Description
Areas of expertise: Cross Functional Team Leadership, Process Improvement, Business Analysis, Strategy and Vendor Management DST Systems/Argus Health Systems, Kansas City, Missouri * Oct 2014 - present Director, Government Program Operations (April 2016 - present) Leader of newly formed Operations team accountable for Medicare, Medicaid and Health Insurance Marketplace (HIM) program service, quality and cost by overseeing a team of 17 (remote, 75% travel). * Accountable for the development of the strategic plan, including resource and capacity planning, and overseeing the tactical implementation and operations to key Medicare, Medicaid and HIM services including Prescription Drug Event (PDE) file management, Plan Finder, reporting and printed materials (i.e. Explanation of Benefits, Transition Letters) to support BPO customers. Active monitoring of 6 Service Delivery metrics @ 99.9998% on-time and 7 - Critical to Quality metrics @ 99.88% accuracy (right the first time). * Using Lean Six Sigma methodology will define and implement value stream processes, operating procedures, metrics (critical to quality) and quality controls while constantly seeking ways to improve the organization's ability to deliver reliable and consistent results to our clients. Participating member of Argus' Quality Council, led the development of monthly dashboard consisting of 25 critical to quality and service delivery metrics. * Department champion leading the deployment of Operational Excellence software across Government Program Operations, Pharmacy Operations and Clinical Operations. Significantly improved efficiency and utilization post pilot period, efficiency from 54 to 77% and utilization from 45 to 61%. Operational Excellence Leader, Clinical Services (May 2015 - April 2016) Lean Six Sigma black belt, converted to employee continued responsibilities. Portfolio/Program/Project Management and Operational Excellence (Quality & Service Delivery metrics, Reliability, Business Process Development) leader for Clinical Services supporting business transformation. Clinical products include Utilization Management (DUR), Medical Drug Management, Formulary/Rebates, Specialty Pharmacy and Medicare STARS improvement program. Also responsible for Risk Assessment modeling and prevention, Business Continuity planning, and Vendor Management service level agreement controls and monitoring. RMK Consulting, Armonk, New York * Oct 2014 - May 2015 Executive Management Consultant, Clinical Program Leader: DST Systems/Argus Health, Kansas City, MO.
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