William Carroll

Background

About William Carroll

I am a Senior Level health care executive with 30 years of experience. That experience has permitted me assist a number of new, innovative companies with how to access the health care reimbursement system. As a health plan executive, the primary areas of focus have been contracting, cost control, and Senior Management. I have also had the opportunity to lead Medical Management, Quality Management, Customer Service and Informatics. I have collaborated with Actuarial Services and Finance in building and managing healthcare cost budgets and tools for managing the reserve setting process for smaller risk pools. My roles have included start-ups, turn-arounds, privately held plans and publicly traded plans. I have consulted for a wide range of clients ranging from venture-backed start-ups to established national Provider Organizations. As Regional Vice President for 8 states. My role was to consult with State Presidents and with the Provider Network Teams on financial performance, provider incentives, complex negotiations, staffing assessment, the implementation of the corporate strategic plan, and the development of the regional provider strategy. As Senior VP for a startup we introduced an innovative approach to provider reimbursement for High Deductible Plans. In our model, we achieved network discounts comparable to the largest health plans in the country and we achieved a unique level of provider support across 5 state development projects. Averde also assisted Tufts in obtaining approval of $88 million in funding for the purpose of establishing Minuteman Health, a Co-Op under the HCA, serving MA and NH. My roles at ConnectiCare and FHP included successful management of $700 million health care cost budgets, multi-state service area expansions, and contract negotiations across multi-state networks. I played a key role in management team's successful efforts to complete a for profit conversion, attract venture capital, complete due diligence related to acquisitions, and the leveraged buy out and sale of the company. The transaction resulted in the creation of $350 million in incremental enterprise value. I have consistently demonstrated the ability to recruit, develop and retain exceptional talent, to innovate in the area of cost and quality control, and to establish the types of internal tools and controls necessary to drive the success of the organization. I have served in a Senior Management capacity in several organizations.