Summary
Overview
Work History
Education
Skills
Certification
Projects
References
Affiliations
Timeline
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ALICIA M. WILLIAMS

Montclair,USA

Summary

Dynamic Senior Director with a proven track record at Elevance Health, specializing in strategic planning and operational efficiency. Expert in driving AI adoption and process optimization, achieving significant cost savings and enhanced member experience. Skilled in executive communication and data-driven decision-making, leveraging tools like Tableau and SQL to deliver impactful results.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Senior Director, Process Optimization

ELEVANCE HEALTH
01.2025 - Current
  • Lead enterprise-level transformation initiative to implement AI-driven capabilities into the Prior Authorization review process, enhancing automation, reducing turnaround time, and improving provider/member experience for Medicare, Medicaid, and Commercial business.
  • Spearhead the design and execution of a process optimization initiative focused on provider dispute submissions for Anthem managed markets, targeting reduced administrative burden and cycle time for resolution.
  • Collaborate with business, clinical, and IT teams to ensure AI tools align with regulatory requirements and internal policy for government and commercial lines of business.
  • Facilitate strategic planning cycles in collaboration with segment leads, translating high-level objectives into execution roadmaps supporting regulatory readiness, health equity, member experience, and operational performance.
  • Establish baseline performance metrics and track improvement in operational throughput and accuracy post-AI implementation using data-driven dashboards and reporting.
  • Identify key process inefficiencies in the dispute management lifecycle and implement scalable workflow enhancements to drive timely adjudication and compliance.
  • Partner with actuarial and analytics teams to quantify cost avoidance and ROI tied to AI adoption and streamlined dispute processes.
  • Present initiative progress, risk mitigation strategies, and performance outcomes to executive leadership and governance bodies.

Product Management – Senior Director

Carelon MBM (a division of Elevance Health)
04.2024 - 11.2024
  • Championed strategic implementation of a new pharmacy utilization management system, driving readiness across Medicaid, Medicare, and commercial pharmacy operations.
  • Developed and implemented business segment plans integrating product launch milestones with operational readiness and compliance goals.
  • Coordinated operational alignment across provider data systems, benefit coding workflows, claims integration, and payment integrity structures.
  • Directed cross-functional execution, system mapping, and reporting implementation to support launch-readiness across regulated pharmacy business lines.
  • Created strategic plans and led communication alignment across business units to ensure stakeholder engagement and continuity.

Execution Director – Enterprise PMO

ELEVANCE HEALTH (Formerly Anthem, Inc.)
10.2022 - 04.2024
  • Led the project initiation and execution of transformation initiatives for Specialty Health and Pharmacy Utilization Management programs, resulting in significant cost savings and operational efficiencies.
  • Implemented robust oversight mechanisms to ensure the successful execution of the projects and alignment with organizational objectives.
  • Partnered with Sales, IT, and Compliance to coordinate enterprise-wide initiatives impacting government reporting, claims, and operational data alignment.
  • Led strategic planning workshops with business unit leaders to align execution priorities with evolving PBM regulatory and market dynamics.
  • Effectively managed project business and IT costs across multiple programs ensuring alignment with budgetary goals, implementing cost-saving measures, and optimizing resource allocation to drive financial efficiency and achieve program objectives.
  • Successfully spearheaded the transformative End to End Process Redesign for the management of Specialty Health and Pharmacy services for enrolled members to enhance efficiency, improve service delivery, and optimize operational workflows.
  • Implemented innovative solutions to optimize operations and enhance the customer experience for members and providers, delivering process mapping and business recommendations across Product Planning, Sales Experience, and Group Implementation organizations.
  • Delivered executive-level insights via Tableau dashboards and performance reporting, enabling data-driven decisions by Senior Leadership.
  • Developed effective and informative presentations on business metrics and strategies for process transformation for Utilization Management processes to C-Level executives and Senior Leadership.

Project Director – Enterprise PMO

ELEVANCE HEALTH (Formerly Anthem, Inc.) STRATEGIC STAFFING SOLUTIONS (CONTRACTOR FROM 05/17 - 04/18)
05.2017 - 10.2022
  • Leader of enterprise-wide initiative to apply penalties against providers for non-compliance with prior authorization guidelines. Annual ROI documented was approximately $40 million.
  • Managed product development of a new IT application for member management, resulting in $15 million in annual savings. Multiple business and impacts, including Claims, Provider Management, Utilization Management, Grievance and Appeals, Customer Service and Payment Integrity.
  • Assessed project scope and defined critical success factors in collaboration with project sponsors, business and IT teams and other impacted stakeholders to maximize ROI from projects. Developed comprehensive project plans for scope, schedule, cost, quality, communications, risk management and resources to support implementation of project initiatives.
  • Led the strategic mobilization and alignment of business and IT project managers for the Prior Authorization and Member Management applications, establishing goals, setting priorities, and ensuring adherence to project timelines and quality standards.
  • Oversaw and coordinated onshore and offshore technical teams specifically in the hands-on development, testing, and troubleshooting for the Prior Authorization penalty initiative and Member Management applications, ensuring rigorous testing protocols and seamless integration.
  • Developed and maintained comprehensive RAID logs (Risks, Actions, Issues, Decisions) to proactively manage project challenges, ensure transparent communication, and drive timely resolution of critical project elements.
  • Led meetings with Senior Management, impacted stakeholders and vendors to address current and anticipated business needs to help ensure successful implementation and maintenance post release.
  • Collaborated with actuarial teams to assess and determine projected value for a new provider penalty initiative aligned with the Prior Authorization project. Leveraged actuarial insights to refine project scope and validate potential ROI, ensuring alignment with organizational financial objectives and supporting data-driven decision-making in strategic planning and resource allocation.
  • Mentored and trained other junior project managers and consultants on project management methodologies and best practices for managing complex projects.

Consultant/Project Manager (Contract)

Fullsight Rx
NEW YORK, NY
01.2016 - 05.2017
  • Developed and managed project plans for IT and operations projects for healthcare clients.
  • Managed the day-to-day activities of cross-functional project teams and ensured adherence to project plans.
  • Advised on medication charge capture, 340B programs and cost saving strategies for health systems.

Pharmacy IT Project Manager

NEW YORK - PRESBYTERIAN HOSPITAL
NEW YORK, NY
09.2009 - 12.2015
  • Managed cross-functional project team overseeing the multi-year implementation of a new automated medication distribution system for inpatient and ambulatory patient population at all hospital campuses.
  • Managed project team consisting of Pharmacy, Procurement and IT to implement a carousel system for Central Pharmacy inventory to support medication needs for inpatient and ambulatory patients, resulting in $19 million in annual cost savings in pharmaceuticals in conjunction with automated dispensing cabinets.
  • Defined and assessed project scope, goals and deliverables that supported hospital technology initiatives in collaboration with senior management and stakeholders. Developed and managed the project plans, work breakdown structures, and schedules to ensure project milestones and deliverables were met for rollout of automated Pharmacy systems.

Education

Master of Business Administration -

BARUCH COLLEGE – CITY UNIVERSITY OF NEW YORK
NEW YORK, NY

Bachelor of Science - Pharmacy

LONG ISLAND UNIVERSITY
BROOKLYN, NY

Skills

  • Strategic planning and execution
  • Operational efficiency
  • Cost containment
  • Cross-functional alignment
  • Executive communication
  • Program and project management
  • Agile and waterfall governance
  • Risk management
  • Execution oversight
  • PMO leadership
  • Strategic roadmaps
  • Operational optimization
  • Utilization management
  • Enrollment and benefit management
  • Claims management
  • Payment integrity
  • Market readiness
  • Member experience
  • Data and business intelligence
  • Performance dashboards
  • Decision support
  • Business case development
  • Regulatory reporting
  • Quality metrics
  • Project management tools
  • MS Project and Smartsheet
  • Visio and SharePoint
  • Asana and JIRA
  • Confluence and ServiceNow
  • Data reporting tools
  • SQL and Tableau
  • MS Excel and PowerPoint

Certification

PMP Certification; Registered Pharmacist – New York, New Jersey

Projects

Led $40M Prior Authorization Payment Program at Elevance Health, integrating automation to improve turnaround times, reduce provider non-compliance and optimize financial outcomes., Spearheaded cross-functional redesign of provider dispute process, improving resolution speed, stakeholder communication, and audit readiness., Delivered $15M in cost savings through enterprise Member Management application; collaborated with IT, Product, and Business units to ensure user adoption and workflow alignment., Led enterprise-wide pharmacy dispensing optimization at New York Presbyterian, coordinating across Pharmacy, Procurement, and IT teams for $19M in annualized savings.

References

References available upon request.

Affiliations

Project Management Institute (PMI), Health Information Management and Systems Society (HIMSS), American Society of Quality (ASQ)

Timeline

Senior Director, Process Optimization

ELEVANCE HEALTH
01.2025 - Current

Product Management – Senior Director

Carelon MBM (a division of Elevance Health)
04.2024 - 11.2024

Execution Director – Enterprise PMO

ELEVANCE HEALTH (Formerly Anthem, Inc.)
10.2022 - 04.2024

Project Director – Enterprise PMO

ELEVANCE HEALTH (Formerly Anthem, Inc.) STRATEGIC STAFFING SOLUTIONS (CONTRACTOR FROM 05/17 - 04/18)
05.2017 - 10.2022

Consultant/Project Manager (Contract)

Fullsight Rx
01.2016 - 05.2017

Pharmacy IT Project Manager

NEW YORK - PRESBYTERIAN HOSPITAL
09.2009 - 12.2015

Master of Business Administration -

BARUCH COLLEGE – CITY UNIVERSITY OF NEW YORK

Bachelor of Science - Pharmacy

LONG ISLAND UNIVERSITY

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ALICIA M. WILLIAMS