Eric Scarmardo Email & Phone Number

Chicago, Illinois, United States

Chicago, Illinois, United States

Responsibilities- Internal Process Improvement- Internal Process Automation- KPI Development and Management- Mentoring and Developing Staff--------------------------• Developed and implemented a Task Tracking system using VB Macros to track task ownership and to monitor successful daily completion of 100% of tasks. • Lead a transformation effort to improve the Mail Processing process resulting in a 65% reduction in labor usage while improving timeliness and accuracy.• Lead a transformation effort to improve the Document Upload process resulting in an audited, consistent process. A 45% reduction is allocated labor was achieved. • Developed a Returned Mail process using VB Macros which reduced manual processing effort by 73% while improving timeliness and accuracy.

Northbrook, Il

Responsibilities- Internal Process Improvement- Internal Process Automation- KPI Development and Management- Ownership of several team-critical processes--------------------------• Reviewed and implemented improvements to monthly Performance Guarantee monitoring process. Via VB script automation reduced manual processing time by 95%.• Developed and implemented a Welcome Season report process which coordinated reporting among multiple teams. Reduced time requirement for individual team reporting from several hours to 10 minutes via automation best practices.• Planned for and led Welcome Season Command Center activities. Led discussions regarding status and problem area resolution strategy.• Developed and implemented custom reporting and associated procedures for the purpose of improving various Service Warranty Metrics. Obtained 100% compliance with RCA completion on Service Warranties.• Developed and implemented budget planning tools which form an agile, repeatable system which produces thorough reporting. Reduced report construction time by 95%.

Northbrook, Il

My accomplishments in this role include: • Developed and implemented a new work flow, a new Med D claim structuring tool, and a daily tracking report to reduce claim processing time by 50%.• Developed and implemented a new work flow, a new daily tracking report, and partnered with the billing team to reduce the outstanding suspend (collections) balance by 24% within three weeks.• Developed and implemented a new work flow, call representative talk tracks, and a supervisor dashboard tool to increase staff productivity by 100%.Coram is a wholly owned subsidiary of CVS Health, dedicated to serving the needs of both infusion and enteral patients. I was brought in to focus on various operational aspects of the enteral business. This business serves both the nutritional and supply needs of feeding tube patients.As the Director of Operations, I have been responsible for certain parts of the enteral business, including reducing suspend levels for both commercial and Medicare Part D Claims ("suspend" represents those claims that are incomplete and cannot, therefore, be billed), improving our Insurance Verification processes, improving our Prescription Verification processes, and managing internal and external strategic relationships.

Northbrook, Il

My accomplishments in this role include:• Developed and implemented the "Sequence of the Request" work flow, a request monitoring system, and initiated power-user training to decrease escalated requests from 75 - 100 per month to less than 5. (Ave. 1000 requests completed monthly.)• Developed and implemented formal work flow and formal control reporting to assured that 100% of member reimbursements were processed and mailed within Service Level-Agreement processing windows. As a result, reimbursement error rates dropped from 15% to less than 1%.• Designed and project managed a rules engine which permitted custom member payment rules as specified by each client. This system resulted in seamless client implementations and a decrease in client complaints to virtually zero.• Mentored and developed staff (15 direct reports) at all levels. When I departed the team, my vacancy and all subsequent vacancies, were filled orderly via internal promotions.• Participated in Medicare Part D CAP definition and execution of solutions permitting CAP closure.The Adjustment Services Team is an operational team tasked with managing CVS Health's claim adjustment processes. From time to time, member claims processed in conjunction with CVS Health's PBM (Prescription Benefit Management) line of business must be adjusted. In some instances, these adjustments are performed to correct a processing error. In others, adjustment is required pursuant to the rules of the Medicare Part D program. Regardless, these adjustments are always time critical and carry a great deal of client scrutiny. As the Sr. Manager of Operations, I managed and improved various functions which support claim adjustment processing. These functions include Member Reimbursement Processing, Pharmacy Reimbursement Processing, Pharmacy Help Desk management, the Adjustment Services Request Process, strategic projects, Medicare Part D compliance, and Account Management team support as required.

Northbrook, Il

My accomplishments in this role include:• Collaborated with multiple internal teams to successfully develop and implement an enterprise claim adjustment system, resulting in staff efficiency of 13%. (Headcount reduced from 15 to 13).• Developed and Implemented a member reimbursement process which replaced several prior manual processes.• Participated in Medicare Part D CAP definition and execution of solutions permitting CAP closure.• Participated in Medicare Part D compliance monitoring.The RMT (Reconciliation Management Team) (a precursor to the Adjustment Services Team) was an operational team tasked with managing CVS Health's Medicare Part D claim adjustment processes. From time to time, member claims processed in conjunction with CVS Health's PBM (Prescription Benefit Management) line of business must be adjusted. In some instances, these adjustments are performed to correct a processing error. In others, adjustment is required pursuant to the rules of the Medicare Part D program. Regardless, these adjustments are always time critical and carry a great deal of client scrutiny.As an Operations Advisor, I was tasked with managing and improving various processes which support claim adjusting. These functions include Pharmacy Reimbursement Processing, Medicare Part D compliance, and the management of and implementation of strategic projects. I also provided Account Management team support as required.

Northbrook, Il

My accomplishments in this role include:• Structured and managed various Financial Systems IT projects, with average budgets of $250k - $1 million. Consistently successfully completed projects with budget variances of less than 3%.• Developed and Implemented a Project Artifact Storage Protocol, improving project transparency, knowledge transference, and status reporting.• Designed, Project Managed, and implemented a new member reimbursement system to support Caremark’s (prior to our merger with CVS) entrance into the Medicare Part D space. Utilizing an Agile development methodology, this project was successfully delivered in 7 months. The Financial Systems team is focused on developing and maintaining various processing platforms aimed at supporting CVS Health's PBM (Prescription Benefit Management) Finance Team. As a Project Manager on this team, I was tasked with managing assigned technical projects. My duties included project set-up and initiation, project/phase monitoring, leading status meetings, project status reporting, project artifact management, and project closure. In this role, I also participated in building and implementing an updated project management methodology.

Northbrook, Il

My accomplishments in this role include:• Led Pharmacy 835 File conversion project, partnering and collaborating with approx. 130 outside vendors. This project was completed on time without error.• Led and successfully completed team code review project aimed at improving processing window efficiency through SQL optimization and the consistent use of standard sub-routines.• Developed and modified code as assigned. Worked with COBAL, SQL, JCL, Java and XML.The Financial Systems team is focused on developing and maintaining various processing platforms aimed at supporting CVS Health's PBM (Prescription Benefit Management) Finance Team. As an Analyst on the Financial Systems Team, I was responsible for assigned design and development projects, as well as other miscellaneous non-coding improvement projects. The design and development projects, utilizing COBOL, JCL, SQL and a host of development and testing technologies, ranged from simple code modifications to the development of new system functionality. During this time, I also participated in various code/process improvement efforts which were aimed at reducing our nightly processing window. Finally, from time to time, I also lead various non-technical projects as assigned.

Jd, Law

Llm, Employee Benefits, Summa Cum Laude

Certificate, Career Computer Professional Program

Bs, Finance, High Honors

Master Of Laws - Llm, Employee Benefits