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Twenty-five plus years of experience in the Health Insurance Industry. Medicaid, Commercial, Medicare Advantage, STARS, HEDIS, Project Management, Appeals and Grievances, System Configuration, Claims Processing, Enrollment, Customer Service and IT. Six years of experience in the Aerospace and IT Services Industry. Experience as part-time professor of Engineering.Successful leader, capable of adapting to diverse industries. Passionate about leading creative individuals in applying analytical skills, imagination, and engineering principles to complex business problems.Cherishes contributing in reputable organizations in which innovative solutions integrating people, processes and technology can be built from the ground up to drive efficiencies to the bottom line and ensure consistent performance. Desires projects that make meaningful positive impact in society.Specialties: Operations & Information Technology Strategic Leadership, Data Warehousing, Business Intelligence, Business Process Management, Innovation, Health Insurance Back-Office Operations, Leading, Entrepreneurial Activities, STARS, Outsourced Services Management / Oversight.
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PresidentPromenade LlcPuerto Rico
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AdvisorCircadian Health Jan 2024 - PresentWest Palm Beach, Fl, UsMember of the organization's advisory council. -
Sponsor - Board MemberBoys & Girls Clubs Of Puerto Rico Sep 2023 - PresentSan Juan, PrThe most personally rewarding activity I have ever been involved with. Committed to eliminating childhood poverty in Puerto Rico which stands at 57%. -
PresidentPromenade Llc Jun 2022 - PresentPromenade LLC does IT and Business Consulting, Real Estate Investment, New Business Development and Content Creation.Promenade Consulting helps organizations with business process automation and optimization, cybersecurity, cloud computing, business seminars, and training.Promenade Real Estate is investing in single family homes in Central Florida.Promenade Creative helps organizations in developing meaningful content.Promenade Start helps new businesses establish and launch operations from Puerto Rico leveraging US best tax and financial incentives.
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Chief Information OfficerTriple-S Jan 2020 - May 2022San Juan, Puerto Rico, UsOversaw the massive enabling of the Triple-S workforce to the remote setting. Crafted a technology roadmap to support the overall corporate strategy. Coordinated due-diligence and integration activities associated to the acquisition by GuideWell. -
Chief Information Officer, Vp Stars, Quality And Business InnovationTriple-S Dec 2019 - Jan 2020San Juan, Puerto Rico, UsResponsibilities:- Responsible for the supervision of the Information Security Officer and providing guidance on the overall Cyber-Security vision.- Responsible for the Strategic Analytics Program, and overseeing the Business Information Architecture function that includes EDI, Business and System Analysis, Enterprise Architecture, Core System Configuration and Maintenance, Data Governance and Analytics.- Responsible for the Partner Management Function that oversees infrastructure, licensing, contractors and outsourcing relationships.- Responsible for the organization's Project Management Office.- Responsible for the Business Process Innovation team.- Responsible for the Business Innovation team, including interoperability initiatives with providers. -
Acting Cio, Vp Stars, Quality And Business InnovationTriple-S Jan 2019 - Dec 2019San Juan, Puerto Rico, UsAccomplishments:Oversaw the completion of the migration of the corporate data center to a tier-3 center with a robust submarine cable station that connects to the MS Azure Cloud and the Internet for utmost resilience, security and data loss prevention.Initiated the migration of critical applications to the MS Azure Cloud, and the transition to voice-over-IP for the corporate phone systems using MS Skype/Teams solutions.Upgraded ten call centers to the latest Avaya technology.As Acting CIO:- Responsible for the supervision of the Information Security Officer and providing guidance on the overall Cyber-Security vision.- Responsible for the Strategic Analytics Program, and overseeing the Business Information Architecture function that includes EDI, Business and System Analysis, Enterprise Architecture, Core System Configuration and Maintenance, Data Governance and Analytics.- Responsible for the Partner Management Function that oversees infrastructure, licensing, contractors and outsourcing relationships.As VP STARS, Quality and Business Innovation:- Responsible for the overall STAR Ratings Program, and HEDIS.- Responsible for the organization's Project Management Office.- Responsible for the Business Process Innovation team.- Responsible for the Business Innovation team, including interoperability initiatives with providers. -
Vice President Stars, Quality And Business Innovations - Triple-STriple-S May 2015 - Jan 2019San Juan, Puerto Rico, UsLead corporate efforts to improve STAR ratings and HEDIS quality metrics. Lead the implementation of a new appeals and grievances process with cloud-based technology. Lead the IT development team and the corporate project management office. Team implemented: WIPRO Member360, Recon360, Broker360, and EDPS products; Mobile Enrollment solution; STARS analytics tool; data warehouse; compliance management cloud-based solution; and Optum CES in less than 15 months. -
Founder And Ceo, Founder'S Institute GraduateWlg Innovations, Inc. Oct 2013 - Dec 2015Developing a new business venture in the social networking and e-commerce space. Won Reto 2.0 from GFR Media in 2014. Finalist in EnterPrize program from Grupo Guayacán, graduated in 2014. Second Place in Hit3001 Startup TV Competition in 2015. Selected to represent Startups of Puerto Rico in 2015 at South by Southwest Interactive.
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Entrepreneur / Operations And Technology ExecutivePedro José Aponte Gil De Lamadrid, Pe Aug 2013 - Oct 2013Consulting for service vendors for health providers.
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Vice President System ConfigurationMedical Card System Inc. Dec 2010 - Aug 2013San Juan, Puerto Rico, PrResponsible for core system configuration including benefits, provider contracts and payment policies, with a primary focus in standardization and automation; and initiating the Reengineering team aimed at looking for opportunities to apply Business Process Management tools. -
Vice President Claims & Operations Quality AssuranceMedical Card System Inc. Aug 2007 - Dec 2010San Juan, Puerto Rico, PrResponsible for claims, and Operations QA Department, with a major focus on monitoring the compliance of vendors to whom core functions were delegated including dental claims processing, mental health services, electronic claims, paper claims, credentialing, pharmacy benefits administration. -
Vice-President OperationsMedical Card System Inc. Jun 2004 - Aug 2007San Juan, Puerto Rico, PrResponsible for four major business functions: claims, membership, call centers, and service centers. Created Operations QA Department, where the appropriate controls were developed to ensure that process optimization, quality and satisfaction was driven from all areas -
Part-Time Professor Of EngineeringPuerto Rico Polytechnic University, San Juan Pr Jun 1997 - Nov 2005Miami, Fl, UsTaught Relational Database Technology, Object-Oriented Technology and Systems Engineering. -
Director Of Systems Engineering / ConsultantInteractive Systems, Inc., A Subsidiary Of Triple-S Management Sep 2003 - May 2004Responsible for the evolution of a sustainable systems architecture consisting of diverse and complex software, hardware and business process components to support the continued growth and industry leadership of the health insurance subsidiaries of Triple-S Management. The project involved the engineering of an n-tier approach to gradually establish a solid component-based architecture upon which the core business systems execute, and other support systems interact.Compiled the New Systems Initiative vision and strategy for the evolutionary development of IT capabilities into the future for a major provider of IT services to a major Insurance Carrier.
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Independent ConsultantIndependent Consultant Jan 2003 - Sep 2003Engaged in diverse opportunities as a principal computer and systems engineering consultant. Worked on various business development activities for an upstart consulting firm.Conducted business process reengineering analysis and design for the sales commission management process. It included the gathering of requirements and the evaluation of current tools and automated components of the process. The end product is the design of a new highly automated process to streamline the calculation of commissions and prompt payment to the producers.
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Vice-President Information TechnologyTolic Dec 1999 - Jan 2003Responsible for the overall direction of technology in the company. Manage the implementation of new Financial Systems, new Telecommunications Systems, and new Insurance Business Support Systems. Implement the corporate vision for Mobile Applications, E-Commerce and CRM. Select technology partners that better fit with the projections and goals defined. Supervise the physical upgrade of facilities to enhance internal and external connectivity.
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Data Warehouse ManagerTriple-C, A Subsidiary Of Triple-S Management Jun 1997 - Dec 1999Responsible for the design and implementation of $1M+ computer information system. Handled complex vendor issues. Directed extraction activities from the production system. Supervised end user support and training. Maintained a short and long range vision that consolidated technology directions and business objectives. Achieved 400% ROI in the first year of the deployment.
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Senior Systems EngineerLockheed Martin Management & Data Systems (M&Ds) Jun 1991 - Jun 1997Mentor/Instructor/Consultant – Object-Oriented A & D, Web Technology, Data Warehousing (4/96 – 6/97)Senior Systems Engineer – Data Warehouse Team (1/96 – 3/96)Object-Technology Methodology Specialist – Telefónica of Spain R&D (9/95 – 12/95)Systems Engineer / Analyst – Baby Bell Reengineering Project (2/95 – 8/95)Systems Analyst and Engineer, New Business Development, Venezuela-ATC (9/94 – 2/95)Software Development Engineer, Program 470 (6/93 – 9/94)Edison Engineering Program (6/91 – 6/93)
Pedro Aponte Skills
Pedro Aponte Education Details
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Villanova UniversityComputer Engineering -
Founder'S Institute -
Rensselaer Polytechnic InstituteComputer And Systems Engineering
Frequently Asked Questions about Pedro Aponte
What company does Pedro Aponte work for?
Pedro Aponte works for Promenade Llc
What is Pedro Aponte's role at the current company?
Pedro Aponte's current role is President.
What is Pedro Aponte's email address?
Pedro Aponte's email address is pe****@****aol.com
What is Pedro Aponte's direct phone number?
Pedro Aponte's direct phone number is +178775*****
What schools did Pedro Aponte attend?
Pedro Aponte attended Villanova University, Founder's Institute, Rensselaer Polytechnic Institute.
What are some of Pedro Aponte's interests?
Pedro Aponte has interest in 5/04, 2/04, Guayama Chapter Ciapr, 4/04 University Of Puerto Rico, Rio Piedras Campus, Bayamón Campus, 12/03, Arecibo Chapter Ciapr, 4/04, Humacao Campus.
What skills is Pedro Aponte known for?
Pedro Aponte has skills like Business Intelligence, Leadership, Strategy, Management, Strategic Planning, Process Improvement, Business Analysis, Analysis, Business Process, Software Development, Project Management, Crm.
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