Ivan Sison Email & Phone Number

Chicago, Illinois, United States

Chicago, Illinois, United States

Blue Health Intelligence (BHI) is an independent licensee of the Blue Cross Blue Shield Association (BCBSA) that helps healthcare organizations gain insights to inform strategic decisions, support value-based care, and advance health equity. BHI has approximately $60 million in annual revenue.Chief of Staff to the VP of Methodology, Analytics, and Data Science team with 30+ staff members. Managed the relationship for the BCBSA account portfolio, ensuring effective communication with senior management and executive leadership, resulting in improved client satisfaction and retention. Developed, implemented, and executed department processes advancing company objectives while fostering an environment for team growth and success.• Synthesized and developed content for executive team presentations including progress on OKRs, project health updates, contracting status, and strategic initiatives for BCBSA portfolio.• Directed and managed a portfolio of 20+ projects to transfer project ownership, resulting in a 50% reduction in project transition time by implementing a standardized transition process.• Executed the vision and rollout of a centralized Knowledge Base (KB) prototype, fostering knowledge sharing among 30+ teams and enhancing operational efficiency.• Established career ladders for consultants, data analysts, and data scientists providing clarity on career progression and fostering team development.

Chicago, Illinois, United States

Cross-functional lead for programs, products, and solutions for BCBSA and BCBS plans. Start-to-finish ownership of daily operations and project execution including contracting/scoping, business requirements, study design/methodology, hypothesis testing, roadmaps, report specifications, milestone progress, and client delivery. The portfolio of projects focused on payer/provider analytics (network performance, value-based care, CMS transparency in coverage, episode groupers, HEDIS quality measures) and benchmarking studies (population health, cost containment, utilization management, risk adjustments, propensity matching).• Managed the solution lifecycle for the annual evaluation of BCBS ACO/PCMH value-based care programs for data pipelines, methodology, analysis, reporting, and feature enhancements. • Consulted and collaborated with clients to evolve the High-Cost Claimant (HiCC) solution of predictive analytics (HiCC scores, cost amounts) to integrate into case management workflow.• Directed and advised clients for Episode Grouper product launches by defining delivery phases aligning on scope, resources, priorities, development effort, and testing plans.• Developed/executed Go-to-Market deployment plan for Cost Transparency solution with compliance for CMS shoppable services and delivery of complex cases and associated services.• Oversaw the semi-annual production refreshes of cost estimates for the Blue Axis Cost tool by managing and reviewing work of data analysts, clinicians, developers, and data engineers.

Chicago, Illinois, United States

Evolent Health is a healthcare technology company that offers payer and provider solutions including Evolent Care Partners, New Century Health, and Evolent Health Services with approximately $1,352 million in annual revenue.Reported to the Chief Technology Officer as a principal process engineer tasked with achieving operational excellence including enterprise portfolio management, prioritization and resource management, data quality assurance, and documentation of SOPs to support SOX compliance.• Managed the Health Plan Services team implementation of issue tracking in JIRA to enable a single centralized view for prioritization, escalation, resource balancing, and resolution.• Documented business unit SOPs and established the process and framework for the Process Governance Committee to maintain SOP inventory and review and approve SOP requests.• Instituted operational data run quality assurance process to ensure consistent and timely quality checks are performed for weekly/monthly refreshes of client production portals.

Chicago, Illinois, United States

Led a team of eight Service Delivery Managers to serve as client advocates and cross-functional leads to support agile development of the Vision product (physician portal solution). Removed roadblocks, set priorities, and developed implementation and rollout plans for new versions and releases of the Vision product. Advised on client solutions for the data analysis of EHR/EMR data and clinical terminologies for ICD-10, CPT, HCPCS, LOINC, SNOMED, NDC.• Directed the monthly delivery of provider scorecards overseeing operational processes for data acquisition, data integration, data quality, measures reporting and client issue resolution. • Championed and advocated client needs and requirements to incorporate in the ongoing development of the Vision product and included in product sprints and releases.• Instituted standard process for issue prioritization and escalation across Client Operations stakeholders and development resource teams to align on resolution timing expectations.• Tested and validated the migration of the Vision product platform upgrades with old vs. new use case comparisons for functionality, data completeness, and data accuracy.

Northbrook, Illinois, United States

CVS Caremark is a pharmacy benefit manager, that works with employers, health plans, unions and state and local governments nationwide to manage prescription plans that help control costs while ensuring access. CVS Health has approximately $322 billion in annual revenue.Managed teams to provide analysis and report deliverables for disease management programs for common chronic and rare chronic conditions. Coached and mentored staff by developing analysis plans including definition of the study population, analysis dataset parameters, methodology applied, output requirements, and report delivery.• Directed analytics team to develop outcomes and metrics reporting for Diabetes Pilot (“Pharmacy Advisor”) which highlighted the program impact of 40% increased gap closure rate.• Delivered operational reports and performed annual reviews including cost savings and ROI reconciliations for employer populations to show impact of disease management programs.• Developed MinuteClinic savings and utilization studies of MinuteClinic users vs. nonusers which showed annual decreases of 8% in medical costs and 14% in ER visits.• Received Disease Management “Extra Mile Award” for providing exceptional analytic support for client reviews, pricing & underwriting, and outcomes reporting content for RFPs.

Mba, Marketing, E-Commerce

Bs, Management