Melanie Hobbs, BSN, RN, LSSGG
Associate Principal
Indianapolis, IN
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Melanie Hobbs is an accomplished healthcare executive, consultant, and thought leader specializing in Medicare, Medicaid, and Special Needs Plans (SNPs). She has deep industry experience in Medicare/Medicaid managed care product innovation and development; Medicare/Medicaid clinical strategy and implementation; clinical program, product planning and operational design; and regulatory, compliance and public policy.
Melanie has a successful track record of leading strategic integration and enhancement of clinically complex government programs ensuring state and federal requirements are met and analyzing and creating implementation strategies for Medicare, State Medicaid Agency Contracts (SMACs) and two- and three-way contract requirements. She developed strategies and outcomes to improve care management of Medicare/Medicaid members through clinical model design and positively impacted Medicare Advantage Star and Medicaid quality performance. She also developed and executed Model of Care design and outcome performance measure strategies to impact financial and clinical outcomes.
Most recently, Melanie led clinical strategy and innovation of Aetna’s clinical special needs plans (SNP) programs through significant dual-eligible special needs plan (D-SNP) expansion, expanding from three states to over 30 states and from 20,000 members to more than 200,000 in less than four years. She successfully led the redesign of the plan’s D-SNP Health Risk Assessment by incorporating social determinants of health (SDOH) and other questions to optimize predictive modeling and risk stratification, created member-centric language for ease of self-administration, and worked to design various modalities for administration; achieved CMS three-year SNP Model of Care approvals for all contracts, created a new approach to oversight of the plan’s SNPs and designed and oversaw the development of tools to support formalized clinical reporting outcome metrics. Prior to joining Aetna, she was a director with UnitedHealth Group where she led clinical implementation for Medicaid, Group Retiree, and SNP products specializing in complex business implementations, expansions, system migrations, and process alignments.
Melanie has held leadership positions in Ascension and Centene Corporation. At Ascension, she led a comprehensive public policy approach to hospital and system level activities to maintain the most favorable environment for St. Vincent Health and its ministries including systematic assessment of relevant local, state, and federal public health policy issues. She performed data analysis to pinpoint opportunities and prioritize initiatives and assessed and analyzed legislative industry and competitive trends and implications.
At Centene Corporation, she led daily operations for a statewide Medicaid organization and led oversight of health plans, vendors, and subcontractors through departmental monitoring, analysis, and action planning. She ensured staffing, budget, and planning of strategic goals to meet internal/external standards and served as the liaison to the state of Missouri for contract compliance, plan reporting, inquiries, and legislation.
Melanie earned her bachelor’s degrees in nursing and business administration from the University of Indianapolis and her lean six sigma from Purdue University. She is also working towards a Master of Science in legal studies through Indiana University’s Conrad Maurer School of Law.
She enjoys boating and outdoor activities; spending time with family, friends and her two mini goldendoodles; and learning to play guitar.