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Work Background
AMS (Advanced Medical Strategies)Director of Product
Jan. 2024Spearheaded daily product management for a suite of payment integrity solutions, defining comprehensive requirements and managing stakeholder engagement for scaling, KPI alignment, and operational excellence across the development lifecycle. Definition, testing, and implementation of innovative internal and external products. Connectivity with cross-functional teams, including clinical, customer success, sales, and marketing to drive product success. Maintaining crucial link with high-value clients, ensuring products align with their needs and expectations. Championed software product capabilities and scaling, relaying market-oriented product benefit storytelling to internal and external stakeholders, enhancing product adoption
AtheneumExecutive Consulting Partner
Jul. 2023 - Dec. 2023Engaged partner in consulting leveraging blend of strategic leadership, operational excellence, technical expertise, and healthcare industry insight to provide valuable guidance to clients in the healthcare technology sector. Demonstrated ability to navigate through complex technological landscapes, driving innovation and operational efficiency in the rapidly evolving healthcare sector while leading high-performing teams to achieve a consistent increases in operational efficiencies Advised expertise in consumer experience management and operations, coupled with deep understanding of Medicare/Medicaid systems, affording knowledge on both strategic and practical aspects of healthcare technology
AlphaSightsExecutive Client Consulting Specialist
Jul. 2023 - Dec. 2023Executed analysis, review and consultation as a healthcare technology executive relaying keen abilities navigating through complex technological landscapes, driving innovation and operational efficiency in the rapidly evolving healthcare sector. Communicated expertise in executing Agile and Lean transformations, reducing time-to-market for new products, and fostering cross-functional collaboration. Exercised unique skills in translating complex technical concepts into actionable strategies coupled with experience in leading initiatives for cloud infrastructure optimization and data analytics as a forward-thinking technology leader.
HumanaDirector of Consumer Experience & Agile Product Life Cycle Management
Jun. 2022 - Jun. 2023Remote, United StatesInitiated Agile & Lean portfolio management for entrepreneurial innovation and modernization efforts, to nurture launch of new products and overall strategy from conceptualization to implementation. Guided teams in modernization and the creation of a new operating model focused on establishing sustainable value through strategy alignment and focused enterprise enablement. Pioneered with IT and Health Plan leaders, achieving 90% of value, timeline, and quality goals, and ensuring the alignment of business strategies. Drive and support integration and collaboration across project teams including meticulous strategic development, planning and project management across business owners, product managers, scrum masters, IT product managers and Enterprise Architecture. Revitalized the implementation and scaling of quality and operations excellence programs, reducing production costs by 40% and operational efficiency by 50%.
HumanaDirector of Consumer Experience & Operations Management
Jun. 2019 - Jun. 2022Louisville, Kentucky, United StatesSpearheaded the implementation of an innovative SAFe/Agile framework strategy in a matrixed organization, leading a multidisciplinary team in end-to-end execution, maintenance, and enhancement of a new Medicare health plan highlighting the service operations functions of: Billing & Enrollment - Founded cross-functional teams executing enrollment, billing, and payment processes performing member interactions, health plan onboarding, product build, and payment activities, streamlining processes improving premium billing efficiency by 30%. Provider Contracts Installation & Pricing - Managed Provider Contracts Installation & Claims Pricing, ensuring network integrity and accurate pricing, leading to a 20% reduction in contract errors and increased provider satisfaction executing payment methodologies for successful claims processing; managing teams overseeing high touch risk-based contract negotiations, performance, payments and P&L of markets valued from $100-$300 million. Grievances & Appeals -Nurtured strong relationships with payer, plan senior leadership, and care management teams leading initiatives focusing on state and federal CMS compliance, achieving no less than 98% compliance. Process & System Optimization - Capturing baseline operating procedures and synthesizing data and direct feedback to identify and address needs and gaps.
UnitedHealthcareDirector of Southeast Region Provider Data & Strategic Partnerships
Jan. 2018 - May. 2019Remote, United StatesDirected the go-to-market strategy and implementation of a provider data attestation product, resulting in a 25% performance improvement. Innovated ROI investigation for product expansions, utilizing market research, financial modeling, and competitive analysis to identify $15M in latent revenue streams, driving strategic decision-making for the company. Employed process improvement evaluations and analysis, achieving a 30% reduction in operational costs.
UnitedHealthcareRegional Manager of Provider Data & Analytics
Jan. 2017 - Dec. 2017Remote, United StatesStewarded team of 20 provider data attestation personnel in all activities related to product for provider network database maintenance, reporting, and quality assurance for 7 States within southeast region. Engaged in effective time management and organizational skills to conduct regular audits on processes and performance related to provider data helping reduce errors by 10% or more as a result. Developed and maintained database integrity standards as well as corrective actions and process management activities improving quality of data with a 75% or greater accuracy rate.
UnitedHealthcareSenior Provider Relations Advocate & Customer Relationship Management (CRM) Expert
Jun. 2014 - Jan. 2017Orlando, Florida AreaInitiated identification and remediation of operational shortfalls through research and analysis of network composition and distribution of specialties resolving 95% of claims issues. Implemented provider education initiatives, resulting in a 30% reduction in claims denials and a 25% improvement in ease of use and access to account receivables. Led cross-functional team in the design and implementation of innovative provider relations initiatives; streamlined communication channels, resulting in a 40% improvement in issue resolution time and a 15% increase in provider retention. Directed strategies relating to the development and management of a provider network, including identifying gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. Provision of end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs.
Independent ConsultantPrinciple Consultant in Management Consulting & Digital Strategy
Feb. 2014 - Feb. 2017Orlando, Florida AreaConducted comprehensive organizational analysis and evaluation, identifying operational inefficiencies and opportunities for growth resulting in a 20% reduction in production costs and 15% increase in overall productivity. Orchestrated project management initiatives in connection with large-scale clients and vendors such as Huron, Deloitte, and Ernst & Young, solidifying revenue streams and fortifying program structures resulting in a 20% decrease in company expenditures. Provided leadership to and coordinate the company’s efforts to increase market breath and penetration, acquire and disseminate new technologies and practices and increase shareholder value through mergers and acquisitions.
Orlando HealthSenior Operations Analyst Specializing in Purchasing & Contract Negotiation
Feb. 2012 - Jan. 2014Orlando, Florida AreaSpearheaded comprehensive administration and analysis of GPO contracts for pharmaceuticals, surgical materials and hospital pricing agreements, resulting in the identification and elimination of non-value-added services, saving the company $1.5 million annually. Designed and implemented an M&A strategy to identify new market opportunities and acquire companies with complementary capabilities; executed two strategic acquisitions, resulting in a 25% increase in customer base. Management of comprehensive projects and initiatives driving progressive institutional quality standards contributing to several million dollars in cost savings annually as well as detailed business analytics in comprehensive and complex formulation.
Orlando HealthGrants Manager with Focus on Development & Customer Experience
Jan. 2010 - Feb. 2012Orlando, Florida AreaManagement and oversight of federal, state, and private grants & contracts including financial, budgetary and revenue administration. Assessment of local, state, national foundation and corporate initiatives as they relate to healthcare funding opportunities including the establishment of strategic objectives as well as the evaluation of philanthropic activities for the execution of process improvements. Providing primary forecasting and reconciliation for all awards while closely working with PIs to develop grant and contract submissions through RFP analysis. Analysis for account set up and recommendations to ORA, in order to appropriately manage new awards in accordance with sponsor requirements. Preparation of multiple complex and varied financial reports (including ad hoc reports) that require selection, preparation, and interpretation of data using complex data query tools and budget preparation.
Orlando HealthBusiness Manager Specializing in Leadership & Business Strategy
Jan. 2008 - Jan. 2010Orlando, Florida AreaAdministrative leadership and strategic planning regarding hospital operations including admission forecasting, care management assessment, market expansion development, patient quality enhancement, as well as pharmacy, capital and non-capital equipment and supplies. Implementation of strategies relating to coordination new processes concerning management in various clinical specialties including Joint Commission readiness education and Lean/Six Sigma execution.
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