Brian Stalder

About Brian Stalder

I can see it! Not just a \"better\" healthcare system but an ideal one that works for everyone without the complexities that necessitate a \"navigator\". Having spent more than twenty years in healthcare operations I know a lot about how and why the mechanisms function the way they do. I\'ve led teams that made great progress in improving the experience. I\'m proud of those accomplishments but am convinced there is much more we can do. If you feel the same way let\'s work together to reimagine and build a system for the future that\'s fair and straightforward, worthy of our family and friends.I\'m a Health Plan leader with extensive experience directing a department in the administration of healthcare benefits and services across Commercial and Medicare programs. I\'ve successfully led large scale operations in a fast-paced, highly regulated, and continually evolving environment. I have expertise in vendor oversight and management, benefit design and implementation, and utilization management operations. I have a proven track record of leading teams to meet compliance requirements, financial objectives, and operational performance metrics. I\'m adept at defining and enabling strategic priorities, achieving cost of care reductions, enhancing quality of care, and championing innovation to deliver value for members.Areas of ExpertiseHealthcare Benefits | Clinical Review Operations | Utilization Management | Operational Efficiency | Regulatory Compliance | Vendor Management | Quality Control | Workforce Management | PBM Contract Negotiation | PBM Oversight | Medicare Part D | Process Improvement | Strategic Partnership | ROI Analysis | Budget Management | Call Center Operations | Staff Development

Experience

1. Senior Business Consultant

   CareFirst BlueCross BlueShield

   Dec 2024 — Present · Baltimore, MD, US

Education

• Campbell University

  MBA, Business

• The University of North Carolina at Chapel Hill

  Bachelor of Arts - BA, Industrial Relations