Amida Care is a Special Needs health Plan (SNP) for persons with chronic care needs, including HIV/AIDS, who have Medicaid and live in NYC. Our mission is to connect people to all the care they need to achieve wellness or to effectively address illness.

Provides strategic and operational expertise in an enterprise-wide environment to create an unbiased partnership to install discipline and ensure business practices, opportunities for improvement and governance are pursued and executed efficiently and effectively. Financial responsibilities (with direct impact to enterprise bottom line – generating/saving millions of dollars annually through various channels including: Stop Loss; Kick/Maternity Billing; Collections and Receivables Plan Management with annual receivables greater than $7B.Collaborate with Legal and Finance departments; host monthly close meetings to ensure resolution on any collection’s activity and reserves.Significant contributions towards EmblemHealth’s short and long-term business initiatives which include Operating Income, Administrative Expenses, Medicare & Medicaid ratings, and Net Promoter Score performance.Innovative and strategic thinker with out of the box solutioning.Responsible for total customer delivery from E2E as it relates to membership and billing, case installation, collections, benefit configuration and the management of delegated vendors in a Global BPO environment.Demonstrates sophisticated conceptual thinking for developing and implementing metric reporting and monitoring approaches that will assist senior management’s fact-based decision making.Serves as a member of the organization’s DEI Council as well as an executive sponsor for one of our ERGs in support of the company’s DEI mission and execution of the Corporate DEI Strategic Plan.

Responsible for the oversight of an array of complex data from multiple sources to uncover opportunities to improve the customer’s experience through seamless case installation and performance monitoring through operational Key Indicators for post Installation activities across all lines of business and across all market segments.Provides business critical change management leadership in a global setting by demonstrating creativity and effectiveness in addressing major strategic challenges with strong communications, planning and tactical implementation. Maintains predictable consistency in various elements of operational performance and key indicators by identifying gaps, trends and deficiencies and driving disciplined root cause analysis to ensure fast, steady progress in operations performance and improvements.Promotes a culture of excellence throughout the plan by exhibiting and respectfully commanding accountability and integrity in an environment with international and global reach.Collaborative and influential partner across the enterprise to build trust, and engage teams to work together across silos to harness insights and develop solutions that yield the greatest customer satisfaction. Oversees the ongoing evolution of an enterprise wide Operational Performance Dashboard to ensure it is easily digestible and actionable.Served as a mentor for the department to retain and promote employees by providing various career paths and guidance for growth opportunities.

Accountable for accurate claims adjudication and payment processes for more than 5.4M claims annually representing approximately $1.4 billion in payments.Led the successful implementation of ACA mandates to support the gateway and FFM (Federally Mandated) marketplace integration and connectivity.Led a departmental mentorship program to increase employee career advancement and leadership awareness and adoption related to the department’s DEI strategic plan focused on creating an inclusive workforce within the organization.Served as the Program Manager and subject matter expert to identify system gaps, process design, implementation and timely execution of projects in accordance with market and industry standards.Responsible for the vendor relationship management and operational and security on site assessments for BPO offshore processes that resulted in a $1.1M dollars in savings through contract negotiations. Managed an operating budget greater than fifteen million annually for six diverse functional areas.Led the operational and technical development and execution of project plans to achieve expected business results for current and future strategic expansion opportunities that increased earnings and operating efficiencies and reduced administrative costs while adhering to regulatory and accreditation requirements.DEI committee member and partner with local colleges to identify diverse talent and opportunities for internships and fulltime positions.