Heidi Wold, NP

CEO and Founder, Heidi Wold Healthcare Consulting

Fountain Hills, AZ 85268  |  Cell Phone: 813-404-7233  |  Email: wold_heidi@yahoo.com

Summary

Heidi is a seasoned healthcare professional with a broad range of executive leadership and operations experience developing and leading teams to achieve transformational changes in government funded programs that positively impact the quality and cost of health care for people in multiple settings- nursing home, health plan, hospital, clinic, community. Heidi effectively partners with key stakeholders in designing and operating successful clinical and business programs/processes within health systems, health plans or other privately funded healthcare organizations for the most vulnerable populations. Through her relationships within the industry across the country and market research she is well versed on the latest CMS, ACA and other significant changes that impact payers, providers and beneficiaries. In her experience with various health plans, provider organizations and health systems, value-based payment programs and by the achievement of successful clinical and financial outcomes, she coaches and mentors many successful healthcare leaders of today.  Whether healthcare affordability, healthcare delivery or clinical IT platform design and implementation, Heidi provides guidance and operating discipline to the teams she works with while also ensuring strategic goals and targets are met.

Highlights

•  30+ years healthcare industry expertise
•  Quality Program and Contract Compliance
•  Health plan operations and process improvement
•  IT platform business requirements and end user design
•  Government program healthcare services proposal writing
•  Healthcare business solutions design, implementation
•  Utilization, Care and Disease Management
•  Clinical workforce leadership/development
•  Vendor/provider contract development and negotiation
•  Government program sales and marketing

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Relevant Accomplishments

•  Built and launched first CHF business/clinical model that reduced $5 million loss for Medicare patients within a health system to $10 million contribution margin
•  Designed and implemented first Medicare Risk adjustment program launched in Florida that yielded a 12.1 ROI
•  Successfully launched ISNP, MLTSS expansions in several markets
•  Expanded retail clinic footprint from 350 to 500 clinics within 14 months
•  Successful retail clinic M and A operational alignment
•  Successfully planned and submitted CMMI Dual-eligible Model of Care to CMS that yielded 5 state contracts
•  Designed and successfully implemented provider based, value based payment program to improve quality and cost of care for chronically ill members that yielded a positive ROI by year two
•  Increased chronic care program sales by 50% in one year
•  Exceeded MLR goals in every health plan program managed
•  Successfully achieved managed care health plan turnarounds in 3 states financially and contractually
•  Created and launched successful consulting business with $50K in sales first year (launched in Sept) and triple sales expected this year

Roles

•  CEO and Founder, Heidi Wold Healthcare Consulting, LLC
•  Sr Vice President of Chronic Care Business Development, Matrix Medical Network
•  Vice President Chronic Care, Matrix Medical Network
•  Vice President of Operations, Walgreens Healthcare Clinics
•  Vice President of Clinical Operations, Chief Nurse Executive, United Healthcare
•  Sr Director of Long Term Care Clinical Operations, United Healthcare
•  Executive Director, ISNP, CSNP, DSNP, MLTSS, United Healthcare
•  Director of Health Services, United Healthcare
•  Vice President Patient Services, St Joseph-Baptist Health Care

Education, Licenses and Certifications

•  Post Masters Certificate Adult Nurse Practitioner, University of Tamp
•  Masters of Science in Nursing- Administration, University of Florida
•  Bachelors of Arts in Nursing, College of St Scholastica
•  Wharton School of Business- Executive Leadership Training Program
•  ANCC Certification- Adult Nurse Practitioner
•  Six Sigma Green Belt
•  Licensed Nurse Practitioner and Registered Nurse in state of FL and AZ

Company/Industry

•  Matrix Medical Network
•  Walgreens
•  United Healthcare
•  Baycare Health System