Mary Ann Lee is entrusted with building profitability for the Stanislaus County Health Services Agency.

"I consider profit anything that's not red," said Lee, the agency's new director of managed care.

The 35-year-old Modesto native is responsible for negotiating contracts and developing agreements with insurers, including health maintenance organizations.

The agency projects an $8.25 million shortfall this year from within its Clinics and Ancillary Services Division, which includes nine outpatient and 12 specialty clinics. The agency deals with numerous health maintenance organizations, each with varying and complex rules involving coverages and billing requirements.

At least some of the deficit stemmed from inadequate accounting and billing practices, according to Managing Director Beverly Finley, who has developed a plan designed to make the agency self-supporting again within three years.

Lee wasn't hired specifically to address the deficit, she said.

"That would be overstating my role, but certainly I play a part in improving things here," she said. "I'm part of the solution in terms of trying to add HMO enrollment and make information available to the various departments."

The agency has contracts with National Health Plans, Kaiser Permanente, Blue Cross, PacifiCare and Blue Shield, along with other insurers including Medicare and Medi-Cal. The agency oversees outpatient and physician services throughout the county, serving more than 400,000 patients annually.

Lee brings experience on both sides of the table. Raised in Modesto, she was a National Health Plans executive before leaving to become a vice president with Cleveland Clinic Foundations.

Private health services have been dealing with managed care for more than a decade. But it's still a relatively new concept to the public agencies.

"We don't have the years and years of experience in managed care that private sector has," Lee said. "I found during my last three years in Cleveland, it was very helpful to have worked for the health plan and to understand the issues they face, to do a good job on the provider side.

Her knowledge of the managed-care industry should expedite contract talks, she said.

"It's real helpful to know what they can and can't do," Lee said. "It makes no sense to fight on something, maybe regulatory, they can't deal with. But there's also a real benefit to understanding where they can work, and going there."

Lee graduated from Beyer High School in 1981, attended Modesto Junior College and received her undergraduate degree from California Polytechnical University, San Luis Obispo. Lee lives in Modesto with her husband, David Lee, who is employed by American Distributing, and their sons Brian, 8, and Jason, 7.