Julie S. Oare

About Julie S. Oare

Respected Director/Supervisor with distinguished 15+ year career leading…

Experience

1. Sr Manager, Safety Net Products and Government Affairs

   Excellus BCBS

   Jan 2023 — Present

   Drives the development of short and long-term strategic product plans to meet business objectives, benefit administration, regulatory requirements, process improvement, efficiency, and member experience. Develops strategic product segment goals and roadmap taking into consideration competitive markets and regulatory influences. Analyzes financial trends and premium rate adequacy by service and/or actuarial class to direct areas of improvement. Works with state agencies (DFS and DOH) to reconcile any premium deficiencies Assess changes in the state and federal regulatory landscape including NYS budgetary actions, Strategic Roadmaps and Federal Waivers. Identifies emerging trends and their implications and develops plans to address. Divisional Lead for NYS Medicaid reform including the initiatives, specialized I/DD plans, waivers, and other population-specific goals. Participates with NYS Health Home leadership and develops programs to enhance enrollment in care coordination for eligible members. Participates and provides feedback to guidance, budget items, regulation by working with internal stakeholders and advocate for Plan position with state and trade associations. Participates and influence state policies for BH services. Works closely with key Clinical Leaders and medical director on external initiatives and overall quality improvement Liaison to state regulatory agencies, including Department of Health, Office of Addiction Services and Supports (OASAS), Office of Mental Health (OMH) and county health planning agencies and stakeholders to identify and implement solutions to improve care. SME for telehealth strategy including policy and initiatives to expand access. Oversees development of business requirements for product and services implementations Ensures alignment with NYS and local BH initiatives. Inform internal stakeholders to define and execute regulatory implementation plans participation in State and initiatives

Skills

• Self-Starter
• Policy
• Powerpoint
• Insurance Counseling
• Insurance Training
• Healthcare Management
• Microsoft Office
• Team Building
• Compliance
• Data Analysis
• Healthcare
• Health Care Reform
• Medical Terminology
• Medicare
• Medicaid Managed Care
• Billing Mediation
• Strategic Planning
• Program Management
• Employee Benefits
• Medicare/Medicaid Reimbursement
• Management
• Microsoft Access
• Leadership
• Medicaid
• Managed Care
• Home Care
• Complaint Investigations
• Claims Management
• Training
• Medical Coding
• Quality Assurance
• Individual Health Insurance
• Hipaa
• Elder Care
• Claims Auditing
• Fida
• Long-Term Care
• Managed Long Term Care
• Quality Auditing
• Health Insurance