Kimberly Young

Experience

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  Ameripath Incorporated (UniPath Inc.)

  Jan 1997 - Jan 2001

  National Director of Reimbursement, 1997- 2001; Billing and Collections Manager, 1997-1999
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  Lifewatch Incorporated

  Jan 2001 - Jan 2001

  National Director of Reimbursement
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  Venturi Technology Partners

  Jan 2002 - Jan 2004

  Business Systems Analyst/Consultant (Veteran’s Health Administration)
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  CVS/Caremark

  Jan 2004 - Jan 2009

  Director of Revenue Management/AR (Specialty Drug Division)

  Strategic and operational oversight for specialty drug contracts. Led a team of up to 111 across accounts receivable, customer services, claims processing and contracting. Interfaced with all insurance companies, including Medicaid and Medicare B, C & D, as well as corporations for self-managed benefit programs. Led numerous Lean Six Sigma projects. Deployed new process controls for quality review of all contracts and fee schedules.

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  Vista Research

  Oct 2005 - Feb 2010

  Consultant

  Served as a pharmacy and PRM industry consultant providing industry updates and analysis to Wall Street investment brokers.

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  Convergence Technologies

  Jan 2009 - Jan 2010

  Consultant/Project Manager

  Managed business initiative to write American Recovery and Reinvestment Act grants for company’s clients. Interfaced extensively with client senior business and executive teams to gather extensive data in order to develop grants. Managed a team of up to two resources.

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  Tenet Healthcare

  Jan 2010 - Jan 2013

  Executive Director of Clinical Integration and ACO - Chicago Health System

  Senior leader charged with developing, implementing and administering clinical integration program from concept to completion partnering with C-suite. Recruited, trained, coached and managed a team of clinical integration and provider relations specialists. Created contracts partnering with attorneys; recruited new physicians. Effectively operated across the organization interfacing with senior leadership, attorneys and physician committees, as well as insurance plans, including Medicare, Medicaid, BCBS, Medicare A & B, etc. Secured Medicare Shared Services Program (MSSP) approval as Accountable Care Organization in 2012. Show less

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  Arrow Strategies

  Jan 2014 - Jan 2014

  Project Manager/Consultant for Health Care Services Corporation (HCSC)

  Member of project team to analyze business, technical and operational processes to launch an Accountable Care Organization for Blue Cross Blue Shield. Led data storage workstream and partnered with IT resources and programmers.Engaged network management, marketing, communications and clinical teams. Aligned and managed stakeholders, analyzed business requirements and developed risk assessment and business justification.

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  PBC Advisors, LLC

  Jan 2015 - Jan 2016

  Senior Healthcare Consultant

  Led business, operational and administration consulting engagements with physician offices, groups and IPAs/PHOs. Interfaced with senior leaders to analyze opportunities and develop/implement solutions across revenue cycle management, staffing/recruiting, policies & procedures, coding/billing, patient services, reporting and workflow.Created and implemented clinical integration policies for a new Accountable Care Organization (ACO). Provided onsite and remote digital Delegated Credentialing Audit for large healthcare plan. Secured additional managed care contracts for individual and group providers. Show less

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  Advanced Resources

  Jan 2015 - Jan 2015

  Consultant for Community Care Partners/ACE

  Led development and implementation of Northshore Hospital’s ACE (Medicaid) program to meet Triple Aim compliance. Coached and managed resources to analyze contracts, conduct patient outreach and enroll new physician offices. Resolved pricing issues.Built program infrastructure, processes and contract management procedures. Designed digital medical records management system to record, process data and generate reports.

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  Blue Cross Blue Shield Association

  Jan 2017 - Jan 2017

  Senior Clinical Consultant

  Led new product/program due diligence and clinical/business case development to assess launch of Infertility Care to Blue Distinction Special Care program. Led extensive clinical and business research to develop clinical and business case. Developed comprehensive White Paper and presented to Governance subcommittee; outlined forecasts, statistics, business justifications, trends, financial analysis, codes, pricing and risk. Answered physician committee inquiries.Led clinical precedent updates for Cardiac Care, Spine, Knee and Hip replacement programs. Show less

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  Boncura Health Solutions

  May 2018 - Jan 2020

  Director of Business Integration

  Strategic responsibility for driving innovation, efficiencies, new technologies, standardization and data/clinical insights across this wholly owned subsidiary of DuPage Medical Group. Focused on quality, cost savings, automation, compliance and client relations. Led multiple strategic projects and initiatives collaborating across all departments. Led planning, execution and evaluation of implementing/onboarding new clients. Orchestrated numerous operational and IT-enabled business process improvements and system optimizations across the enterprise building a data-driven organization with improved business insights, automation and standards.Developed and implemented KPIs across the business, as well as dashboards and new reporting to improve executive decision making, as well as client engagement and client experience.Developed and implemented standardized new client onboarding processes to ensure accuracy, compliance and quality. Project manager for four IT projects (Claims, Collections, Authorizations). Partnered with business to gather/analyze requirements; collaborated with IT teams for custom development or integration of third-party software. Show less

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  MKY Ventures, LLC

  May 2021 - now

  President

  Specializes in ISP/WISP Broadband Grant Services at the Federal, State, County, and Municipal levels.