Vice President of Payer Solutions
Kevin Nielsen entered the healthcare space in 2003 when he saw his health insurance rates climbing much faster than his paycheck and decided to be part of the solution. In his first Blue Cross Blue Shield role, he ran the Medical Cost Action Program targeted at cost savings initiatives across provider contracting, medical management, and product innovation. Throughout the next eleven years, Kevin oversaw and led projects and process improvements across the entire health plan spectrum including the ICD-10 code conversion, pharmacy benefits manager implementations, standing up the qualified health plans for the Affordable Care Act, and developing the provider accountable care organizations (ACOs) and related value-based arrangements. Kevin partnered with providers to develop a comprehensive dataset to enable them to manage their populations and the reports that tracked their progress and opportunities. Working with providers he oversaw provider contracting, provider data management, network adequacy analysis, fee schedule analytics and management, value-based contract performance, and provider network compliance activities. Kevin oversaw cost savings of more than $40 Million in his last year at the Blue Cross Blue Shield plan through the relentless study of medical cost and identifying opportunities that both saved money and improved the quality of care for health plan members. Kevin has an undergraduate degree in Mechanical and Aerospace Engineering, a Six Sigma Blackbelt certification, and holds a Master’s in Business Administration.
Kevin leads the solution development focused on bringing a competitive advantage to health plans and health insurers in the provider data space. HealthLink Dimension’s payer solutions are dedicated to improving the healthcare industry for health plans and their members.