Technical Program Director

• Dec 2017 - Present

Director, Medicaid Reporting and Analytics

• 2014 - 2017

Lead team responsible for delivery of Medicaid reports. Define service level agreements and delivery schedule for monthly state regulatory reports. Hired 5 SQL developers to build, run, and automate reports. ▶︎ Achieved 100% on time delivery while partnering with account teams to meet state Medicaid Regulatory and ad-hoc report deadlines set by health plan clients. ▶︎ Documented all client report requirements, ensuring all final reports met client needs; based on initial success, regulatory reporting requirements increased from 360 to over 10K reports annually and ad-hoc report requests more than doubled to over 600 annually.▶︎ Implemented new report which tracked claims paying due to “smart adjudication rules”, eliminating need for prior authorization reviews, reducing member abrasion and enabling ability to bill for those claims.▶︎ Reduced operational impact to account and reporting teams while generated cost savings by developing suite of self-service, client-available Medicaid oversight reports.

Director, Government Programs

• 2009 - 2014

Partnered with Government Programs and IT executive leadership to manage $20M Medicaid and Health Care Reform project portfolios. Ensured project prioritization and communicated status to leadership. Led 2 teams of 8 business analysts (including indirect reports) responsible for defining business requirements and conducting user acceptance testing for Medicaid and Health Care Reform projects.▶︎ Implemented multiple system enhancements to ensure Express Scripts is compliant with Affordable Care Act regulations.▶︎ Identified Medicaid functionality gaps between adjudication systems, post-Express Scripts / NextRx merger, and implemented consolidated functionality on Express Scripts platform, resulting in increased efficiency and reduced operational costs; integrated system on single Express Scripts platform after 2012 Medco acquisition.

Director, NextRx

• 2008 - 2009

Express Scripts acquired NextRx in 2009Led a team of 5 business system analysts responsible for researching and resolving Medicare Part D benefit setup / adjudication issues and defining business requirements / user acceptance criteria for IT projects. ▶︎ Reduced resource contention and increased productivity by hiring 3 new business analysts and overseeing development of Medicare Part D training program.▶︎ Organized and formalized issue intake through creation of Med D Help Desk process, reducing duplication of effort and improving organizational efficiency.▶︎ Created formal business and test requirements document for IT projects, resulting in reduced costs through better documentation and less rework

IT Project Director

• 2002 - 2008

Led multiple complex projects as part of Anthem Specialty Business Division. ▶︎ Reduced cost and increased fulfillment efficiency by implementing Mail Order Integration project, which merged Mason, OH and Fort Worth, TX systems on a single mail order platform, consolidated eligibility and claims data to 1 database, and improved load balancing across both pharmacies.▶︎ Spearheaded integration and consolidation of Prescription Management and WellPoint Pharmacy Management Rebate Systems, resulting in millions of dollars of increased revenue.▶︎ Implemented several modifications to dental and vision adjudication and eligibility systems, ensuring compliance with HIPAA privacy rules.