Sean Fitzgerald
Regional Vice President Provider Solutions, Fl @Elevance Health
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WORK HISTORY
Regional Vice President Provider Solutions, Fl @Elevance Health
FL, US
Oversees and continuously optimizes the local-market care delivery model, seeking and identifying new opportunities to enhance, enable and improve market provider account management expertise and the overarching provider experience.• Delivers competitive cost-of-care trends throughout Florida, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products.• Develops new provider networks that establish a competitive advantage, optimizing respective provider relationships to most effectively benefit health plan growth priorities.• Aligns contracting decisions with medical management strategy, integrating quality metrics and unique (non-traditional) incentives into the overarching contracting process, shepherding a market transition from “fee-based” reimbursement to a model based on quality achievement.• Ensures compliance with all regulatory and accreditation standards (local and federal).• Collaborates with Product Development to recommend and implement innovative benefit plan designs in parallel with annual planning processes.• Mentors, hires, trains, coaches, counsels, and evaluates the performance of approximately ~150 direct report associates
EDUCATION
Suffolk University Law School
Juris Doctorate
UNH Peter T. Paul College of Business and Economics
Business Administration
University of New Hampshire
Business Administration
SKILLS
ABOUT SEAN FITZGERALD
Regional Vice President, Provider Experience
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