Candace Gilbert

Built and led an 8-person Health Economics team, establishing the enterprise ROI methodology for medical cost initiatives and advising executive and operational leaders on medical cost performance. Directed a claims integrity and recovery program that recovered $5M-$18M annually and led the transition from Excel-based analytics to Snowflake with AI-supported coding.

Led 5 finance managers through monthly P&L reporting, financial close, and planning while concurrently leading Health Economics. Partnered with Regional Presidents to translate enterprise strategy into financial, operational, and data-driven priorities.

Led analytics and strategic planning for Network and Specialty Care, co-developing an in-house specialty care strategy and establishing the financial and medical cost framework for the program.

Led a team of 6 directors and 70 indirect reports, delivering market action plans across 5 states. Drove $5M in savings through a medical cost accountability process and supported 150% year-over-year enrollment growth.

Led a cross-functional organization of 8 direct and 85 indirect reports, centralizing the enterprise referral function and reducing medically unnecessary referrals by 50%. Executed a 6-month turnaround strategy generating $6M in savings.

Served as strategic partner to the President across Operations, Sales, Facilities, Credentialing, and payer contracting. Led enterprise initiatives for member retention, PPO growth, and change management.

Led a team of 10 analysts and medical economics managers delivering enterprise medical cost and operational analytics. Built organizational analytics capability and supported the MSO department's consulting services to approximately 20 external practices.

Delivered medical cost and operational analytics across four markets, advising approximately 50 physicians and market/corporate leadership to translate data into cost-management and performance-improvement strategies.

Developed commercial strategies and secured four major hospital accounts while managing and expanding a five-state territory for a medical device company. Served as a scientific and clinical resource to physicians.

Postdoctoral fellowship in breast cancer research at the University of Miami Sylvester from 2011 to 2012.

Ph.D. in Brain Cancer Biomedical Research from the University of Massachusetts Medical School from 2005 to 2011.

Bachelor of Science in Biology from the University of Florida in 2004.