Strategic Leader offering extensive experience in PBM/ Healthcare /PBM experience with 10+ years formal and informal leadership to 20+ individual contributors. Proactive, collaborative, supportive communicator with a passion for culture and member experience. Large-scale enterprise Client and System implementation, Program Leader, Senior Product Manager, Project Manager, Mentor, Operations Manager.
Experienced with designing and implementing functional architectures that align with business objectives. Utilizes deep knowledge of system integration and process optimization to enhance operational efficiency. Track record of successful project leadership and stakeholder collaboration.
Overview
19
19
years of professional experience
Work History
Senior Functional Architect, PBM Product
RxSense
05.2024 - 01.2025
Provided strategic support with comprehensive expertise collaborating with product teams, engineers, and developers to create best-in-class Pharmacy Benefit Management to exceed expectations and functionality
Continuously monitored industry trends and evolving technology standards to inform future projects'' functional architecture decisions.
Achieved successful system implementations by identifying functional requirements and translating them into technical specifications.
Senior Implementation Project Consultant
PSG Pharmaceutical Strategies Group
10.2023 - 03.2024
Guided multiple clients for 1/1/2024 PBM implementations including industry standards and best practice, pharmacy claim surveillance, and project lead for product development with vendors and TPAs for Commercial, Medicare Advantage/DSNP plans.
Enhanced client satisfaction by providing regular progress updates and addressing concerns in a proactive manner.
Pharmacy Benefit Management Consultant
Self-Employed
11.2022 - 09.2023
Consultant providing guidance to multiple Clients for 1/1/2024 PBM implementations to include Industry Standards, Reject and Paid claims surveillance, Project Lead for Product Development with vendors and TPAs for Commercial, Medicare and DSNP plans
PBM/Healthcare Consultant offering guidance to Clients and Vendors in Benefit and System implementations, member migrations, Project Management, Risk identification/mitigation to ensure Client success with minimal negative member impact
Evaluated client needs and expectations, establishing clear goals for each consulting engagement.
Senior Product Manager
Anthem, Inc.
10.2020 - 10.2022
Led retail pharmacy network product development strategy for Anthem Inc
Successfully launched medication delivery programs to consumers locally and domestically
Developed and provided training and resources for 500+ Anthem Sales, Account Management and Clinical partners
Collaborated with internal partners and stakeholders by aligning on Project Plan milestones to develop and implement cross-functional product development for all lines of business including Commercial, Medicare, Medicaid, and DSNP populations and project management completion
Established Developed and Maintained Project Plan and Implemented cross-functional solution for self-funded response to the Public Health Emergency mandate to allow members to obtain COVID test kits at Point of Sale, Digital thru Portals and Apps or reimbursed thru Direct Paper Direct claim submission
Increased product adoption by identifying customer needs and developing innovative product features.
Established strong relationships with key stakeholders, fostering collaboration across departments for seamless product development.
Led cross-functional teams for successful product launches, resulting in increased market share.
Leveraged Agile methodologies for efficient project management and rapid iteration cycles in response to changing market demands.
Senior Product Manager
Aetna Medicare
06.2019 - 10.2020
Collaborated with internal and external functional partners through all phases of Medicare Parts B, D, and DSNP annually
Developed Project Plan to incorporate all annual tasks and functional area partners and stakeholders’ activities including annual premiums, bid-related activity, and STARS ratings reviews CMS Guidance/Filing to ensure all work was completely timely and with accuracy
Managed product roadmaps, aligning with company goals and ensuring timely delivery of key features.
Ensured regulatory compliance by working closely with legal departments on necessary documentation and approvals.
Program Project Lead
CVS HEALTH Caremark
02.2018 - 06.2019
Project Voyager Client Implementation Lead in support of PBM Migration activities (system and member migration) from Express Scripts to CVS-Anthem Inc
Accountable for development and program project plan maintenance for Commercial, Medicare and Medicaid business with oversight and alignment with 26 unique Workstream areas ensuring dependencies, risk mitigation to keep all areas on track to ensure on-time deliverables/milestones beginning at project initiation thru Go-Live then post-Go-Live support to identify best practices
Delivered Program-level matrix status reporting and communications to all Clients, Consultants, Leadership, Stakeholders, Workstreams, internal and external stakeholders and cross-functional workstreams
Optimized resource utilization by accurately forecasting project needs and allocating resources accordingly throughout the project lifecycle.
Collaborated with cross-functional teams to ensure seamless integration of various project components.
Facilitated clear communication between internal departments, ensuring all parties remained aligned on goals throughout the duration of each project.
Implemented best practices in documentation management systems that improved efficiency, accessibility, and security of project-related information.
Balanced multiple projects simultaneously, maintaining focus on priorities and deadlines.
Senior Client Implementation Lead
OptumRx United Healthgroup
07.2013 - 06.2017
Business Project Manager Benefit Implementation responsible for end-to-end implementations including customer migrations, system using Microsoft tools, Salesforce, and RxClaim
Implemented effective change management strategies, facilitating smooth transitions for end-users during system upgrades.
Trained staff on new systems and procedures, increasing efficiency and reducing user errors during the transition period.
Subject Matter Expert (SME) on all Accumulator benefits, spending accounts and processes providing ongoing support to internal and external functional partners for UnitedHealthcare Division support of 12+ million member lives
Worked closely with Clients, IT, IT Development, and Model Office, QA and UAT testing teams to gather all requirements, establish connections for file exchanges/integration with vendors and employer groups
Partnered with Clients, UHC Account Management teams, and internal functional areas to evaluate, identify, and implement process improvements to improve efficiency, quality, and streamline work flows
Developed and led virtual and in-person training to 500+ attendee audiences inclusive of all levels with the organization
Fostered a collaborative team environment by promoting open communication, sharing best practices, and recognizing individual contributions.
Monitored project progress closely, adjusting resources as needed to meet or exceed established milestones.
Maintained strong relationships with clients throughout implementations by providing regular updates on progress, addressing concerns promptly, and soliciting feedback for continuous improvement efforts.
Improved customer satisfaction with timely issue resolution and proactive communication during system implementations.
Managed multiple simultaneous projects, maintaining focus on priorities and deadlines while ensuring consistent results.
Consistently met or exceeded client expectations for delivered solutions by maintaining high standards of quality and attention to detail throughout the implementation process.
Operations Manager
Express Scripts Medco Health Solutions
01.2006 - 04.2013
Hired and managed an Operations team of 6 individual contributors
Led training for internal and external stakeholders and developed enhancements to on-boarding processes
Partnered with Clients, UHC Account Management teams, and internal functional areas to evaluate and identify opportunities for organization improvements and Standard Operating Procedure Documents
Developed and led cross-functional in person and virtual training sessions
Supervised operations staff and kept employees compliant with company policies and procedures.
Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.
Led hiring, onboarding and training of new hires to fulfill business requirements.
Analyzed and reported on key performance metrics to senior management.
Facilitated smooth collaboration between departments through clear communication channels.
Achieved higher employee retention rates by fostering a positive work environment and providing opportunities for professional growth.
Developed strong relationships with vendors, resulting in better pricing and improved service quality.
Spearheaded process improvements, resulting in increased productivity and reduced operational costs.
Led successful change initiatives, ensuring seamless transitions during organizational restructuring efforts.
Assisted in recruiting, hiring and training of team members.
Trained and guided team members to maintain high productivity and performance metrics.
Education
Bachelor of Science -
University of Wisconsin-River Falls
Skills
PBM/Healthcare
People management
Facilitation and Presentation skills
Subject Matter Expertise (SME)
Training and Onboarding
Tableau
Jira
Salesforce
Strategic Planning and Alignment
Relationship management
Product Development and Management
Project Management
System Implementation
Data migration and Integration
Program Lead
Motivated leader
Achieving high levels of accuracy
Project monitoring
Employee motivation
Product launches
Customer focus
User acceptance testing
Team motivation
Client support
Cross-functional collaboration
Documentation management
Risk management
Strategy development
Product roadmaps
Agile methodologies
System implementation
Planning and implementation
Scope definition
Product roadmapping
Product development
Software implementation
Management
Performance monitoring
Operations oversight
Leadership skills
Product metrics
Policies and procedures implementation
Competitive analysis
Operations management
Client relationships
Technology implementation
Collaborative mindset
Project management abilities
Client relations
Product lifecycle management
Requirements writing
Coaching and mentoring
Project leadership
Business planning
Relationship building
Change management
Regulatory compliance
Network architecture
Motivational leadership style
Brand building
Market penetration strategy
Staff training
Continuous improvements
Mentoring
MS office
Process improvements
Continuous integration
Recruiting and hiring
Strategic planning
Business case development
Data gathering
Workflow management
Project planning and development
Motivated self-starter
Cost management
Data mining
Project management
Staff development
Process improvement
Root-cause analysis
Microsoft office expert
Work flow planning
Project planning
Product management
Digital product management
Program enhancement
Timeline
Senior Functional Architect, PBM Product
RxSense
05.2024 - 01.2025
Senior Implementation Project Consultant
PSG Pharmaceutical Strategies Group
10.2023 - 03.2024
Pharmacy Benefit Management Consultant
Self-Employed
11.2022 - 09.2023
Senior Product Manager
Anthem, Inc.
10.2020 - 10.2022
Senior Product Manager
Aetna Medicare
06.2019 - 10.2020
Program Project Lead
CVS HEALTH Caremark
02.2018 - 06.2019
Senior Client Implementation Lead
OptumRx United Healthgroup
07.2013 - 06.2017
Operations Manager
Express Scripts Medco Health Solutions
01.2006 - 04.2013
Bachelor of Science -
University of Wisconsin-River Falls
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