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Online Resumes with "Utilization Management"
Experienced results-driven professional with strong leadership and relationship-building skills. Accomplished program manager and application architect with extensive experience in front office and back office operations due to extended exposure to SDLC program delivery in the Fortune 100 business sector.
Ideal Companies: CVS Caremark, Aetna, OptumRx, United Health Group, Humana Pharmacy Solutions, Envolve, Centene, Envision Rx, Anthem, Ingenio, WellCare, Tufts Health Plan, Harvard Pilgrim Healthcare, Healthfirst, McKesson, Amerisource Bergen
Tags for this Online Resume: Acquisitions, Annuity, Architect, Back Office, Compaq, Data Conversion, Data Warehouse, e-Commerce, Financial, Financial Services, PBM, Government Programs, HIPPA Compliant, Operations, Business Process Management, Business Systems Analysis, Shared Services, Lean Six Sigma, Scrum Master, MS Project, MS SharePoint, MS PowerPoint, MS Excel, MS Visio, Relational Database Management, Business Process Modeling Notation, MEGA, Agile Project Management, Waterfall Project Management, Medicare, Health Care Reform, Process Improvement, Formulary, Claims Adjudication, Utilization Management, Business Requirements, Strategy, Salesforce, CRM, EPMO, CMMI, Veeva, Data Science, Data Lake, Business Cases, Procurement, Oracle, Data Governance, Managed Markets, Supply Chain, ROI, Compliance, Vendor Management, Metrics, Reporting, Dashboarding, SDLC, KPI, COE, Trend Analysis, Executive Reporting, Trainer, Remediation, Business Owner, Consulting Services, Affordable Care Act (ACA), Agile Methodology, Applications Architecture, Applications Delivery, Benefits Strategy, Big Data, Budgeting, Business Process Change Management, Business Process Design, Business Processes Improvements, Business Process Flows, Business Process Management Bpm Software, Business Process Mapping, Business Process Modeling Notation (BPMN), Business Process Strategy, Business Process Transformations, Business Systems Consulting, Business Systems Design, Business Systems Implementation, business use case, Capability and Maturity Integration (CMMI) Requirement Management and Requirement Development Training Certification, Capability Maturity Model Integration (CMMI) Assessments, Center of Excellence, Claims Processing, Client Presentations, Client-Server, Collaborative Innovation, Continuous Process Improvement Initiatives, Cross Trainers, Customer Experiences, Customer Relationship Management (CRM), Data Definition Language (DDL), Data Warehousing Systems, DB2, Drug Information, Drug Utilization Reviews, Enterprise Solutions Architecture, Executive Presentations, Gaps Analysis, Government Affairs, HIPAA Compliance, HIPAA Guidelines, HIPPA Regulations, Information Systems Analysis, Internal Consulting, IT Systems Analysis, Key Performance Indicators (KPIs), Leadership, Leadership Mentoring, Mainframes, Management Consulting, Management Dashboards, Matrix Management, Medicare Claims, Medicare Part D, Medicare Prescription Drug Plans, Medication Therapy Management, Mentoring Programs, Microsoft Access, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft SharePoint, Microsoft SQL Server, Microsoft Visio, Microsoft Word, multi-tiered communication, Needs Assessment, New Product Introduction (NPI), Object-Relational Database, Object-Relational Databases (ORD), People Leadership, Performance Management Reporting, Performance Metrics, Pharmacy Benefits Management (PBM), Pivot Tables, Portfolio Management, Predictive Analytics, Prescriber, Prescription Drugs, Process Improvement Management, Process Reengineering, Procurement Operations, Project Management Life Cycle, Relational Database Management System (RDBMS), Requirements Traceability Matrix (RTM), Return on Investment (ROI), Scrum Methodology, Solution Architecture, SQL Relational Databases, Strategy Creation, Structured Query Language (SQL), Sybase, Systems Development Life Cycle (SDLC), Technical Project Management, Therapeutics Committee, Training the Trainer, Unified Modeling Language (UML), Use Cases, Waterfall Model, Web Based Services, Writing User Stories
Team Leadership: Proven Senior Manager for project and program management, controlling budgets, allocating resources, team utilization, team training, service delivery and client satisfaction. Defined team strategy, competencies and technical resource allocation for targeted customers. Managed and developed project managers / business analyst teams, cross functional teams, contractors, customers and vendors. Result: Success...