Elixir

An integral member of the Elixir Solutions Executive Leadership team, I spearheaded strategic planning, directed divisional operations, and managed a dynamic team of associates(40+) and consultants. 
•	With a focus on operational excellence, I managed a multi-million dollar budget to align with enterprise goals while prioritizing client and member needs.
•	Managing a multi-million dollar budget to keep pace with, and align, with enterprise goals, while keeping the client and member in focus. 
•	Played a pivotal role in stabilizing and elevating Elixir Solutions into a top-tier Pharmacy Benefit Management (PBM) organization through strategic planning initiatives and operational enhancements. 
•	Leading and cultivating a high-performing management team, consistently delivered on-time, high-quality deliverables, reducing production defects and implementation timelines by 50% year over year.
•	Reduced production defects and implementation timelines by 50% year over year
•	Consistently exceeded KPI's and built a communication and reporting portfolio for executive leadership. 
•	Building and nurturing executive partnerships and vendor relationships, was a key aspect of my role, resulting in over $2M in annual ROI through collaborative solutions and initiatives and $500k annually on labor and production cost. 
•	Transformed the organizational culture to foster a positive, inclusive environment, leading to reduced employee turnover, heightened morale, and increased productivity.
•	Managed and mentored a team responsible for configuration and testing of all Elixir Commercial and Medicare clients, which totals thousands of groups and plans and tens of thousands of claims, daily. 
•	Implemented machine learning generative AI solutions strategically within Elixir Solutions, optimizing resource allocation and workflow processes, resulting in a significant decrease in Turnaround Time (TAT) for critical tasks, thereby enhancing efficiency and improving client and member outcomes.

Senior Director

CareFirst BlueCross BlueShield

Served as a trusted resource, advisor, and connection point to departmental and enterprise leadership for strategic initiatives, special assignments and projects.
•	Managed multiple strategic initiatives and projects which have led to increases in provider and member satisfaction and $1M+ in savings annually.
•	Led, coached, and advised multiple areas and resources to provide best practices, advisory services, and skill refinement, which have led to a 78% increase in program savings year over year.
•	Managed, drove, and delivered multiple new ACO (Accountable Care Organization) programs, which are integral to the short- and long-term success of CareFirst and will help contribute to membership growth and overall savings.
•	Built and maintained professional relationships across the organization, ensuring key programs achieved quality and timeliness goals.
•	Led several highly visible and critical programs that exceeded key metrics for quality, production defects and business approvals leading to significant ROI, provider satisfaction and member engagement.

Product Operations Manager

Team leader of 10+ associates and facilitator for key strategic Facets initiatives spanning the entire enterprise, which led to multi-million dollar in savings and substantial ROI. 
•	Managed multiple complex matrixed Facets projects and initiatives from idea to implementation. 
•	Worked with cross functional teams to help mitigate Facets audit findings and reduce future exposure and risk.
•	Analyzed, documented, and drove to completion, production issues during a Pharmacy Benefit Manager (PBM) conversion, helping to stop $1M+ in losses annually.
•	Worked with the business, IT, Facets support, operational support, customer service and external vendors to stop, mitigate and resolve high impact conversion issues, resulting in significantly more efficient processes and multi-million dollars in savings annually.
•	Helped to provide $3M in cost savings annually through Facets value chain efficiency projects and member experience projects.
•	Helped to identify and solve cross-functional challenges and opportunities, in partnership with peers throughout the enterprise (Business, Audit, IT, Operations, etc.).
•	Acted as a trusted advisor to senior management through meaningful conversations, employing creative problem solving, leading high-impact efforts, and support in the completion of divisional and enterprise initiatives.

Facets Product Manager

Optimity Advisors

•Program manager, providing oversight throughout the program lifecycle, including execution, monitoring and controlling activities of a multi-million dollar program. 
•Worked with the Project Management Office (PMO), Blue Cross Blue Shield Association (BCBA) Business team, and other internal stakeholders to develop the program level milestone schedule and execute established management processes. 
•Worked and collaborated with peer Program Managers to coordinate and consolidate program level status, issues and risks
•Established and managed cost, schedule and performance baselines for programs
•Implemented best practices and processes to track progress of services and development of capabilities in terms of defined cost, schedule and performance outcomes
•Provided metrics and analysis to support forward-looking decision-making based on data and qualitative measures. 
•Leveraged data and analysis from systems engineers, configuration managers, contracting officers, and/or financial managers to inform program performance measures.

Manager

TriZetto Healthcare Products

•Provided insight, guidance and facilitation of an enterprise wide gap and efficiency analysis that resulted in savings of $2 million annually. 
•Facilitated multiple level meetings, presentations and deep dives into client functionality, business processes, pain point analysis, and Facets system functionally that helped leverage best in class processes and industry leading techniques to increase overall claims efficiency. 
•Areas and departments where meetings and analysis were held, include Provider Data Management, Provider Network, Provider Pricing, Contracts, Claims processing, Workflow, Medicare Advantage, NetworkX utilization, and Customer Service.

Principal Consultant

XLHealth

•Helped manage and support XLHealth’s largest revenue stream by providing insight and guidance into product configuration, workflow customization and value stream efficiencies. 
•Facilitated decision making and key analysis that provided XLHealth with $1 million dollars in ROI and savings annually.  
•Extensive knowledge and experience identifying the user’s needs and translating them into functional specifications using structured methodologies and tools.

Lead Facets Configuration/Business Analyst

UnitedHealth Group

•Senior business analyst for AmeriChoice’s Medicare Advantage Product which spanned multiple states and generated multi-million dollars in revenue annually
•Provided focused and key analysis of the FACETS system, including upgrades, new lines of business, and projects. Resulting in greater efficiency and thousands of dollars in savings
•Daily duties include business requirement documents, project plans, and updates to management and senior management

Senior Facets Configuration Analyst/Business Analyst 

Logix Guru

Techincal Recruiter

FedEx Freight

-Managed several hundred thousand dollars worth of inventory daily.
-Organized and managed all in and outbound traffic, along with day to day tasks involving the following: Logistics, Operations, Customer Service, and employee safety. 
-Managed a group of talented logistical engineers

Expert in Operations, Time Management, Quality Control and Team Leadership

Supervisor

| Listen | Learn | Act |

Results-driven healthcare executive with over 17 years of expertise in leadership roles, particularly focused on Information Technology, Health Plan Operations, and Pharmacy Benefit Management. Demonstrated success in spearheading strategic planning, program development, and performance management initiatives. Adept in harnessing data-driven insights and AI(Artificial Intelligence) machine learning to optimize performance and deliver tangible outcomes. Recognized for adeptness in fostering and sustaining strategic relationships across organizational hierarchies. Additionally, successfully leveraging skills in generative AI and CRM to enhance capabilities and offerings in the healthcare and PBM space.

CORE COMPETENCIES

Strategic Planning & Execution | Data Analysis & Visualization | Leadership & Team Building | Program Development & Management | Quality & Operational Improvement | Business Intelligence Systems | Executive Communication & Relationship Management | Artificial Intelligence Integration & Optimization

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