Dorien M. Rawlinson
Cell: (303) 981-4032
Larkspur, Colorado 80118 Home: (303) 681-3560
SUMMARY OF QUALIFICATIONS
Independent, results-oriented healthcare executive with more than 20 years experience in various areas
of research, insurance, health administration and public health policy. Skills and expertise include:
Public Health Policy Product Development, Project Management
Healthcare Operations Management Grantsmanship, Academic Medicine
Strategic Planning and Implementation Human Capital Acquisition, Personnel
Healthcare Compliance and Regulation Training, Peer mentoring
Contract Negotiation and Administration Clinical Research Trial Administration
2008 - 2012 University of Colorado Denver, School of Medicine
Research, Grants and Finance Manager, Department of Orthopaedics
Responsible for Grant applications, contracts, award management, Clinical Trial
administration, industry and sponsor relationships, financial management, procurement,
HR and payroll in an Academic setting.
Submitted over 60 grant applications totaling 12 million dollars in requested funding during the
2011 fiscal year.
Award management of 7 clinical trials, 4 research awards and 13 resident and fellowship
educations awards, total grant award income for current fiscal year of approximately $2.4 million.
Develop and manage relationships with industry sponsors and peer organizations and charitable
Oversee clinical trial standard operating procedures, IRB management and internal audits
Serve as purchasing, procurement, travel system liaison and authorizing official.
Departmental account reconciliation and close out of grants, AEF funds, and donations.
Project Management and fiscal guidance for annual Golf Tournament and CME programs.
2003 - 2008 Rocky Mountain Health Management Corp. dba Rocky Mountain Health
Director, Front Range Provider Administration
Responsible for Managed Care, Medicare, and Self-Funded provider networks and
professional relations on the Colorado Front Range. Including contract negotiation and
service for over 2000 physician, IPA, ancillary and hospital provider agreements for the
eastern half of the state, as well as all ancillary contracts for the entire state.
Completed strategic network negotiations, allowing the opening of Colorado service areas in both
Metropolitan and rural areas.
Negotiated complex hospital network negotiations that resulted in an 8-10% hospital cost savings
for my area of responsibility.
Implemented a robust self-funded network provider along with specialized marketing tools to
provide group-specific network and cost analysis.
Established service metrics and personal accountability models for the Department
Identified and implemented operational changes including reimbursement methodology changes
Served as Business champion for E-Health Initiative in 2006.
Lead product development efforts including introduction of partially self-funded products,
dependent coverage plans, and revised dual option pricing.
Member of Corporate Steering, Legislative Advisory, Fraud and Abuse Committees.
Rawlinson, Dorien M.
2001 - 2003 State of Colorado, Department of Regulatory Agencies
Health Policy and Research Analyst, Division of Insurance
Responsible for Health Policy and research activities as a part of the Commissioner’s
Office. Responsibilities included facilitation of health policy decisions, recommending
actions to improve the access and affordability of health care, active participation in the
legislative process, development of rules, bulletins and position documents representing
Managed regulatory policy and procedures for Division including oversight of the Health Policy
Advisory Committee and cooperative work with the Attorney General’s office.
Chaired committees overseeing small group laws, basic health benefits plan, and network
Implemented privacy standards as a result of Gramm-Leech-Bliley Act, HIPAA.
Investigation of unauthorized entities, illegal insurance activities and review of market conduct
examination protocols and reports
Involvement in national health policy development through NAIC, interface with local CMS
officials, CHP+ Evaluation Working Group, and the Health Academy.
Served as key representative in outreach programs including speaking engagements, media
responses, and writing articles for state publications.
Appointed to Total Compensation Advisory Committee – State of Colorado Employee Benefits
1999 - 2001 UnitedHealth Group, UnitedHealthcare of Colorado
Responsible for oversight of Integrity and Compliance Program for the health plan,
including preparation, management and corrective actions for market conduct
examinations, ongoing monitoring and auditing, drafting filing and implementing new
policy forms, regulatory reporting, analysis and risk management.
Managed regulatory examinations including market conduct, financial, quality examinations
Oversaw Business Contingency Plan, Safety Committee and Disaster Recovery Plan
Contract and Policy form development, filing, implementation and related audit activities
Statutory and Regulatory interpretation and analysis
Risk Management including assessment, monitoring and auditing. Findings reported through
corporate legal department
1993 - 1999 Rocky Mountain Administrative Services Company (RMASC)
Blue Cross Blue Shield of Colorado, Nevada, and New Mexico ( now Anthem BCBS)
1997- 1999 Compliance Director – BlueCross BlueShield of Colorado and HMO Colorado, Inc
Responsible for development and design of an integrated compliance program for the
Colorado Market Business Segment. Evaluated prior compliance process to determine
strengths and weaknesses in order to develop a new program approach that integrated
business operations with the legal counsel and product development.
Established standards, templates, and training programs for company compliance
Audited critical compliance-related business risks, managed state market conduct examination
Worked with industry and regulatory groups to negotiate new legislation/regulation
1995 - 1997 Project Manager, Product Development – Strategic Services Division
Responsible for development and implementation of products and strategic initiatives for
Colorado, New Mexico, and Nevada, as well as RMASC subsidiaries
Managed the development and implementation of the BlueAdvantage product line which helped
increase the company’s enrollment to the highest ever reported
Managed the physical consolidation of business operations for the Colorado and Nevada plans
Rawlinson, Dorien M.
1993 - 1995 Manager, Customer Service – Health Management Services
Managed customer service and special projects for a national dental administrator.
Trained and supervised customer service representatives in two locations to ensure excellent
service to customers in nine states. Project manager or participant in various strategic initiatives
and new business implementations
Improved customer service outcomes to meet all service metrics and decreased call volume
through improved first call techniques
Project manager for new client implementation for plans in Virginia and Washington
University of Colorado Denver – Denver, Colorado
Colorado School of Public Health – Aurora, Coloroad
Health Services and Management Program
Certificate of Public Health Sciences Candidate, MPH candidate
Northern Arizona University – Flagstaff, Arizona
School of Health Professions
Bachelor of Science, Health Services Administration and Business Management
Founder, Leadership in Healthcare Policy, Research and 2012 - Present
Compliance in the Greater Denver Area
Colorado Women’s Forum in Health Care 2009 - Present
Vice President, 2011
Acting President, 2012
University of Colorado Denver 2010 – Present
MBA- Health Administration