• Implemented delegated claims processing with 3 external provider organizations• Led cross-functional and cross-organizational teams of vendor, partner, and internal resources• Worked closely with internal and external customers to ensure alignment, and managed expectations for stakeholders throughout the project lifecycle• Directed UAT for eligibility (834), encounters (837), and member out-of-pocket file exchanges in an Agile environment• Identified and documented application workflows for all file exchanges to facilitate test development

• Implemented 3 Medicare Advantage plans for new clients utilizing Scaled Agile Framework (SAFe)• Collaborated with leaders across the organization to build and execute plans to meet aggressive implementation schedules • Integrated Medicare Advantage business and IT systems for the new plan implementations including Eligibility, Finance/Billing, Claims, Fulfillment, and Reporting functions

• Implemented Managed Long Term Care, Medicaid, and Medicare programs for Centene’s health plan launch in Pennsylvania • Integrated Centene’s and Health Net’s systems and business processes to lower costs and improve service for Members and Providers• Built and managed the process to collect, catalog, review, update, track, and deliver to regulators 100’s of Policies and Procedures from all departments as part of Readiness Review• Partnered with the Provider Network team to collect and process Medicaid Provider Data and to meet Medicare adequacy in a new market under a tight timeline• Managed and supported multiple Health Net integration work streams including Reporting & Analytics, Quality, Risk Adjustment, Encounters, Compliance, Vendors, and Web/Mobile to successfully meet program requirements

When Lumeris (Essence Healthcare) partnered with two Blue Cross organizations to bring new MA plans to market, my teams were responsible for gathering requirements, validating performance, and managing the overall IT implementation. My Analyst team worked closely with business leads to document existing processes and to establish requirements for new processes. Similarly, my Quality team partnered with business leads to develop test plans and execute them to ensure that our systems would meet all requirements. My Project Management team kept the integration efforts on track and was also the ‘bridge’ connecting our internal teams to the customer.Prior to, during, and after the implementations, my teams diligently supported business areas across the organization including Enrollment, Finance, Claims, Member Services, Medical Management, Quality, and Reporting.• Partnered with internal and external customers to understand their requirements and to deliver effective solutions• Collaborated with leaders across the organization to build and execute plans to meet aggressive implementation schedules and maintain staffing constraints• Developed and integrated Medicare Advantage systems for our Blue Cross customers, including Enrollment, Billing, Claims, Medical Management, and Reporting functions• Led the implementation and certification teams responsible for the Blue Cross Inter-plan Teleprocessing System• Developed and launched customized sales, marketing, enrollment, member, and provider websites• Integrated with multiple vendors including Pharmacy, Vision, Dental, Radiology, and Behavioral Health• Enforced adherence to government and industry standards• Led Project Management, Business/System Analyst, and Quality Analyst teams and reversed the history of high turnover in the department

• Prioritizing, scheduling, budgeting, and implementing enterprise infrastructure projects • Managed the IS Training, Procurement, and Project Management Teams • M&A: Integrated an acquired firm’s (approximately 300 individuals) infrastructure and systems with no unplanned downtime

When Maritz acquired new business with Hewlett-Packard I led the ongoing development, implementation, and operation of HP's proprietary platforms. This included the development of project and operational processes to support the implementation of new features and functionality.Because our solution was focused on the HP retail, wholesale, and technical support channels, flexibility was a top requirement for my IT team. As quickly as needs changed within those channels, projects would be initiated, modified, or eliminated. A key part of my role was frequent and close collaboration with client stakeholders and the Maritz account team to develop strategies and to ensure that my team was aligned with those strategies. • Planning, development, testing, implementation, and operations of web-based, channel engagement (Shopper Marketing) projects ($6M/yr) • Managing technology program budget, and controlling costs while maintaining commitments to schedule and quality • Managing on-shore and off-shore staff, freelance, and contractor resources including software developers, system administrators, project managers, system analysts, quality analysts, and customer service representatives • Led open-source based and clean-sheet application development projects in Java/MySQL and .Net/SQLServer environments• Successfully utilized modified agile, iterative, and waterfall methodologies to deliver projects that were on-time, on-budget and that exceeded client expectations• Consulted with clients and partnered with account management to consistently identify, propose, and win incremental sales (approx $200K/qtr) • Established processes and metrics demonstrating program effectiveness • Established and enforced new quality processes significantly reducing re-work • Managed the implementation of Content Management Systems and used these platforms to significantly reduce operational costs • Applied lessons learned to follow-on projects in a process of continuous improvement

• Managed staff of Technical Project Managers • Utilized staff, contractor, and offshore resources to control costs and maintain quality• Managed the design, development, implementation, and maintenance of a wide range of custom applications• Evaluated system modifications to support product planning and development• Established processes to streamline estimation, improve code reviews, and increase re-use of code • Managed multiple client relationships and projects • Built highly successful relationships with diverse clients through technical expertise and consistent, client-focused service• Worked closely with Sales to ensure seamless execution for our clients