Susan Fleischman

Lead team of 1500 individuals across Quality, Utilization Management, Care Management, Pharmacy, Behavioral Health, and Medicaid Key accomplishments: ● Initiated the first-ever Clinical Strategy for Blue Shield of CA Health, establishing governance and processes for ongoing strategy refinement. ● Directed establishment of new Population Health program, enhancing Medicaid services throughout California. ● Achieved Health Equity Accreditation for Covered California ● NCQA re-accreditation ● Developed and mentored medical leaders to ensure seamless leadership transition upon retirement. ● Led development of RFP for complex longitudinal care vendor, through vendor choice and implementation replacing prior vendor with Concerto Care. ● Co-developed with CIO a first-of-its kind innovative care management platform with Sales Force, leveraging Cloud technology to optimize care delivery.

Key accomplishments: ● Guided Promise Blue Shield of California through successful state Medicaid audit, showcasing expertise in regulatory compliance and program support. ● Assumed role of Interim Chief Medical Officer at Blue Shield Promise, leading to permanent executive position due to demonstrated leadership and strategic management.

Key accomplishments: ● Grew membership from 260K to 1M members. Spearheaded entry into Medicaid markets in two new states. ● Developed and executed a national strategy to retain members during Affordable Care Act Medicaid expansion. ● Established robust Medicaid infrastructure, comprising call center, website, and compliance teams, facilitating efficient service delivery and regulatory adherence. ● Developed partnerships and shared best practices to improve healthcare outcomes for Medicaid super utilizers, contributing to system-wide enhancements in care delivery. ● Directed subsidized healthcare products and traditional charity care, ensuring comprehensive support for low-income members outside of public program eligibility

Western Regional Medical Director State Sponsored Business Medical Director in the State-Sponsored Business unit which served over 1.5 million members in Medicaid and Children’s Health Insurance Program in multiple states. • Supported growth, new business development and entry into 5 new states with 200,000 new members within two years. • Provided business and medical leadership and oversight to the successful transition of California’s County Medical Services Program (CMSP), which transitioned indigent adults in 34 rural counties into managed care. • Supported network development and ongoing relationships with contracted physicians and Federally Qualified Health Centers. • Supported development of medical policy and guidelines. • Provided clinical oversight for utilization management and care management. • Identified need, developed and implemented first Pay for Performance program for State Sponsored Business. • Implemented and strengthened the grievance and appeals process for State Sponsored Business through the active pursuit of quality of care issues.

Medical Director and Physician Director of Medical Services at the Venice Family Clinic in Los Angeles, the largest free clinic in the United States. The clinic provides health care services to low-income, uninsured individuals and families, including the homeless. Supported: • Expansion of the clinic from a storefront organization to a multisite network of clinics providing 100,000 visits annually. • Created a service delivery system funded through a complex network of public and private payers, grants, and in-kind services. • Takeover of county healthcare facilities by private entities, leading to creation of the LA Public-Private Partnership (PPP). • Receipt of the Pew Primary Care Achievement Award in recognition of the Venice Family Clinic’s excellence in primary care. Provided testimony to numerous governmental agencies and committees including Congressional Breakfast on the Healthcare Crisis in Los Angeles County, California State Senate Committee on Health and Human Services, California State Senate Insurance Committee, City of Los Angeles regarding healthcare access and issues of the uninsured.