Florence Kariuki MHA, RN, FHELA
Ms. Kariuki is a nursing leader at Horizon Blue Cross Blue Shield of New Jersey, serving as Director, Clinical Design-Community Health, for the company’s Health Care Management and Transformation department. She is responsible for designing and implementing innovative clinical programs that advance health care transformation and payment reform through value-based partnerships. Among other initiatives, she has led the design and implementation of programs aiming to reduce potentially avoidable ED utilization and readmissions, increase community/home-based care, optimize care coordination infrastructure, and evolve Horizon’s palliative care offerings. She is currently leading the scale and expansion of both the Community-Based Palliative Care and Social Determinants of Health initiatives. Ms. Kariuki supports a payor/ provider integration strategy, with a consumer and community centric care coordination model, built upon the tenets of the triple aim.
Ms. Kariuki helped catalyze the development, launch, and expansion of Horizon’s value-based programs, from practice-level Patient-Centered Medical Homes (PCMH), to Accountable Care Organizations (ACO), and now larger Organized Systems of Care (OSC). She meets with and collaborates regularly with Hospital C-Suite Leadership to translate strategy into tactical execution, in form of hospital and community-based programs. She also participated in the New Jersey Healthcare Executive Leadership Academy (NJ HELA) immersion, sponsored by the MSNJ, NJHA, and NJAHP. Ms. Kariuki is also involved in organizing free community-based health fairs aimed at supporting underserved and uninsured residents, through a Faith-Based Organization.
Ms. Kariuki obtained her BSN Magna Cum Laude from William Paterson University and her MHA Summa Cum Laude from Seton Hall University. She has held previous positions as a Faculty Assistant at Seton Hall University’s Nursing Program and recently served as a publishing co-author for a graduate level Nursing Policy text book, to be published by the end of 2019. She currently serves as an External Advisory Board Member for the New Jersey Healthcare Quality Institute (NJHQI), and as a Board Member for the Health Coalition of Passaic County (HCPC). She is also serving as a Lead Faculty for the Center to Advance Palliative Care (CAPC).