Jesse C. Email & Phone Number

Glastonbury, Ct, Us

Executive leader at a top SaaS provider specializing in underwriting and payment integrity digitization tools, accountable for maximizing customer value across the client lifecycle. As SVP of Customer Success, I oversee product implementation and client renewals across all segments, including Carriers, Health Plans, and Vendors, partnering with client leadership to deploy workflow automation, driving both savings and efficiency.Highlight: Spearheaded customer lifecycle transformation, improving operational efficiency an elevating customer satisfaction.

Senior leader at an industry leading TPA, overseeing the payment integrity and network strategy with P&L accountability and end to end ownership of a multi-line product portfolio (strategy, pricing, operations). Built a nationally located team from the ground-up, fostering a culture of trust and operational excellence, rapidly expanding organizational capabilities and product performance that delivered multi-year growth of 25%+ annually. Operations included clinical claim review, negotiations, repricing, FWA, and vendor management teams.Highlight: Led complete overhaul of medical cost savings product portfolio, developing a cohesive value proposition and strategic road map that included network design, pricing structure, go-to-market (GTM) strategy and operations to deliver multiple new products/enhancements.

Hartford, Connecticut Area

Led the Pharmacy Benefit Management (PBM) business and Out of Network strategy at an industry-leading TPA, with full P&L accountability for the product portfolio. Managed a nationally located, high performing team responsible for product strategy, operations, business development, clinical, pricing/underwriting, analytics, and reporting.Highlight: Led the pharmacy product turnaround initiative at Meritain Health, orchestrating a comprehensive transformation that encompassed department restructuring, development of a compelling value proposition, product rebrand and implementation of a strategic pricing strategy.

Joined Aetna in January 2013, as a member of inaugural the Financial Leadership Program (EFLP), a leadership program established to develop talent for Aetna Financial leadership roles. I graduated the EFLP early 2018, successfully completing rotations centered around corporate strategy/initiatives.The program structure is an up-or-out rotational program where high potential professionals are placed in different functional and operational leadership roles for 1-2 years per rotation. In addition to the underlying roles, various leadership development training courses were embedded throughout as well as exposure/mentorship from Aetna Senior leadership. Additionally, the program provided opportunities to support the overall talent strategy, where we revamped the finance internship program and built out an early career rotational program end-to-end (program framework/recruiting/onboarding/training).

Hartford, Connecticut Area

Partnered with Health & Clinical Services, Technology, Finance, and Procurement leadership teams to develop and deploy a continuous improvement strategy, drive operational excellence and sustain business growth throughout each organization. Successfully led a diverse team of Lean Six Sigma subject matter expert consultants to execute various process improvement initiatives including value stream mapping, process redesign and root cause analysis. Consistently delivered results and exceeded targets (savings, quality, customer service/satisfaction).

Hartford, Connecticut Area

As part of the Accountable Care Solutions (ACS) team, I collaborated across the organization and health systems to drive value-based care provider partnerships/deal structures. Responsibilities included financial viability analysis of both potential and existing value-based arrangements with Health Systems (from pay-for-performance to joint venture arrangements).Collaborated across multiple departments including Sales, Actuarial, Informatics and the Market Network Teams to develop the business cases and present the impact both internally to management and externally to Provider C-suite. Selected Accomplishments in the role included: 1) Developed and implemented the Joint-Venture valuation playbook leveraged in the successful launches of the JV strategy expansion.2) Coordinated research initiatives to identify alternative funding solutions and structuring options for joint-ventures, working with subject matter experts across the company, developing a playbook to provide counterparties with multiple options.3) The development of various financial models including a membership valuation model.4) Led process improvement initiatives including the re-engineering of the financial business case modeling to automate and streamline financial modeling process.

Hartford, Connecticut Area

As a key member of the Business Unit CFO’s team responsible for planning, forecasting, and analytics for Aetna’s Government businesses (including Medicare Advantage/Prescription Drug, Medicaid, and Individual Exchange). I provided enhanced analysis to drive results. Selected highlights include:1) Managed the offshore support staff including daily productivity and primary vendor relationship owner for the department.2) Led various pre- and post-merger integration activities, including the coordination a Company-wide Cost Accounting Project, working across the organization with various Finance / Business Leaders to obtain understanding of costs and processes in place and work with subject matter expert in the development of proper methodology.3) Led multiple process improvement initiatives, working with various departments to improve effectiveness and efficiency, through re-engineering, automation and streamlining of processes. Reduced production time for the monthly Medicare Advantage Risk Adjustment reconciliation by 75%.

West Hartford, Ct

As a Manager in BlumShapiro’s Advisory and Assurance department, I provided assurance services and consulting for clients in a wide range of industries, with an industry focus within: Healthcare, Financial Services, Manufacturing / Distribution and Professional Services, as well as Employee Benefit Plans. Led all aspects of multiple concurring engagements, from planning to issuance of financials, serving as liaison with client senior leadership and the Firm, managing the relationships and service teams for the Firms key accounts.I was actively involved in business development efforts, cultivating relationships to grow new business and retain existing clients with involvement from proposal to pitch, producing new business that aligned to the Firm's strategic profitable growth initiative.Advisory and consulting work included valuation support, corporate compliance, and business risk assessments. Additionally, I was involved in talent development, including both recruiting and staff training.

Provided assurance services and consulting for clients in a wide range of industries, with an industry focus within: Healthcare, Financial Services, Government/Not-for-Profit, Manufacturing / Distribution and Professional Services, as well as Employee Benefit Plans. Activities included: assessment of controls, analytical procedures, detailed substantive testing and preparation of the financial statements and other deliverables. Advisory and consulting work included valuation support, corporate compliance, and business risk assessments. Actively involved in talent development, including both recruiting and staff training.

Provided assurance services and consulting for clients in a wide range of industries, with an industry focus within: Healthcare, Financial Services, Government/Not-for-Profit, Manufacturing / Distribution and Professional Services, as well as Employee Benefit Plans. Activities included: assessment of controls, analytical procedures, detailed substantive testing and preparation of the financial statements and other deliverables. Advisory and consulting work included valuation support, corporate compliance, and business risk assessments. Actively involved in talent development, including both recruiting and staff training.

Provided audit services on publicly traded and privately held entities with diverse industry exposure including health care, financial services, private equity, real estate, manufacturing and employee benefit plans.

Hartford, Ct

Bristol, Ct

Glastonbury, Ct

Masters Of Science, 3.71/4.00

Bachelor Of Science (B.S.), Accounting, 3.75/4.00

Magna Cum Laude