Revenue is leaking in places your reports don't show.
Denials, underpayments, and missed AR follow-ups quietly compound month over month.
Strategic Advisory · Healthcare Leadership
Built to Optimize.
Designed to Scale.
"We work with healthcare leaders when the problem isn't operational — it's structural."
Selective. Senior-led. Structurally focused.
We work with healthcare organizations where the operational fix isn't the strategic answer.
The Problem
If you're scaling a healthcare business, you already know:
The reports look fine. The team is working. The vendors are hitting their SLAs. And revenue still isn't where it should be. That's not a billing problem. That's a structural one.
Your operations weren't built to scale.
Workflows that worked at one location, one provider, or one payer mix break the moment you grow.
You don't have the data to make confident decisions.
Reports tell you what happened — not what to do, where to invest, or what to fix first.
How We Engage
Four engagements. One method.
Every engagement begins the same way — with a structural read of your revenue cycle. What follows depends on what we find, and what your organization is ready to do about it.
— One —
The Diagnostic
A 30-day structural assessment for leaders who need clarity before they commit to change. We surface what your dashboards can't — where revenue is leaking, why workflows break under scale, and which structural decisions are quietly capping performance.
For leaders who suspect the problem isn't where the reports say it is.
— Two —
The Payer Strategy Engagement
Strategic work on payer contracts, renegotiations, fee schedule analysis, and portfolio optimization. Most healthcare organizations leave significant revenue on the table not because their billing is broken, but because their payer relationships are unmanaged. We treat the payer portfolio as a strategic asset, not a back-office concern.
For leaders whose payer contracts are aging, underperforming, or coming up for renewal.
— Three —
The Advisory Retainer
Ongoing strategic counsel for organizations navigating scale, transition, or transformation. Monthly working sessions with principals. Direct access between sessions. A continuous thought partnership for the decisions that don't fit into a project plan.
For leaders making structural decisions on a rolling basis.
— Four —
The Transformation
Embedded engagement for organizations undertaking significant structural change — acquisitions, platform migrations, payer transitions, or operational restructuring. We work alongside your leadership team for the duration of the initiative.
By application. Selective availability each quarter.
A Publication of The Optivise Group
The Corporate Heist.
"A working investigation into how American healthcare actually operates — and how the system extracts what it does, from whom, and why."
The Long Con · A Column
The Original Con.
"A working investigation into how America got health insurance and forgot to ask if it wanted it."
"Most cons require a con artist. This one didn't. This one happened the way most large American disasters happen — quietly, accidentally, in a meeting nobody took good notes at, in service of solving a completely different problem."
"This is the story of how a wartime accounting trick became the operating system of American healthcare."
The Principals
Senior advisors. No handoffs.
SR
Shandee Robinson
Co-Founder · Principal
Shandee brings over fifteen years across healthcare's clinical and financial operations — five years in direct patient care across acute, post-acute, and ambulatory settings, followed by more than a decade in revenue cycle. She has worked nearly every position in the cycle, with particular depth in workflow architecture, payer contract negotiation, and high-dollar recovery.
AS
Anita Senters
Co-Founder · Principal
Anita brings nearly two decades of operational depth across internal medicine, multispecialty practice, and hospital systems. A Medicare specialist with deep experience in denials management and workflow design, she has built and led revenue cycle teams from scheduling through final payment — including practices operating at AR days under 28.
— Begin Here —
Selective engagements. Direct conversations.
We work with a limited number of organizations each quarter. If your situation calls for strategic advisory, we'd like to hear from you.
Built to Optimize. Designed to Scale.