Jim Cunningham

Jim Cunningham Email and Phone Number

Chief Operating Officer | Service Operations | Business Transformation | M&A Integration @ Zelis
bedminster, new jersey, united states
Jim Cunningham's Location
Greater St. Louis, United States
About Jim Cunningham

Service and operations executive delivering scale and efficiencies that keep quality healthcare affordable and accessible.Background:• Chief Operating Officer for $60B business division• Served in company’s leadership driving initiatives that profitably grew revenue from $4B to $160B• Key roles integrating >$110B in mergers & acquisitions• Optimized unit costs and overall operating expenses with annual budget responsibility up to $600M• Drove cultural turnaround and improved employee engagement by >40% across global team of 10KCommitted to sustainable solutions that improve and expand services, and optimize the experiences provided to clients, patients, providers, and employees. Highly analytical, I address complex business challenges to identify key issues and implement innovative solutions. My experience is concentrated in leading: • operational turnarounds, • business transformations, • strategic enterprise programs, and • M&A integrations across multiple businesses serving internal and external customers.Strong enterprise presence with ability to connect across organizations from front-line to C-Suite and Board of Directors.Skilled in:Strategy Development & Execution | Operational Efficiency | Business Transformation | Business Process Outsourcing (BPO) | Operational Excellence | Regulatory Compliance | M&A Due Diligence & Integration | Supplier Management | Quality Improvement | Talent & Culture Development | Operating Expense Reduction | Project & Program Management | Budget & Expense Management | Client Relationship Management

Jim Cunningham's Current Company Details
Zelis

Zelis

View
Chief Operating Officer | Service Operations | Business Transformation | M&A Integration
bedminster, new jersey, united states
Website:
zelis.com
Employees:
572
Jim Cunningham Work Experience Details
  • Zelis
    Chief Operating Officer, Payments
    Zelis 2024 - Present
    Greater St. Louis
    Lead operations supporting all payer and provider services for the Payments and Communications businesses.Functional service areas include:Clients: Implementation, Client Experience, Communications Channel OperationsProviders: Compliance & Risk, Network Implementation, Service Center, Payment Remittance, Payee Identification & Network Security (PINS), FraudInternal Shared Services: Strategic Enablement, Payment Operations, Project Management Office, CX Operations, Workforce Planning, Operational Site Expansion, Business Insights & Reporting, Quality
  • Zelis
    Senior Vice President, Client Services
    Zelis 2022 - 2024
    Greater St. Louis
    Led operations supporting payer and provider services for the Payments business.Functional service areas include:Clients: Implementation, Client Experience, Communications OperationsProviders: Network Implementation, Service Center, Payment RemittanceInternal Shared Services: Strategic Enablement, Project Management Office, Workforce Planning
  • Mckinsey & Company
    Senior Advisor
    Mckinsey & Company 2022 - 2023
    Remote/Greater St. Louis
    Healthcare practice M&A advisor, engaged in:• Buy side diligence• Integration strategy• Asset optimization• Operational scale and readiness• Provider and patient engagement• OPEX and CAPEX recommendations
  • Evernorth
    General Manager & Chief Operating Officer, Pbm
    Evernorth 2019 - 2022
    Remote/Greater St. Louis
    Transitioned from Express Scripts to Evernorth following Cigna’s $67B acquisition in December 2018.Expanded scope to serve as COO leading all operations supporting $60B pharmacy benefits business unit, and integrate operations to enable enterprise service model.Scope included 10K global resources & $600M budget.Functional service areas included:Clients: Benefit Configuration, Eligibility, Consumer Driven Health (CDH), Client Service CenterMembers: Customer Service, Claims, Communications & DistributionProviders: Prior Authorization/Utilization Management, Medical Benefit Drug ManagementNetwork Pharmacies: Retail Pharmacy Help DeskInternal Shared Services: Project Management Office, Analytics, Quality & Continuous Improvement, Workforce Planning, Business Process Outsourcing (BPO) & Supplier Management, Corporate Real Estate, Business Continuity
  • Express Scripts
    Vice President & General Manager, Pbm Operations
    Express Scripts 2017 - 2019
    Greater St. Louis
    Promoted to improve operations supporting $60B pharmacy benefits business unit.Responsible for strategy & service across team of 3.5K global resources & $200M budget.Functional service areas included:Clients: Benefits, Eligibility, Consumer Driven HealthMembers: ClaimsProviders: Coverage Review/Prior Authorization, Medical Benefit Drug ManagementInternal Shared Services: Project Management Office, Analytics, Facilities Strategy & Planning, Workforce Planning, Quality & Continuous Improvement, Corporate Real Estate, Business Continuity
  • Express Scripts
    Vice President Client Services
    Express Scripts 2015 - 2017
    Greater St. Louis
    Selected to launch new operating models for Benefit Services & divisional Shared Services organizations.Scope included team of 400 people & $40M budget.Functional service areas included:Benefit Configuration, Analytics, Quality & Continuous Improvement, & Program Management
  • Express Scripts
    Vice President, Member Experience & Strategy
    Express Scripts 2012 - 2015
    Greater St. Louis
    Transitioned to lead new organization focused on omnichannel contact strategy & >500M annual patient interactions following $29B Medco acquisition.Led 3 functions with >200 resources & $200M operating budget.Service areas included:Member ExperienceCampaign Management, database marketing operationsCommunications Fulfillment, with >500M outbound communications through omnichannel delivery
  • Express Scripts
    Vice President, Integration & Client Implementation
    Express Scripts 2010 - 2012
    Greater St. Louis
    Promoted to integrate $4.7B NextRx acquisition & implement Express Scripts’ largest client.Delivered largest client implementation in company history, spanning 12 health plans and >17M patients in only 18 months.Led $120M budget & team of 350.Functional Service Areas included:Implementation, Prior Authorization, & Customer Experience & Strategy
  • Express Scripts
    Senior Director, Client Services
    Express Scripts 2008 - 2010
    Greater St. Louis
    Promoted to lead concurrent turnarounds across 2 operations.Led team of 160 employees across 4 sites responsible for >20K annual plan changes & comprehensive clinical program portfolio.Functional services included:Client Benefit Administration and Campaign Management
  • Express Scripts
    Senior Director, Account Management Services
    Express Scripts 2005 - 2008
    Greater St. Louis
    Promoted to lead operational recovery & profitably grow book of Commercial Division clients with $39M in annual gross margin.
  • Express Scripts
    Senior Manager, Corporate Quality
    Express Scripts 2003 - 2005
    Greater St. Louis
    Selected to establish Medicare Ombudsman office for company’s entry into new regulated Medicare Part-D market, & to transform service resolution & reporting teams for non-regulated business.
  • Express Scripts
    Project Manager, Clinical Operations
    Express Scripts 2001 - 2003
    Greater St. Louis
    Selected to improve internal & external service levels & quality of clinical outreach programs.
  • Practice Patterns Science, An Express Scripts Subsidiary
    Senior Consultant, Health Plan Operations
    Practice Patterns Science, An Express Scripts Subsidiary 1999 - 2001
    Greater St. Louis
    Promoted from Consultant to lead divisional turnaround for integrated data products/services supporting all health plan clients.
  • Ssm Health
    Outpatient Rehabilitation & Community Wellness
    Ssm Health 1997 - 1999
    Greater St. Louis
    Responsible for in- & outpatient cardiopulmonary care, and community wellness programs.Promoted to lead wellness programs across three network hospitals.

Jim Cunningham Education Details

Frequently Asked Questions about Jim Cunningham

What company does Jim Cunningham work for?

Jim Cunningham works for Zelis

What is Jim Cunningham's role at the current company?

Jim Cunningham's current role is Chief Operating Officer | Service Operations | Business Transformation | M&A Integration.

What schools did Jim Cunningham attend?

Jim Cunningham attended Truman State University.

Who are Jim Cunningham's colleagues?

Jim Cunningham's colleagues are Steven Bouse, Gregory King, Kelsie Grillo, Pmp, Jacob Speaks, Alice Heins, Nanditha Matam, Jordyn Storey.

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