Christina Kelly

Pharmacy and healthcare financial leader with 15+ years of experience spanning pharmacy operations, specialty medication economics, managed care, reimbursement strategy, financial analysis, and revenue optimization. Proven ability to analyze high-cost medication utilization and reimbursement, identify cost-containment opportunities, develop financial models, and translate complex pharmacy data into actionable recommendations for clinical, financial, and operational stakeholders. Experienced in specialty drug and infusion economics, formulary financial impact analysis, payer reimbursement models, medication utilization, denial and claims analysis, and enterprise pharmacy strategy.

Generated approximately $10M in annual medication cost savings through infusion medication coordination and free-drug program optimization while improving reimbursement performance across hospital and ambulatory settings. Strong cross-functional partner to pharmacy, finance, managed care, revenue cycle, clinical leadership, technology teams, and external vendors. Experienced in presenting data-driven recommendations and translating complex pharmacy and financial concepts for executive and operational audiences.

Revenue Cycle Operations Director at Healthrise (2025-07 – Present)

Lead enterprise initiatives focused on financial performance, operational efficiency, data analytics, and regulatory compliance across patient access, mid-cycle operations, and patient financial services.

• Lead cross-functional financial and operational initiatives using performance data to identify opportunities for revenue optimization, process improvement, and cost reduction.
• Develop and monitor enterprise performance metrics, including clean claim rate, denial rate, accounts receivable performance, and other financial KPIs.
• Collaborate with Finance, IT, Compliance, Revenue Cycle Operations, and external vendors to evaluate business performance and implement improvement strategies.
• Support strategic planning through data-driven analysis, technology evaluation, and development of actionable recommendations.
• Translate complex financial and operational information into clear recommendations for leadership and cross-functional stakeholders.

Pharmacy Revenue Integrity Manager at OhioHealth (2018-01 – 2024-12)

Directed the system-wide Pharmacy Revenue Integrity Program supporting 12 hospitals and 60+ outpatient locations, with responsibility for pharmacy financial performance, reimbursement optimization, specialty medication economics, and cross-functional pharmacy strategy.

• Generated approximately $10M in annual medication cost savings through infusion medication coordination and optimization of free-drug programs.
• Analyzed high-cost medication utilization, reimbursement, and operational workflows to identify opportunities to reduce pharmacy expense and improve financial performance.
• Served as an enterprise liaison among Pharmacy, Managed Care, Revenue Cycle, Finance, and clinical stakeholders, supporting evaluation of payer and reimbursement issues.
• Participated in the Pharmacy & Therapeutics Committee and Oncology Formulary Subcommittee, providing financial impact analysis to support formulary and medication-management decisions.
• Evaluated the financial implications of specialty and oncology medications, incorporating acquisition cost, reimbursement, utilization, and operational considerations into recommendations.
• Developed and implemented strategies to improve medication reimbursement and reduce financial leakage across hospital and ambulatory settings.
• Reduced outpatient infusion initial denial rates to ≤4%, improving claims performance and reducing avoidable reimbursement loss.
• Analyzed medication-related claims and denial trends to identify root causes, payer issues, workflow opportunities, and potential financial recovery.
• Collaborated with internal stakeholders and external vendors to implement pharmacy financial and operational improvements.
• Presented pharmacy financial and revenue optimization strategies at national and regional professional conferences.

Pharmacy Revenue Integrity Coordinator at OhioHealth (2014-01 – 2018-12)

Supported enterprise pharmacy reimbursement, medication financial analysis, payer engagement, and revenue recovery initiatives.

• Developed payer reimbursement models for high-cost outpatient medications, evaluating reimbursement performance and financial impact.
• Led medication denial analysis and payer engagement initiatives to identify reimbursement barriers and opportunities for revenue recovery.
• Analyzed medication claims and reimbursement performance to identify trends, root causes, and opportunities for process improvement.
• Supported financial evaluation of specialty and high-cost medications across outpatient and hospital settings.
• Played a key role in EHR charge validation for seven hospitals, restoring revenue neutrality within 10 days of go-live.
• Collaborated with pharmacy, revenue cycle, managed care, finance, and clinical stakeholders to improve medication reimbursement and financial performance.

Clinical Pharmacist at Riverside Methodist Hospital – 1,059-bed Academic Medical Center (2009-01 – 2014-12)

• Provided multidisciplinary clinical pharmacy services, medication therapy management, pharmacokinetic dosing, and clinical consultation.
• Developed strong clinical expertise in medication utilization, therapeutic decision-making, and specialty medication management.
• Collaborated with physicians, nurses, pharmacy leadership, and multidisciplinary teams regarding medication selection and utilization.

Doctor of Pharmacy in Pharmacy – Ohio Northern University – Raabe College of Pharmacy

Bachelor of Science in Biology – The Ohio State University