MARY ELLEN O'DONNELL

Summary
Healthcare executive with extensive experience in strategic consulting, risk reduction and turn- around initiatives in health plans, managed care organizations and care management programs. Experience includes:

Business and opportunity analyses
Strategic planning and definition of business objectives
Program planning and development to meet business objectives
Project leadership for risk assessments, operations evaluations, implementation and program operations
Preparation for and/or compliance with regulatory and accrediting agencies
Analysis of data and reporting needs to support business analyses
Marketing and sales of care management services Data Management.

History

Senior Vice President, Business Development, Marketing, Client Relations 1994-2003
CareAdvantage, Inc.
Iselin, New Jersey (Milwaukee office)

Responsible for the successful development of the care management consulting line of business. This comprehensive role included the marketing, sales, staff leadership, client relations and quality assurance. Successfully developed and retained key, long-term clients. Designed and negotiated innovative business relationships using performance-based, at-risk fee structures. Led consulting teams in engagement design, implementation and ongoing delivery. Consistently exceeded client expectations.

Responsible for marketing and sales staff including the development of marketing materials, sales strategy, proposal development, contract development and negotiations.

Practice Director, Strategic Consulting Services 1993-1994
Blue Cross and Blue Shield Association
Chicago, Illinois

Responsible for marketing and delivery of general health care consulting services to Blue Cross and Blue Shield Plans, HMOs and subsidiaries. Practice emphasis was on benchmarking, managed care best practices, operations reengineering, market analysis, strategic planning, quality improvement and NCQA preparation. Successfully met annual revenue goals.

Engagements included reengineering health plan medical management operations, benchmarking health plan administrative costs and practices against local and national competitors, establishing a health plan's risk profile relative to their competitors and developing a market strategy in anticipation of sweeping state insurance reform.

Director, Utilization Management 1988-1993
Blue Cross and Blue Shield Association
Chicago, Illinois

Responsible for improving health plan utilization management performance and piloting related state-of-the-art systems technology. Developed an outpatient review program and physician profiling development guide. Developed, marketed and delivered a successful nurse reviewer training program to twenty Blue Cross Blue Shield plans. Facilitated the successful URAC accreditation of twenty-seven health plans and managed a national case management network.

Manager, Managed Care 1980-1988
Blue Cross and Blue Shield United of Wisconsin
Milwaukee, Wisconsin

Responsible for the health plan’s care management program, including its design, implementation, start-up and subsequent operations management. Results achieved include growth of the program to cover plan’s indemnity business, adaptation of the program for HMO and PPO products and achievement of cost saving goals and client satisfaction. Operations development included the strategic planning process, budget planning and management, staff development and training programs, MIS management, marketing support and performance reporting. This operation was subsequently spun off into a for-profit subsidiary.

Additional positions included management of corporate health policy development, the provider fee database, medical underwriting, medical fraud audits and claims processing.

Utilization Review Coordinator 1976-1980
Columbia Hospital
Milwaukee, Wisconsin

Coordinated the start-up and management of the delegated utilization review function for the local PRO. Also responsible for coding and quality control of hospital medical records.

Education

Baccalaureate degree with a major in business administration
Cardinal Stritch College, Milwaukee, Wisconsin
Alverno College, Milwaukee, Wisconsin, emphasis on management and communication
Marquette University, emphasis on education