Darryl L.
Executive Healthcare Operations Director
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Darryl L. is a seasoned professional with over 25 years of success in the healthcare industry, specifically in managing and innovating health plan operations and provider practices. As a Director of Operations, he has guided cross-departmental teams at leading organizations like United Healthcare, Aetna, and CINQCARE INC, focusing on developing innovative solutions for Medicaid and Medicare health plans. Darryl is adept in Health Plan Operations, driving initiatives that enhance member experience and operational efficiency. At CINQCARE INC, he excelled as the SE Region Business Development & Operations Manager, leading growth and process improvement initiatives while consulting with operational staff and clinical teams to enhance member outcomes. During his tenure at United Healthcare, Darryl led a provider referral program saving significant costs annually. His expertise in Value-Based Care Models, ACO REACH Administration, and project management has been instrumental in advancing health care service quality and financial performance. Darryl holds a Master's degree in Human Services from Lincoln University and a Six Sigma Green Belt certification.
Experience
SE Region Business Development & Operations Manager
CINQCARE INC · 2022 — 2025Provided operational leadership and guidance to employees while aligning strategies with corporate goals to improve protocols and maintain high-quality primary care for vulnerable populations. Led initiatives in growth, process improvement, and marketing. Advised operational staff and clinical teams on enhancing business practices and implementing procedures, establishing repeatable processes aimed at improving member health outcomes. Played a pivotal role in business development and operations related to provider practices and community engagement. Acted as the primary liaison for provider practice operations concerning ACO REACH program administration and reporting. Directed operational implementation and process enhancements in collaboration with the clinical team to improve care engagement and service performance KPIs. Supported provider recruiting, vendor oversight, and specialized project initiatives. Oversaw inbound and outbound call center activities to boost member engagement and satisfaction.Director, Operations & Performance Alignment
United Healthcare · 2016 — 2019Delivered executive-level leadership and set strategic direction for enhancing business systems and technologies employed in managed care product delivery. Monitored operational performance across the health plan while identifying emerging customer needs and driving innovative solutions. Engaged in developing growth strategies and acquisition plans. Initiated a provider referral program that led to significant annual savings for the Rhode Island Health Plan. Launched teams focused on benefit setup and system configuration for Rhode Island and Delaware markets. Served as a Subject Matter Expert, bridging operations tasks with corporate strategies and regulatory requirements.Director, Service Operations
Aetna · 2013 — 2016Managed high-performing teams within the Member Service Call Center, Enrollment, Claims, Complaints, and Grievance sectors across Pennsylvania. Took responsibility for overseeing all member complaints, grievances, encounter submissions, and claims processing activities for the health plan. Directed operational initiatives that resulted in an increased acceptance rate of claim encounters. Implemented strategic plans to enhance member satisfaction scores within the Member Service Call Center. Utilized market insights to boost CHIP program enrollments significantly.Director of Operations Support
Health Partners Plans · 2000 — 2013Conducted comprehensive research, planning, project management, and operations support across various departmental levels while managing a $1.5M budget across three operational cost centers. Led a team that provided essential project management and support services encompassing claims processing, member services, and strategic initiatives. Successfully transitioned claims processing operations from an external vendor to in-house processing, resulting in efficient payment timelines and considerable annual savings. Spearheaded projects that introduced new Medicare lines of business. Developed and enforced operational procedures and performance audits for various departments, including the Medicaid and Medicare member service call centers.
Skills & Expertise
Education
- Master of Human ServicesLincoln University
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