Cynthia Wicks has more than three decades of healthcare industry experience within national managed care organizations, health insurance companies, ACOs, physician IPAs, and hospital system organizations. She has a strong balance of analytical expertise and matrix management abilities providing leadership to businesses undergoing startup, rapid growth, or major transformation, and is able to work with boards, board-level committees, and executives to provide vision and establish strategy.
Cynthia is highly successful at establishing project specifications and working with cross functional teams to develop, implement and execute strategies on time and on budget with a keen ability to maximize process and organizational efficiencies and anticipate and mitigate risks through creative solutions. She is a subject-matter expert in payor/provider relationships, negotiations and alliances, provider risk and incentive reimbursement models, alignment of provider reimbursement models with benefit designs, incentives, metrics, and fund flow models for commercial, self-insured, Medicare Advantage, and managed Medicaid products. Cynthia has worked with hundreds of physicians improving quality and total cost of care metrics to assure maximum success with value-based contracts.
- Returned $6-$7 million of incentive monies to the ACO providers caring for 65,000 members under some form of risk contract
- Renegotiated three-year affiliation agreement for 600-physician IPA with a larger regional risk-bearing IPA, turning around a previously strained relationship
- Developed network strategy and managed staff contracting complete behavioral health network (facilities, clinics, physicians, psychologists, and social workers) in ten months enabling health plan to bring these services in house providing seamless clinical integration, care coordination of complex cases, and benefit coordination for members
- Developed limited network and tiered network partnerships with providers for the purpose of marketing and selling small business products and providing aligned incentives for the featured providers
- Wrote and negotiated a hybrid capitation PCP contract for a unique medical home program designed to both transform PCP office workflow and practice models and provide enhanced reimbursement based on quality and total cost of care metrics
Cynthia earned her MBA from Rensselaer’s Hartford Graduate Center and her MHA from Duke University. She holds a BA in biology from Bucknell University, Lewisburg, PA.