Jim Burns Email & Phone Number

Menomonee Falls, WI, US

Milwaukee, Wisconsin, United States

• Led analytics staff of three managers and 17 analysts, for a Dental and Vision Insurance organization serving 36 million members across 30 states and multiple Managed Care Organizations (MCO’s) and State Governments.
• Spearheaded strategic claims cost control interventions for $2B Medicaid and Medicare contracts for multiple States and Managed Care Organizations (MCO’s).
• Developed, implemented, and successfully led the Financial Impact management process.
• Drove Payment Integrity efforts to over $20M in annual claims cost savings.
• Directed the team responsible for all analytical support of over $200M annual sales of Medicaid and Medicare Sales and requests for proposal (RFP).
• Led Artificial Intelligence (AI) proofs of concept projects for computer vision x-ray analysis saving $1M a year.

Greater Milwaukee Area

• Headed staff and project teams for strategic client implementations representing $850M in annual revenue.
• Propelled the cross functional 70-person re-implementation of the Texas Medicaid and CHIP Contract representing $850M in annual revenue.
• Championed and led the $15M Claims Cost Savings initiative for the state of Texas.
• Developed and managed a $12M Pay for Quality program for the state of Texas.
• Served as the client facing liaison for the Western Territory, ensured zero client loss during tenure.

Greater Milwaukee Area

• Oversaw five remote client-facing teams and maintained Profit and Loss (P&L) responsibility for the Western Territory, Idaho, Texas, New Mexico, Hawaii, Wisconsin, Minnesota, Illinois, and Missouri.
• Managed financial performance, Profit and Loss (P&L) for over $100M in annual revenue.
• Generated over $25M new business opportunities within existing accounts.
• Fostered and maintained relationships with key contacts across a variety of healthcare and community-based organizations.

• Led a 19-member team responsible for all Electronic Data Interchange (EDI) services for 14 million members nationwide.
• Directed and prioritized all data services requests, inquiries, and projects for 100+ clients nationwide.
• Identified $1M cost savings in over 15 million claims annuallyComprehensive trading partner and client data transaction management including but not limited to claims, authorizations, provider data, eligibility, and.

Milwaukee, Wisconsin, United States

Managed a 15-member team responsible for eligibility loads and encounter extracts for all 10 million members.

• Private wealth management
• Private wealth management team advising on assets of $150 million
• Managed and advised $37 million book of retail brokerage clients
• Identified and acquired additional $5 million and 30 new accounts in 2007 alone

Menomonee Falls, Wisconsin, United States

• Produced monthly credit event analysis of the 15 million+ Kohl's Charge customers' purchasing behavior in nearly 700 stores nationwide.
• Designed and executed ad hoc Kohl's Charge customer analyses to serve C Level executives.
• Led and organized direction for new and existing market direct mail projects.
• Targeted and purchased (over 6 million in 2006) prospective customers' information based on specific demographics for new and existing Kohl's markets.
• Built effective ZIP code strategies for grand opening new markets.
• Created ongoing ad hoc examinations of the 15 million+ Kohl's Charge customers' purchasing trends that netted over $4 billion (2006).