In a standard benefits stack, nobody independently and prospectively governs what happens between authorization and outcome. That is the structural gap in healthcare payment — sharpest where the payer and the loser are the same entity — and it is the only thing I work on.
I've been on both sides of it for fifteen years — building health systems, and today as Staff Vice President of Carelon Growth (Elevance Health), owning six specialty clinical risk books across $50B+ in spend, publishing the research, and shipping the products that came from staying in the gap. Published in Pharmacy Times. 65,234 patients studied. Seven governance products built.
Your product org ships late, kills too slow, and can't tell you which products are worth the investment. I created FORGE — a complete product lifecycle framework with seven phases, kill criteria, and a dual-lane architecture that separates exploration from execution. I'll implement it in your org so products move on a clock, not a prayer.
24 templates. 7 phases. Implemented inside a national payer's product organization.
You're negotiating value-based contracts and the model lives in a spreadsheet one person understands. I'll model the contract, stress-test the corridors, and give you a financial picture you can defend in the room. I built Cadence, Curated, Caliber, and Compass from this exact work.
ClearBill, my billing-integrity platform, returned $9.2M to payers in its first six months. 65,234 patients studied across three cohorts.
Your org just swung too far toward control and the builders are leaving. Or too far toward speed and nothing is governed. I've spent a decade and a half in that cycle. I'll design the structure that holds both — PE portfolio companies, post-M&A integration, product org redesign.
200,000+ patients across the companies I've led. Built from scratch. Ran as CEO through acquisition.
I also design clinical programs, build financial models, conduct market research, and develop intellectual property. If you need someone who operates across the full stack — strategy through shipped product — that's the engagement.
Current: Staff Vice President of Carelon Growth (Elevance Health). Redesigned the specialty risk commercialization process for the health services subsidiary. Single author. Now the operating standard across the organization. · Previous: Benefits strategy advisory for a Fortune 100 retailer's benefits organization (Head of Benefits).
The best engagements start with a real problem. Sometimes you know exactly what's broken. Sometimes you need someone to find it. I do both — diagnose the gap, design the fix, and ship it. Discovery, strategy, architecture, execution. Same rigor at every stage.