Jim Heffley Email & Phone Number

Remote: Louisville, Ky

Manage provider data integration / conversion activities associated with acquisitions, launch of new lines of business and expansion into new geographies.

Remote: Louisville, Kentucky

Director, Provider Data Configuration (01/21 – 12/21)• Led provider integration teams to ensure accurate loading and maintenance of provider data for Arizona, Virginia and Massachusetts health plans.• Monitored productivity and performance standards and reporting to ensure compliance with internal standards and state / federal regulations.

Remote: Louisville, Ky

• Developed and implemented strategies to simply processes, including vendor / partner management.• Collaborated with cross-functional teams to ensure seamless coordination of operational functions performed by other departments.• Managed provider network adequacy reporting, data quality metrics and provided analytic support to leadership.

Louisville, Kentucky

Developed a team of highly skilled subject matter experts focused on optimizing provider network growth, efficiency and capacity. Led the development and management of Humana’s provider master data management processes and systems. Partnered with leadership to develop new tools / metrics to improve provider contracting processes, operational efficiencies and enhance sales closure rates.• Pioneered innovative self-service application for measuring / reporting / mapping provider network adequacy for over 400+ internal and 150 competitor networks. Data integration with group sales evaluation / quoting tools improved closure rates over 100%.• Evaluated, selected and managed relationships with outside vendors to enhance competitive analytics, improve provider data quality and enable Humana’s provider contract management system.• Generated custom analytics in support of new business strategies/concepts and M&A activity.• Managed IT project ideation, planning, budgeting and project implementation for the provider contracting organization (annual budget $4M-$6M). Built relationships with information technology partners and articulated technical concepts to non-technical internal and external team members and senior leadership.• Enhanced and refined the heuristic and probabilistic matching algorithms used for establishing provider data linkages (golden record) across siloed legacy provider data systems and multiple outside provider data sources.

Served as company’s first Director of Internet Marketing. Managed cross-functional teams to increase adoption rates and e-transaction volume. Implemented direct-to-consumer and business-to-business campaigns to expand plan member, provider and broker / agent visits and online registration. Identified and negotiated strategic vendor partnership for establishing affinity marketing programs to increase awareness and usage of Humana.com. Conducted usability testing for optimizing web navigation and user experience for and partnered with vendors to optimize search engine results and rankings. Authored business plan and assisted with launch of Availity.com.

Developed and managed marketing efforts to support growth of Medicare, Commercial, Dental and Specialty Product lines. Led development and launch of Humana’s first Medicare Advantage web site. Created e-mail newsletter to enhance communication between National Account Sales and Health Care Consulting community. Improved direct mail response rates to HumanaDental promotions from 3.9% to 10.4% through copy and design improvements.

Emmaus, Pa

Directed growth of Annual Book sales channel for leading publisher / direct marketer of self-help information products (Prevention, Men’s Health, Runner’s World Magazines).

Louisville, Kentucky Area

Managed marketing and circulation activities for health newsletter division of Ziff-Davis Publishing.

Louisville, Ky

Managed quarterly direct mail campaigns for Medicare and Commercial insurance products. • Monitored and evaluated promotional results: response, appointment and sales conversion rates.• Leveraged customer segmentation and profiling data to develop targeted creative efforts.