Earnest Farley.
Services

Not a menu of everything.

Six areas where the capability has been built more than once, the results documented, and the method named. Each service below is something already delivered in a named organization, with a number attached. The point is not that these are things I could do. It is that they are things that have been done, repeatedly, and are built to be done again.

Practice 01

Operations Performance & Turnaround

Governing proof: A $7M operating loss turned to a 22% positive margin in 12 months (HCTec, $41M division), and $17.5M in annual savings across 22 consolidated service lines (Prisma).

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  • Margin turnaround and P&L recovery

    Full financial turnaround of an underperforming division through the Global Operations Model.

    $7M operating loss to 22% positive gross margin in 12 months, all financial targets exceeded · HCTEC

  • Service line consolidation and shared-services design

    Consolidate fragmented functions into a unified shared-services division with a governance council.

    22 service lines consolidated for $17.5M annual savings, governed by a council of 18 hospital CEOs and CNOs · PRISMA

  • Contract methodology and scope-creep remediation

    Forensic contract analysis, standardized evaluation protocol, and pricing safeguards.

    $3.5M in annual uncompensated work eliminated; renewal gross margin up 15 points · HCTEC

  • Cost-to-serve reduction

    Structural cost takeout without quality loss.

    Operating costs cut 24% ($3.1M) · PRISMA; $8M annual reduction via SaaS operating-model transition · CERIDIAN

  • Workforce management and capacity modeling

    Interval-based staffing, demand forecasting, and skills-based scheduling.

    97% service level via NICE IEX; provider capacity up 23% via EPIC and Kyruus redesign · PRISMA

  • Value Management Office and benefit realization

    A formal structure that holds promised savings accountable after the project ends, using the VMO + RAPID decision framework.

    $22M in committed benefit tracked; implementation time cut 35% · PRISMA

  • Scaling under pressure

    Build the operating infrastructure a fast-growing unit has outgrown.

    80 to 750+ employees with a top 90th percentile KLAS rating, 4th of 25 providers · HCTEC
Fit: PE-backed healthcare services, health systems with underperforming support operations, divisions carrying an unmanaged P&L.
Practice 02

Contact Center & Service Operations

Governing proof: An NPS turnaround from -52 to +20 across a 1,000+ person operation spanning the US, Mauritius, and India, with average handle time cut 98% (Ceridian).

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  • Contact center transformation

    Rebuild a struggling center into a rapid-response operation through the Rapid Response model.

    Response time 2 hours to 90 seconds; NPS -52 to +20 across 4,000+ enterprise customers · CERIDIAN

  • Skills-based routing and call-flow engineering

    Match interaction complexity to representative skill, then re-engineer queuing and handle times.

    First-call resolution 40% to 90% · CERIDIAN; 78% to 98% with speed of answer cut from 5 minutes to 2 · HCTEC

  • Onshore and offshore model design

    Cost-benefit case, transition plan, and privacy architecture for a blended workforce.

    Offshore scaled to 250 employees for $4.5M annual savings · CERIDIAN; PHI removed from the offshore equation, coverage expanded to nearly 24 hours · FRACTIONAL

  • Telephony and workforce optimization

    Value-map the full interaction so software friction stops consuming capacity.

    Interval-based staffing and call-flow redesign treating the software itself as a staffing decision · FRACTIONAL

  • Clinical contact center and nurse triage

    Stand up evidence-based triage and care-management operations.

    A 75-RN clinical contact center within 15,000+ daily interactions across voice, digital, and in-person channels · PRISMA

  • Predictive dialing and outbound optimization

    Deploy outbound technology and data-driven targeting.

    Five9 predictive dialing: 35% productivity gain, 28% higher program participation · CHANGE HEALTHCARE

  • New-agent ramp compression

    Turn senior expertise into knowledge articles and training so ramp time collapses, through Cultural Currency.

    Development cycle cut 75%, one year to 90 days · HCTEC
Fit: Contact centers that have become the complaint department, multi-site or multi-country service operations, businesses where an unanswered call is lost revenue or delayed care.
Practice 03

Customer Success & Client Retention

Governing proof: 75% of at-risk contracts retained (28% of revenue) through an on-site customer success model (HCTec), and 100% retention of top-tier at-risk customers (Ceridian).

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  • Customer success function build

    Define the CSM role from scratch: responsibilities, metrics, QBR cadence, and account plans, on the On-Site CSM model.

    75% of at-risk contracts retained; $6.6M in new business from six enterprise clients · HCTEC

  • Account health and risk-score systems

    Data-driven early warning that predicts churn before it shows up in a renewal, via the Customer Risk Score.

    100% top-tier at-risk retention with a Rapid Resolution concierge team · CERIDIAN

  • Strategic account rescue

    Turn a failing marquee account around with an ROI-backed remediation plan.

    $47.5M in recoverable revenue surfaced (Aetna); $13.2M capitation recovery (Affinity Plan of New York) · CHANGE HEALTHCARE

  • Executive QBRs and vendor governance

    Governance structures that align vendor incentives with client financial and quality goals.

    95% renewal rate with performance exceeding SLA targets by 13% · CHANGE HEALTHCARE

  • Revenue expansion from existing accounts

    Productize excess capacity and cross-sell into the installed base.

    $1.3M in recurring revenue from productized answering-service and after-hours nurse capacity · PRISMA
Fit: Services and technology businesses with concentrated revenue in a few large accounts, organizations with high logo churn, health-tech companies scaling a customer base faster than their success function.
Practice 04

Technology, AI & Clinical Adoption

Governing proof: A 67% versus 46% AI drafting recommendation gap across 1,200+ radiologists (Mosaic), and 87% physician adoption versus a 55% industry average on a $25M platform integration (Prisma).

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  • Physician and clinician AI adoption

    Drive adoption in a professional population no one has authority over, using Behavioral Architecture: structural-barrier triage, behavioral change methodology, and a practice-aligned champion model.

    67% versus 46% recommendation gap between AI-drafting and reporting-only radiologists, documented as the platform's commercial argument · MOSAIC

  • Platform migration under deadline

    Move a clinical population off a legacy system without a safety event.

    Full legacy voice-recognition migration on hard contract deadlines, zero patient safety incidents; 698 radiologists deployed against a 500 target · MOSAIC

  • CRM and EHR integration

    Integrate customer and clinical systems for a single operating view.

    $25M Salesforce-EPIC integration: 30% efficiency gain at 87% physician adoption versus a 55% industry average · PRISMA

  • Machine learning and predictive operations

    Build models that pre-empt operational failures.

    Escalation-prediction model at 98.5% recall versus a 41% benchmark: $46,650 annual cost avoidance, 420% ROI, 147-ticket backlog eliminated, triage effort cut 79% · MOSAIC

  • AI governance and security review

    Package the security and compliance case that gets clinical AI through a health system's gate.

    A 47-question hospital security package with Covered Entity framing, built as a reusable company template · MOSAIC

  • Digital self-service deployment

    Deploy AI-powered self-service that lowers cost and lifts engagement.

    NICE CXone and Genesys self-service: direct labor cost down $3.5M, patient engagement up 40% · PRISMA
Fit: Health-tech companies stalled on clinical adoption, imaging networks and radiology practices, health systems deploying AI into physician workflows.
Practice 05

Value-Based Care, Population Health & Patient Experience

Governing proof: A 42% readmission reduction and $12.5M in population-health benefit (Prisma), and program participation raised from 16% to 55% across 500,000+ covered lives (SHPS).

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  • Population health program design

    Build condition-specific programs and the operations to run them at scale.

    CAD, CHF, diabetes, asthma, and maternity programs across 500,000+ covered lives; participation 16% to 55% · SHPS

  • Behavior-based engagement and outreach

    Cialdini's influence principles and Prochaska's stages of change applied as working instruments, not book-club references.

    Predictive direct-marketing outreach lifting contact rates 45% · TT&W; SSI conversion raised 30% · CHANGE HEALTHCARE

  • Readmission reduction and risk stratification

    Target the highest-risk populations with the interventions that move the number.

    42% readmission reduction for Dual Eligible patients, worth $12.5M in benefit · PRISMA

  • Patient experience transformation

    The C.A.R.E.S. Framework: an omnichannel experience model built on behavioral science.

    Patient satisfaction 55% to 82%, CSAT above national benchmark · PRISMA; satisfaction above 90%, surpassing the VHA national average · VALOR

  • Access optimization

    Redesign scheduling and capacity so patients get in faster.

    Primary care wait 27 to 12 days, specialty referral 18 to 2 days, no-shows 22% to 7% · PRISMA; patients seen per hour 2.5 to 4 for a $4M revenue gain · VALOR

  • Capitation and revenue recovery

    Recover revenue left on the table in risk-based and government programs.

    $13.2M capitation recovery (Affinity Plan of New York); $47.5M in recoverable revenue demonstrated (Aetna) · CHANGE HEALTHCARE
Fit: Health plans and risk-bearing providers, Medicare and Medicaid programs, employers with 500,000-covered-lives-scale populations to move.
Practice 06

Fractional & Interim Operating Leadership

Governing proof: The most recent fractional engagement converted to a permanent executive role. The client built a role to keep the work, which is its own reference.

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  • Interim operating leadership

    A senior operator inside your organization on a time-boxed basis, at SVP or COO altitude, owning a P&L and a mandate.

  • Turnaround leadership

    Drop-in leadership for a division or function that is losing money or losing clients, working from the named models above rather than improvising.

  • Post-merger and acquisition integration

    Integrate acquired operations and clinicians without disrupting the base.

    M&A integration of 400 physicians across 95 sites with zero client disruptions · MOSAIC, ENVISION ACQUISITION

  • Operating model and governance design

    Build the shared scorecards, decision rights, and escalation tiers that make clinical and operational teams answer to one set of numbers: the One Scorecard principle.

  • Diagnostic sprint

    A fixed two-to-four-week on-site assessment that names the two or three structural problems worth solving and returns a roadmap. Diagnosis happens on the floor, not in the conference room.

Fit: PE-backed healthcare services companies, growth-stage digital health, health systems bridging a leadership gap.
Read two fractional engagements in full →
How to buy

Four ways in. One standard throughout.

Diagnostic Sprint

Fixed two-to-four weeks. On-site assessment, findings, and a prioritized roadmap. The lowest-commitment way to start and the natural entry point for any practice above.

Project Engagement

Defined scope, a named model, and milestone-based delivery. Best for a specific turnaround, consolidation, migration, or program build.

Fractional Retainer

A part-time senior operator on a monthly basis, embedded in the leadership team. Best for organizations that need the altitude without the full-time seat.

Interim Executive

Full-time, time-boxed leadership through a transition, a turnaround, or a search.

How engagements run

Diagnose. Build. Prove it holds.

01 · Diagnose

A short, fixed-scope assessment: where clinical and operational accountability actually sit, what the numbers say, and which constraint is structural versus behavioral.

02 · Build

The engagement itself: governance, operating cadence, adoption architecture, or turnaround execution, with your team doing the work alongside me so the capability stays.

03 · Prove it holds

The 90 for 90 standard applies to my own work: an engagement is complete when the key metrics hold for 90 consecutive days, not when the report is delivered.

Start with a conversation, not a contract.

Tell me what is not performing. I will tell you honestly whether I am the right person for it, and if I am not, who might be.

Get in touch

earnestfarley@gmail.com · 678.221.4217 · linkedin.com/in/earnestfarley