Tom Paulson Email & Phone Number

As the Revenue Integrity (RI) Director, Business Consultation I am responsible for directing the overall development, management and implementation of Revenue Integrity’s Center Of Excellence Market Engagement Organization. The role is responsible for all aspects of driving collaborative decision-making and implementation of corporate, regional and local actions to maximize risk adjustment activities and initiatives for the enterprise. Specifically, the role is accountable for increasing market level engagement, collaboration, and accountability by bridging the gap between RI National and Market level resources to drive risk adjustment results.

Spearheaded crucial highly visible and sensitive key initiatives under the direction of legal/compliance. Created a project management framework to set strategic goals, prioritize work, measure meaningful process improvement across various implementations, and communicate challenges to executive stakeholders.

Bismarck, North Dakota

Evaluated major digital corporate initiatives with the executive sponsor to strengthen compliance based on global security best practices, improve the efficiency/accuracy of reporting, and become the first business area to share interactive Tableau dashboards securely to external users. Invested in personal growth by completing Lean Six Sigma (ABX) training and being selected to attend an internal aspiring leaders conference for high potential talent.

Bismarck, North Dakota

Leveraged assets, resources, and capabilities to create innovative digital tools that focused on driving risk adjustment outcomes by providing clear and actionable data internally to Aetna users and externally to the provider community. These tools included the creation of Aetna's first ever text messaging campaign which focused on health assessment engagement as well as an externally available risk adjustment website. Interfaced with a diverse stakeholder audience ranging from legal/compliance to internal/external end users to translate feedback into technical specifications that leveraged modernized technology to create new intervention channels and efficiency.

Bismarck, North Dakota

Researched, analyzed, and managed projects directly tied to the integration of credentialing activities. Provided consultation on the design, testing, and enhancement of business processes with a focus ranging from technical assistance to work flow development. Fostered a consultative relationship with internal business partners and facilitated channels to gain feedback from key resource areas in an effort to improve service delivery.

Bismarck, North Dakota Area

Participated in cross functional project teams to identify and document functional requirements, work flow, information sources, distribution paths, and system specifications through the use of complex research and analysis techniques to support business operations.

Bismarck, North Dakota Area

Developed, designed, and implemented standardized training programs for health care services that included orientation, job content, technology, and customer service. All trainings promoted continuing compliance with accreditation and regulatory standards.

Bismarck, North Dakota Area

Provided direct customer service to potential providers, maintained accurate records, conducted initial risk assessments, and participated in numerous critical projects to support overall business needs.

Bismarck, North Dakota Area

Master Of Business Administration (Mba), Business Administration And Management, General, 4.0

Relevant coursework includes; Management Theory and Application, Human Resource Management, Executive Economic Analysis, Information.

Bachelor Of Arts (Ba), Communication, General, Magna Cum Laude