomes in Medical Cost Action Plan initiatives in conjunction with CMO and Healthcare Analytics Consultant From December 2015 to Present (1 month) Sr IT Data Analytics Consultant @ General Responsibilities • Leads analysis, synthesis and reporting of the client’s existing clinical and value measures. • Manages the prototyping, implementation and evaluation of the Customer’s ad hoc reporting and non-standard reporting requirements. • Leads requests from the extended account team to analyze operational performance, value delivery and financial objectives • Identify and incorporate current industry-specific and book of business metrics into analytics to highlight relevant trends and support fact-based recommendations and decisions. • Communicate key messages, risks, and opportunities in financial, clinical and operational information to the extended account team. • Coordinates Information Technology, and other functions, to improve the quality of analytics and reporting processes. From October 2014 to Present (1 year 3 months) Sr Director Performance Management - JPMC Account at Optum @ I hold the end to end accountability to drive Optum's operational performance against client deliverables as a single entry point for UHC Strategic Client Executive and Optum Strategic Account Executive into Optum's service delivery.I make Customer commitments and manage Customer expectations jointly with Acct Executives. ensuring customer commitments are aligned with service delivery capabilities. I have oversight and ensure delivery of an end to end business model against Customer commitments inclusive of all services and all delivery modalities (telephonic, in person, mail, portal, email). Internally I drive Customer performance against operational, value and Performance Guarantee metrics and internally communicate Customer status I ensure compliance with standard operational processes against Customer commitments, scalability and sustainability of Customer specific operational processes delivering against those Customer commitments. I also Identify process gaps and work with the appropriate product and operational owners to address and solution for those gaps. I work with product owners and finance to ensure profitability, develop and lead execution of continuous improvement programs ensuring quality delivery to mitigate defects while driving resolution of delivery defects through accountable owners. My role proactively identifies and mitigates potential defects and customer specific quality defects ensuring they are resolved in timely manner. From September 2013 to October 2014 (1 year 2 months) Customer Analytics @ Leads the analysis, synthesis and reporting of the Customer’s existing clinical and value measures. Manages the prototyping, implementation and evaluation of the Customer’s ad hoc reporting and non-standard reporting requirements. Leads requests from the extended account team to analyze operational performance, value delivery and financial objectives. Proactively recommends improvements in clinical, financial and operational performance analytics. Identify and incorporate current industry-specific and book of business metrics into analytics to highlight relevant trends and support fact-based recommendations and decisions. Communicate key messages, risks, and opportunities in financial, clinical and operational information to the extended account team. Coordinates Information Technology, and other functions, to improve the quality of analytics and reporting processes. From November 2012 to September 2013 (11 months) Director of Operations, UHC Medicare & Retirement @ Established, implemented, and executed operational infrastructure that supports all Medicare clinical programs. Operational infrastructure includes workflow management, data management, and financial management. Established communication and engagement strategy with key stakeholders. Leveraged expertise and prioritize Medicare needs with partners; Serving as the subject matter expert for delivery of clinical analysis and reports Developed plans and led teams of professionals to execute plan tactics Assessed program/initiative needs and created relevant plans; simplified complex processes facilitated opportunities for synergy and integration; set objectives and goals Fostered collaboration with Medicare Program Directors to develop and present insightful and actionable analyses that resulted in operational efficiencies for their programs as well as financial savings Led issue resolution efforts across multiple channels including National accounts, key accounts and Medicare/Medicaid lines of business. From December 2010 to November 2012 (2 years) Senior Clinical Data Analytics Consultant @ Responsible for Direct and Cross Carrier Report Solutions, Proactively managing high level, complex customer reporting issues Serving as the subject matter expert for delivery of clinical analysis and reports Analyzing and reporting on medical cost drivers, existing service performance and clinical program outcomes Collaborating with Clinical Performance Managers to develop and present insightful and actionable analyses Leveraging standard and ad hoc reporting and analyses to review historical information and identify region and customer opportunities to influence health benefit costs and cost drivers Delivering or participating in presentations on new products/services, ongoing process improvement efforts and/or operational Participating in and/or leading the design/continuous improvement of clinical reports Contributing to the development of clinical recommendations and solutions that will reduce medical cost trends, admissions Helping to develop meaningful metrics and targets, and measuring actual market results Fostering and maintaining collaborative relationships with customers, ensuring goals, customer satisfaction, increased productivity business processes are achieved Training stakeholders on how to effectively access and use reports Leading issue resolution efforts as required From October 2009 to December 2010 (1 year 3 months) Senior Director Customer Solutions @ Responsible for leading the strategy for performance management in the Public Sector space Monitored on a client by client basis, trend and performance against book of business targets for key indicators and developed corrective action plans when required. Collaborated with account management, site operations leadership and program partners to execute on action plans and monitored monthly. Performed annual clinical analytical review on top accounts and others as requested and a) communicated variances to, or achievement of, committed metrics consistent with OptumHealth product definitions and/or performance guarantees and b) identified clinical product opportunities and made recommendations with defined value to support client population needs. Developed solutions based on clients business requirements and/or internal operational process gaps. Responsible for working independently on complex clients, including those that require sophisticated integrations or new processes. Acted as a clinical subject matter expert to products and operational staff for innovative customer program design and development. Provided oversight of customer implementations. Worked independently on those implementations that involved multifaceted clinical products and deliverables. Communicated client specific factors that may affect performance to account management, site operations and program partners From October 2007 to October 2009 (2 years 1 month) Clinical Manager Disease Solutions & Case Management @ Managed and was accountable for professional employees delivering clinical support across a wide array of health topics and conditions Set team direction, resolved problems and provided guidance to members of our team Adapted departmental plans and priorities to address business and operational challenges Delivered product, service or process decisions, that could impact multiple groups of employees and/or customers (internal or external) Monitored, managed and controlled operational performance metrics in conjunction with established program value targets Ensured that weekly audits were conducted of case documentation (including tracking logs) to ensure that standards were met, and successful outcomes were achieved Reviewed operational and performance metrics regularly and drove action plan development and execution to correct metrics that deviated from target Conducted regular team meetings for communication and feedback, staff training and development, sharing of program results, and collaborative problem solving Ensured training and access to all OptumHealth clinical review tools including case tracking/documentation tools, consumer health history, network information tools, process maps, discharge planning and risk management referral criteria, and benefit coverage information From January 2005 to October 2007 (2 years 10 months)

Mj Farmer, RN is skilled in: Managed Care, Disease Management, Provider Relations, Utilization Management, Medicare, Clinical Research, Healthcare Management, Medicaid, Healthcare, Healthcare Information Technology, HIPAA, Program Management, Performance Improvement, Strategy, Team Building