Holly Heisler
About Candidate
Population health and program evaluation leader with 15+ years of experience improving outcomes for Medicare, Medicaid, and vulnerable populations. Expertise in chronic disease management, health equity, value-based care, HEDIS, and CMS Star Ratings performance improvement. Strong background using claims, clinical, and mixed-methods data to identify care gaps, stratify risk, and evaluate program effectiveness. Proven ability to lead cross-functional teams and translate data into actionable strategies that improve quality outcomes, member experience, and regulatory performance.
Experience working within a managed care organization (MCO) environment at an independent health plan, leading performance improvement initiatives focused on HEDIS/Star Ratings, cost-of-care optimization, and provider network performance. Applied claims and quality data to identify utilization trends, close care gaps, and support cross-functional strategies across quality, provider network, and operations teams to improve clinical outcomes and member experience.
Extensive experience supporting federal agencies including CMS, CDC, HRSA, SAMHSA, and VA, with a focus on large-scale program evaluation, performance measurement, and implementation support. Skilled in developing evaluation frameworks, logic models, and data collection strategies, and synthesizing complex findings into executive-level insights. Adept at managing multi-site initiatives and collaborating with healthcare providers, payers, and community organizations to drive measurable improvements in population health and health equity.
Holds master’s degrees in healthcare administration and public health.
Core Competencies:
- Population Health Program Management • Value-Based Care • Chronic Disease Management
- Program Evaluation • Performance Measurement • KPI Tracking • Health Equity & Disparities Reduction
- Cross-Functional Leadership • Stakeholder Engagement • Executive Reporting
Location
Education
Work & Experience
Health plan-based quality improvement role focused on CMS Star Ratings, HEDIS performance, and Medicaid/Medicare population health outcomes. • Managed end-to-end execution of quality improvement projects, including design, implementation, evaluation, and reporting aligned with federal/state quality and strategic/organizational goals • Applied claims data and HEDIS measures to identify care gaps, assess population risk, and support targeted quality improvement interventions • Contributed to initiatives impacting CMS Star Ratings, preventive care quality measures, and chronic disease management outcomes • Analyzed qualitative and quantitative data to evaluate program effectiveness and identify best practices for quality improvement and care delivery enhancement • Developed and delivered performance reporting to support regulatory compliance, quality monitoring, and organizational strategy • Engaged cross-functionally with provider groups, regulatory agencies, health plans, and community-based organizations to support quality initiatives and system alignment • Supported organizational initiatives in health equity, cultural competency, health literacy, health reform implementation, and children’s health programs
Lead design and evaluation of federal and health-related programs, translating data into strategies that improve system and population health outcomes. • Develop program evaluation frameworks, KPIs, and performance metrics for federal programs • Lead cross-functional collaboration across federal agencies and healthcare/nonprofit partners • Conduct mixed-methods analysis (surveys, interviews, focus groups, qualitative/quantitative analysis) Selected Projects: • CDC / Hemophilia Federation of America Prevention Program: As project lead, designed evaluation framework, logic models, and performance measures; assessed provider training and patient education; identified care gaps in underserved populations • U.S. Department of State PCS Modernization Study: Served as study coordinator for operational and experience assessment across 7,000+ staff; synthesized 200+ stakeholder inputs; delivered modernization roadmap
Led evaluation and implementation support for large-scale federal initiatives for CMS, HRSA, AHRQ, and NSF, focused on program effectiveness, health equity, and performance improvement. • Developed performance measurement frameworks aligned with CMS and federal reporting requirements to support program evaluation and accountability • Evaluated a $40M Learning Health System initiative across 11 Centers of Excellence, supporting clinician-scientist training and health system innovation through data-driven evaluation and reporting • Conducted qualitative and quantitative analyses to identify care gaps, disparities, and program performance trends across multi-site federal initiatives
Led evaluation and implementation of federal health programs across CDC, SAMHSA, and VA. • Designed and evaluated 20+ population health and behavioral health programs focused on chronic disease, prevention, and health equity • Conducted mixed-methods evaluation to identify disparities, care gaps, and implementation barriers • Developed logic models, evaluation frameworks, and performance measurement systems Selected Projects: • CDC Women’s Wellness Connection: Evaluated value-based screening model for cancer screening; assessed cost and quality outcomes • CDC – Million Hearts / Hypertension Prevention Evaluability Assessment: Conducted mixed-methods evaluability assessment of national cardiovascular disease prevention initiatives focused on blood pressure control and chronic disease outcomes; developed evaluation plans, data collection tools, and synthesized findings for federal stakeholders • CDC – Collaborative Drug Therapy Management (CDTM) Case Studies (Heart Disease & Stroke Prevention): Conducted multi-site qualitative case studies of pharmacist-led care models in FQHC, independent pharmacy, and retail settings; analyzed implementation barriers and facilitators for team-based chronic disease management and care coordination • SAMHSA Suicide Prevention RCT: Supported multi-site randomized controlled trial across 9 sites • VA QUERI Evaluation: Conducted qualitative evaluation using 100+ stakeholder interviews
