Meri HorowitzPage 2

MERI HOROWITZ, CPA

Longmeadow, MA 01106

MOBILE: 413-847-0017 HOME:413-567-1008

Meri Horowitz Linkedin

SUMMARY

Healthcare Professionalwith extensive experience on Payer and Provider sidein Healthcare Finance (including SOX 404), Strategy, and Operations. Drives strategic change in healthcare by successfully engaging partners in population health/value-based arrangements. Creates solutions to improve healthcare operations and financial performance.Proven leader who champions high profile complex assignments and interacts effectively withall levels of management. Key project manager for business integrations and special projects, as well as in the roll-out of a new Accountable Care Solutions business. Enhances business processes and controls in Corporate Services, Health Plan Service Operations, Healthcare Management, Mail OrderPharmacy, and Retail Pharmacy Operations.Excellent verbal and written communication skills, and relentless focus on professional development and innovation.

Key Competencies: Relationship Management|Negotiation|Strategic Direction Setting|Project Leadership and Execution|Auditing| Financial Trend Analysis and Reporting|Talent Selection, Mentoring, and Employee Development|

PROFESSIONAL EXPERIENCE

AETNA INC.– Hartford, CT 1997 - 2017
Director of Strategy and Operations, Accountable Care Solutions (ACS) Northeast Region (2011- 2017)
Led transformation to Accountable Care Organization (ACO) value-based arrangements in New Jersey, one of Aetna’s top markets.Negotiated, contracted, and implemented Commercial and Medicare collaboration arrangements with six key clinically integrated health systems.Engaged Health Systemand Integrated Delivery System C-Suites to drive strategic change, improve care outcomes, coordination of services, and projected savings through new tools, programs and initiatives offered within accountable care solutions.
  • Introduced programs and initiatives that achieved double digit efficiency improvements, and medical cost savings of up to 10% ($63 per member per month).
  • Partnered with Market Leadership and actuarial to identify, build, market and implement competitive co-branded insurance products with key strategic partners.Pricing and care management efficiency savings moved product offerings from number four position to first and second position in the market attracting 60% of a National Account’s membership.
  • Oversaw ACO data analytics that drove clinical program strategies impacting over 125K attributed members. Established cross-functional workteams and governance structureto improve delivery and coordination of patient care while reducing system inefficiencies.EngagedACO physician leadership in data findings and program initiatives to drive medical cost savings (e.g., embedded case management, provider steerage strategies).
  • In collaboration with Market Leadership and ACO partners, drove top line commercial membership growth through development and delivery of unique value proposition.
  • Established monthly and quarterly dashboard reporting for senior leadership that included financial performance, key risks and action items, work stream status, competitive pricing position and membership reporting.

Audit Portfolio Senior Director (2000 - 2011)
Served the Audit Committee of the Board of Directors by providing strategic leadership and direction setting, and overseeing the timely delivery of high quality audit services across the organization, which included: Provider Service Center Operations, Provider Contracting, Member Services, Billing and Collection, Claim Payment, Expense Management, Human Resources and Procurement.Portfolio included several large scale special projects related to the integration and alignment of acquired business entities, as well as medical cost and regulatory issues (resolution of Medicare Sanctions).
  • Ensured that business areas received high quality, timely, risk-focused, efficient audit and assurance services through ongoing risk assessment and the appropriate establishment and maintenance of an annual audit plan.This included meeting with senior leaders quarterly to discuss the Internal Audit Package and current areas of risk.
  • Set strategic direction for the department, as a management team member,including audit methodology approach, technology, and the annual audit plan.
  • Built and managed high performing teams by fully engaging staff and aligning talent, processes, and technology to optimize business results. Supervised 10 audit project managers/consultants, and select staff on special projects and initiatives.
  • Worked closely with Sarbanes Oxley function to implement and complete annual SOX 404 assessment (accountable for coordination of up to 26 components).

Audit Project Manager (1997 - 2000)
  • Led audits for top risks of the company; effectively planned, scoped and performed audits of healthcare business processes, system platform conversions (System Development Life Cycle Reviews), business integrations and other key risk areas of the Company (Year 2000 project). Recognized by the office of the CFO for outstanding dedication and commitment.
  • Built positive audit presence with business leaders, displaying strong conceptual understanding of business area operations and objectives.Effectively communicated results to drive senior leadership support/action.

MEYERS BROTHERS KALICKA, P.C. – Holyoke, MA (Previously Blum Shapiro/Meyers Brothers, P.C.) 1994 - 1996
Senior Audit Consultant
Healthcare specialization providingfinancial, tax and operational support to medical practices. Performed business valuations and operational audits for medical practices under buy-out/merger consideration.
WINCHESTER HOSPITAL – Winchester, MA 1991 - 1994
Corporate Accounting Manager
Principal financial managerfor five reporting entities, which included: a freestanding surgery center, a medical office building, a philanthropic subsidiary, an investment entity and the parent corporate entity.Achieved overall responsibility for all corporate reporting, auditing and accounting uniformity of a $77 million healthcare system. Designed and implemented a variety of corporate financial reports including: consolidated financial statements, a system-wide cash flow model, comparative financial ratio analysis, statistical highlights and other analyses as requested by senior management.Supported the Chief Executive Officer in the construction and leasing of a medical office building, which entailed ongoing financial analysis, generation of service proposal requests, and extensive interaction with legal counsel and the Finance Committee.
PRICEWATERHOUSECOOPERS, L.L.P. (PwC) – Hartford, CT(Previously Price Waterhouse, L.L.P.) 1990
Staff Auditor
Audited a variety of industries (banking, insurance, mutual funds, manufacturing, healthcare and transportation) in addition to participating on various consulting engagements in the development of management reporting systems.
EDUCATION
BentleyUniversity, Master of Science Degree in Accounting Cum Laude
Bentley University, Bachelor of Science degree in Management Cum Laude, Honor Society
Beth Israel Hospital (Boston), College Honors Internship Program
PROFESSIONAL ACHIEVEMENTS
  • Nominated to participate in and develop first Aetna Finance Leadership Development Program
  • Leadership participant on the Aetna Finance Talent Forum
  • Led Finance Employee Survey action team on behalf of the Chief Financial Officer of Aetna
  • Co-lead of Women’s Leadership Organization at Aetna
  • Passed all four parts of the Uniform CPA Examination during first sitting

PROFESSIONAL AFFILIATIONS
  • Coram Deo Recovery Board of Directors (Volunteer)
  • American Institute of Certified Public Accountants
  • Connecticut Society of Certified Public Accountants
  • Institute of Internal Auditors
  • Beta Alpha Psi, The National Accounting Fraternity
  • Healthcare Financial Management Association