Andrew Curtis

Strategy Director at Anthem, Inc.

Virginia Beach, VA

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About

For more than twelve years I have only accepted opportunities that grow me as a servant leader. This has included starting a Medicaid non-emergency transportation business, accepting government positions early in my career to understand their culture and nuances, earning a place in a unique leadership development program through Amerigroup, as well as leading Soldiers as a reserve Army Officer and non-profit Vice Chair on the board of a local YMCA. My evolving roles with Anthem and many other career interests’ show that I seek to take on meaningful work that positively impacts others. My career focus in health care management is based on an unwavering interest in integrative, community centric business operations that promote quality health. Having led multi-million dollar projects and programs, I have developed knowledge and skills in: clinical product implementations, healthcare operations, account management, call center operations, public speaking & meeting facilitation, program strategy development, public health management, Medicaid risk adjustment, HEDIS & EPSDT outreach strategies, process & data analysis, process & performance improvement, and business analysis & planning.

Ask me about
Managed care operations
Medicaid Program Integrity
Medicaid RFPs
Work experience
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Jul 2021 - Present

Anthem, Inc.

Growth Director, Medicaid Operations

Oct 2013 - Present

Virginia National Guard

Environmental Science Officer

Drill assignments, Officer-In-Charge (OIC): Convoy Operations, Range Operations, Field Sanitation, Prev Med Sustainment Training Center missions. Oversaw Flu outbreak Preventive Medicine response during annual training at Camp Dodge, IA January, 2018. Completed Field Sanitation certification on May 8, 2017. Board approved as 429th Brigade Environmental Science Officer for Medical Company C February 24, 2017. Active Secret Security Clearance; Completed Officer Candidate School in August 27, 2016. Graduated Basic Combat Training (BCT) at Fort Jackson, South Carolina on September 11, 2014.

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Nov 2018 - Jul 2021

Anthem, Inc.

Program Integrity Strategy Director

I provide a single point of contact for all Anthem Central Region Medicaid health plans to Program Integrity shared services and resources that support fraud, waste and abuse total program savings and cost of care initiatives. Keys to success include fostering strong, collaborative relationships with Program Integrity shared services areas and my health plans. Varying levels of tactical strategic techniques are used to support the planning and development of short and long range strategies that deliver successful program integrity results year over year.

Jan 2019 - Dec 2020

YMCA of South Hampton Roads

Vice Chair, Advisory Board Member

I collaborate with full-time Y leaders and employees, Y members, and other Advisory Board members to make planning and policy decisions aimed at furthering the YMCA's mission. We also work identify opportunities to partner with local community members and organizations to pursue a shared commitment to nurturing the potential of kids, promote healthy living and foster a sense of social and community responsibility.

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Sep 2017 - Nov 2018

Anthem, Inc.

Medicaid Operations Director

Lead claims payment integrity Provider Relations communication strategy and provider education tools development. Oversee cross-functional workgroup to enhance patient liability claims payment accuracy and encounters mapping. Implementing reimbursement policy review process for Iowa health plan’s departments to ensure review, exceptions identification and structured feedback to the Government Business Division Reimbursement Policy department. Conduct monthly operational trainings and Q&A sessions for Provider Relations team. Implemented and led vendor performance oversight for $4.7M in non-emergent ER claim offsets through GenPact. Oversaw state onsite historical claims audit to review Rx, patient liability, tiered ER, rejected and duplicate payments.

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Apr 2016 - Sep 2017

Anthem, Inc.

Business Change Director

Oversaw healthcare management services sub-team implementation of Tennessee Long Term Services (LTSS) ECF Choices Intellectual Disability Intellectual and Developmental Disabilities (IDD) Medicaid services–$300M in estimated incremental top end revenue. Current project manager of Virginia Managed LTSS implementation for healthcare management services sub-team. Executive level collaboration skills driving cost of care investment portfolio results across multiple departments and functional areas. Create and present executive level presentations to elicit decisions, feedback and support from GBD business owners and sponsors. Represent senior leadership as decision maker on projects, guidance to project resources on complex issues.

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Jan 2015 - Apr 2016

Anthem, Inc.

Business Change Manager

Portfolio oversight of the 2016 GBD Program Integrity $27M MCM Pillar Investment portfolio with a $43M savings target. Executive level collaboration skills driving cost of care investment portfolio results across multiple departments and functional areas. Create and present executive level presentations to elicit decisions, feedback and support from GBD business owners and sponsors. Provide project management support and tracking of GBD Program Integrity analytics 3 year plan. Infuse change and culture management expertise into the HCA GBD Program Integrity team to drive cohesiveness and productivity. Led the prioritization and scheduling activities for the Governance and Strategic Initiatives team. Represents senior leadership as decision maker on projects, guidance to project resources on complex issues. Principal project support for key vendor management initiatives, such as IBM and SAS Fraud Analytics Proof of Concept projects. Project managed of the 2015 GBD Overpayment Recovery Look-back alignment project - annualized impact of over $10M. Oversaw $3.2M 2015 investment budget for a portfolio with $6M savings achieved.

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Jan 2014 - Jan 2015

Anthem, Inc.

GBD Account Management Consultant

Lead the coordination and execution of complex planning procedures for health plan projects and initiatives. Engaged and educated corporate senior leaders, health plan CEOs and department leaders to meet program goals and objectives. Partnered with stakeholders to identify potential issues, risks and project and operations changes. Built support for business change by fostering collaborative working relationships with corporate and health plan functional areas. Conducted root-cause analysis reviews to source disrupted workflows and collaboratively evaluate appropriate solutions. Coordinated operational projects and programs that improve member and provider experience, save capital and improve margins. Organizes project and operations prioritization and resources scheduling process to enhance decision making. Led the project management of the Maryland Behavioral Health Carve Out impacting $20 million of market revenue. Oversaw timely submission of reports from corporate functional areas for configuration and operations projects. Facilitated weekly operational meetings to track issues and connect the health plan with functional units in the organization. Supported operational improvement initiatives that leverage interactive SharePoint tools to engage corporate partner departments. Project managed health plan “runout” periods for legacy markets where the company ceased operations– Amerigroup VA & NM. Actively tracked and coordinated open issues resolution for the northern region Medicaid markets – NY, NJ and MD. Proactively identified issues and opportunities for improvement in operations at the corporate and health plan level. Participated in learning collaborative to expand knowledge in all corporate functional areas and stay current on industry best practices.

Jul 2012 - Dec 2013

WellPoint, Inc.

LDP Associate

Project manager for Health Care Analytics Cost of Care Risk Adjustment project with $10 million ROI for FY2012. HEDIS project coordinator for new health plan Hybrid project – Amerigroup Louisiana health plan. Oversaw fax strategy for chart chases accounting 40% of 3,100 medical records; achieved over 90% retrieval rate on faxes. Developed innovative strategies to increase the EPSDT service numbers for membership. Utilized deep dive analysis techniques to enhance strategies around creating provider profiles and 39 week initiatives. Project manager for customer service Transfer Rate Awareness & Reduction project– achieving 5 point rate reduction in 90 days.

Aug 2011 - Jun 2012

Fairfax County Department of Family Services

Process Manager

Participate in operations related strategic planning, business process redesign and information technology initiatives. Conduct direct and indirect support to the primary social services program areas - Adult and Aging Services, Child Care, Self-Sufficiency, and Children, Youth and Families Services. Oversee the implementation of Result-Based Accountability quality improvement program for 4 regional offices, the records center, call center and central office for Office Service Management program. Support direct and indirect customer service functions including mail services, case processing, facilities management, and resource development and redesign planning. Collaborate with department managers to develop and implement improved operations administrative policies, procedures, and processes. Contribute to the planning and design of automated technology applications and information systems requirements for data collection and maintenance and case processing. Prepare narrative and statistical reports; including recommendations for changes or enhancements to improve efficiency and effectiveness of operations services. Regular travel throughout Fairfax County for meetings and to work directly with the staff in each of the department's five regionally-located field offices.

Jun 2010 - Aug 2011

Fairfax County Health Department

Community Health Specialist

Assist in developing long-range strategic plan for; Conduct regular program evaluation through monthly statistical reports, quarterly reports to the state and federal program offices. Create technical reports for review and discussion to increase program efficiency and effectiveness. Collaborate with internal management, partner agencies and community stakeholders to refine program goals and objectives. Coordinate grant budgets and expenditures to complete deliverables for a variety of local, state and federal grants. Manage three unique member databases for statistical tracking of program growth, efficiency and effectiveness. Oversee and manage MRC's online automated program database for member data tracking and incoming/outgoing correspondences. Work with contracted vendors to ensure exclusively licensed technology is maintained and improved for effective program use. Develop advertising and recruitment strategies through online, radio and community event venues. Provide outreach support for community initiatives with partner agencies to encourage family public health preparedness. Coordinate community outreach and training opportunities for MRC members to increase self-sufficiency in emergency preparedness. Assists in developing, coordinating, and supporting the county's disaster and emergency response efforts.

Jun 2009 - May 2010

Virginia Department of Health (VDH), Richmond

Project Manager

Developed broad based knowledge of project management best practices on the state government level. Managed budget of $345,000 for the Center for Disease Control (CDC) & VDH, contracts, and requests for procurement. Provided leadership support to the Virginia Asthma Coalition (VAC); VAC liaison to the VDH Division of Chronic Disease. Create technical reports for submission the CDC for progress updates and funding support. Established and nurtured relationships with volunteers, researchers, administrators, clinicians, and other statewide asthma stakeholders. Obtained supplies through purchase orders and other standard government methods of procurement. Conducted group setting instruction in asthma management and statewide public input focus groups for new state plan. Developed asthma related public notices and flyers for H1N1 epidemic and seasonal Flu. Conducted educational trainings and programs related to basic asthma education and control. Interpreted program policies and concepts to contracted vendors, department staff and community groups. Represents the project manager at meetings, conferences, workshops, and other asthma forums.

Jun 2008 - Dec 2009

IJA Transportation

Managing Partner

Managed a16 employees on daily task assignments. Provided logistical support to administrative staff, drivers and business partners. Coordinated new application submissions, interviews, hiring, and training. Monitored employee payroll for accuracy. Reviewed, analyzed and evaluated training courses and programs to assess quality and effectiveness. Analyzed problems, issues and systematic company administrative requirements and concerns. Researched, reviewed, and coordinated employee benefits. Created comprehensive employee manual and business plan.

May 2006 - Jun 2008

Logisticare LLC, Norfolk

Quality Assurance & Transportation Coordinator

Developed extensive customer service skills and communication techniques to mitigate customer complaints and problems. Communicated with Medicaid recipients regarding transportation inquiries. Developed an in depth understanding of the Medicaid transportation system in the state of Virginia. Received over 100 client calls per shift regarding Medicaid transportation trip information. Ensured the security and privacy of personal information, as required by the Health Insurance Portability and Accountability Act. Promoted to Quality Assurance Coordinator in under one year of employment. Composed reports regarding trip complaints for submission to Department of Medical Assistance. Developed relationships with transportation providers and healthcare facilities.

Jan 2002 - Mar 2006

YWCA, Norfolk

Before and After School Aide

Monitored and coordinated safety of all children. Developed interpersonal relationships with children, parents and staff. Devised weekly snack plans with staff based on healthy snack options. Participated in and passed American Heart Association CPR training every 2 years. Communicated with parents in written and verbal form in regard to childcare/programmatic updates. Served as an activity planner to promote teambuilding, cooperation and effective communication skills among participants.

Jun 2005 - Aug 2005

Pediatric Research, Norfolk

Summer Scholar, Center

Helped two physicians and a research coordinator on a NIH grant-funded program to implement a comprehensive disaster preparedness plan for the Portsmouth City school system. Provided direct support to researchers for data input, constituent phone calls, and training sessions. Assisted in coordinating training sessions with city public school staff, police officers, and firemen.

Education

2006 - 2008

Masters, Public Health

2001 - 2006

BS, Biology

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