Kristopher Burns
Director, Provider Network Strategy at Humana Healthy Horizons in Ohio
- Role
- Director, Network Strategy at Humana
- Location
- Louisville, KY, US
- LinkedIn followers
- 500 followers
About Kristopher Burns
Solution-driven leader with proven track-record of building consensus around creative solutions in provider network administration and operations in Fortune 60 healthcare business. I can quickly comprehend end-to-end enterprise processes and resources and align them to the specific business needs of the market.When I’m not making it happen at work I can be found spending time with my family, attempting to prepare the perfect steak, or playing loud music at local venues.
Experience
Director, Network Strategy
May 2022 — Present · Louisville, KY, US
Network build and strategy lead for Ohio Medicaid Managed Care Plan contract worth ~$3.3B-Developed Network Optimization strategy to realize $1.5m in annual savings-Led the product development and launch of VBC programs for the market-Developed first-in-enterprise team focused on Network Optimization and Value-Based Program build for Humana Healthy Horizons in Ohio Medicaid Managed Care plan, recruiting and empowering top talent to successfully execute on one of the most operationally complex Medicaid contracts-Negotiated and executed a first-in-enterprise full risk arrangement with the largest Pediatric ACO in the nation, with roadmap to placing the majority of the pediatric population under global risk-Increased overall adequacy by 4.8 points to achieve 97.4% adequacy by go-live with clear line of sight to adequacy of over 99%-Developed reporting and accountability structure for adequacy that reduced fine exposure by 39% within 6 months through provider contracting and data governance-Created Medicaid-first Value Based Program Governance Committee - a cross-functional committee to ensure Value-Based programs align with and support health plan\'s financial, population health, Social Determinants of Health (SDoH), and Quality goals-Leveraged enterprise influence to bring key contracts to close-Develop processes and reporting to ensure compliance with Medicaid contract requirements
Education
Western Governors University
Master of Business Administration - MBA, Business Administration and Management, General
2017 — 2019
The Southern Baptist Theological Seminary
Master of Divinity (MDiv), Christian Ministry
2009 — 2013
Arkansas Tech University
Bachelor of Arts (B.A.), History and Political Science
2005 — 2008
Skills
- Transact-Sql (T-Sql)
- Religion
- Microsoft Excel
- Nonprofit Organizations
- Social Media
- Non-Profit Administration
- Theology
- Call Centers
- Christian Leadership
- Christian Ministry
- Team Management
- Data Analysis
- Christian Theology
- Event Planning
- Coaching
- Leadership
- Church Events
- Customer Service
- Youth Ministry
- Public Speaking
- Expository Preaching
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