Summary
Overview
Work History
Education
Skills
Accomplishments
Operational Experience Overview
Awards
Training
Timeline
Generic

Amber Elgin

Mesa,AZ

Summary

Accomplished senior executive with a proven track record of driving growth and operational excellence. Skilled in strategic planning, operational leadership, program management, and leveraging data to inform decisions. Known for fostering team collaboration and advancing capabilities to support business growth in an evolving landscape. Highly proficient in leadership, communication, and consistently delivering impactful results.

Overview

19
19
years of professional experience

Work History

Senior Director, Claim Product & Data

UnitedHealthcare
02.2020 - Current
  • Strategic leader driving claim product capabilities supporting 2-3M claims/day with enterprise level claim intake, validation, business rules and routing infrastructure. Focused on re-imagining a frictionless and simple experience that is affordable, transparent and consistent.
  • Large Scale Capital Program Leadership, from concept, OIA/ROI evaluation, capability development resulting in high quality implementation in agile product development framework.
  • Delivered enterprise critical priorities for new business expansion, system migrations, regulatory requirements for federal and state mandates, and strategic capital programs across 85+ projects in 2024 with supported ROI valued at $208M
  • Enabled collaborative and business centered focus across the complex technology landscape to modernize infrastructure, reduce complexity and drive a simplified reusable architecture while maintaining delivery of 700M+ claims in 2024
  • Designed methodology to articulate workforce needs to support growing business critical efforts while mitigating business risk (regulatory, quality, technical debt) to support $48M in additional enterprise ROI and $11M in risk avoidance for 2022+
  • Accountable for product model strategic roadmap, implementing systems to improve customer experience
  • Direct management of large-scale Pre-Processing capital projects involving 35+ applications and 20+ capabilities in 2025
  • Achieved departmental goals by developing and implementing strategic plans and initiatives.
  • Increased employee satisfaction, providing regular coaching and skip-level sessions.
  • Led cross-functional teams to successfully launch new products, meeting deadlines and budgets.
  • Navigated complex regulatory environments to ensure compliance with local laws, standards, and regulations relevant to the business domain.
  • Optimized project timelines by effectively delegating tasks and prioritizing workload among team members.
  • Cultivated a culture of innovation by promoting creative thinking and encouraging employees to take calculated risks in pursuit of solutions.

Transformational Thinking Program Co-Lead

UnitedHealth Group
10.2019 - 01.2022
  • Voluntary leadership and consultative role supporting Transformational Thinking for Social Impact
  • Sponsored by Human Capital and Social Responsibility with participation spanning the enterprise
  • Leveraged design thinking and creative problem-solving methodologies to solve high priority issues
  • Led human centered design workshops on experimentation through MVP development, testing and iteration to enable and empower a community of practice
  • Catalyst for partnerships and networking across the enterprise, enabled by shared passion for social impact and credible transformation in support of customers, communities and diversity

Director Transformation

UnitedHealthcare Benefit Ops Transformation
07.2018 - 02.2020
  • Leader in the highly visible MOVE (Modernizing Operating Value for Everyone) program with an enterprise focus on driving value to the Commercial operations organization
  • Value Architect role evaluated initiatives across the commercial business to identify synergies and realize cost savings
  • Managed value subscriptions tied to yearly commitments and impacted operational areas
  • Ensured CBA feasibility, transparency in communication for programs claiming operational savings
  • Effectively served as a trusted resource for both program leads and operational leaders


Director Business Process, Flex Program

UnitedHealth Care Claims Management
09.2017 - 07.2018
  • One of two leaders selected for an accelerated development program.
  • Led program that scaled and re-balanced leadership levels across Operations. Impacts included adjustments to span of control, reduction of redundant functions and enhanced accountability for operational leaders.
  • Led work outside current work function for one year before being promoted to permanent Transformation role
  • Gained extensive experience in change leadership, innovation and multi-disciplinary approaches to business challenges
  • Engaged across the enterprise to drive innovation and operational improvements to transform the business
  • Joined Transformation Team for E&I Operations challenged with highest visibility projects delivering upon key business priorities

Director Claims, Strategic Initiatives

UnitedHealth Care Claim & Provider Services
02.2014 - 09.2017
  • Reduced prompt pay interest exposure by 40% by developing strategic initiatives focused on Prompt Pay Interest remediation, affordability, systems enhancements and product implementations impacting operations, across 3 years
  • Managed prompt pay remediation program for commercial claims including governance, C-suite reporting, forecasting, data analysis and real time auditing to drive a ZERO interest environment
  • Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
  • Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.
  • Leveraged data analytics insights for informed decision-making in critical areas such as risk reduction, cycle time improvement, and regulatory constraint management.

Associate Director Claims

UnitedHealth Care Claim & Provider Services
09.2012 - 02.2014
  • Managed operational areas that supported claim rework, adjustment, issue resolution quality and workforce management capabilities that continuously achieved SLA's and PG's for timely processing and resolution
  • Led projects focused on reducing waste with rework in the E2E system landscape
  • Leadership spanned 200+ FTE's, guiding daily operational performance as well as training and improvement plans.
  • Mentored junior staff members, providing guidance on professional development opportunities and career progression paths within the company.
  • Reduced operational costs by identifying inefficiencies and implementing cost-saving measures within departments.

Director, Operations Claims and Sr. Manager Ops

Premera Blue Cross Operations
09.2006 - 09.2012
  • Functional responsibility for processing over 1.2M claims/month with 98% turnaround time maintaining 99% accuracy
  • Responsible for claims operations, claims quality performance and process improvements for the site location in Bend, Oregon.
  • Sponsor role for LEAN events, Operations wellness initiatives and Corporate Green Team
  • Health Plan Senior leadership representing Claim Operations
  • Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
  • Facilitated cross-functional collaboration for improved decision-making processes within the organization.


Board Member

United Way of Deschutes County
01.2009 - 12.2010
  • Board member actively supported the Community Impact Panel and the Budget Allocations Committee delivering critical support to the county.
  • Collaborated with other board members to develop and execute programs and initiatives to advance organizational mission.
  • Served as a strong advocate for corporate social responsibility, influencing positive community impact.

Education

MIS - Masters in Information Systems

Roosevelt University
Chicago, IL

MBA - Masters of Business Administration

Arizona State University
Tempe, AZ

Bachelor of Business Administration and Management - undefined

Mesa State University
Grand Junction, CO

Skills

  • Leading cross-functional teams
  • E2E Business development
  • Cultural change leadership
  • Stakeholder engagement
  • Legal compliance management
  • Strategic program management

Accomplishments

  • Achieved $20M+ value by completing highly complex infrastructure modernization with accuracy and efficiency spanning 3 years, through 2025.
  • Achieved $208M in supported value in 2024 completing 83 projects for the enterprise.

Operational Experience Overview

Multi-faceted operations leadership includes regional health plan site leadership and departmental roles. Led functions including: Claims, Rework, Appeals, Quality, Workforce Mgmt, Prompt Pay Interest Remediation, Strategic Initiative Impact Assessment, Internal Controls, Performance Guarantees, Customer Reviews and MTM Audit processes

Awards

Leadership Edge Executive Development, 2025 selected

CEO Award, Premera Blue Cross, 2011

Training

  • Leadership Edge, Mar 2025- Sept 2025
  • LeSS Transformation Jan 2022
  • Scaling Lean & Agile Development Aug 2021
  • UHC Ops Mentorship Nov 2020-June 2021
  • Accelerating Change & Transitions Oct 2018
  • FLEX Program FY 2017
  • Human Centered Design Mar 2016
  • Brookings Institute: Art & Science of Negotiation May 2018
  • CEO Award FY 2011, Premera Blue Cross
  • Leadership Horizons Executive Development FY 2009
  • Lean Leader Certification FY 2008
  • Lean Leader Japan SuperFlow June 2008

Timeline

Senior Director, Claim Product & Data

UnitedHealthcare
02.2020 - Current

Transformational Thinking Program Co-Lead

UnitedHealth Group
10.2019 - 01.2022

Director Transformation

UnitedHealthcare Benefit Ops Transformation
07.2018 - 02.2020

Director Business Process, Flex Program

UnitedHealth Care Claims Management
09.2017 - 07.2018

Director Claims, Strategic Initiatives

UnitedHealth Care Claim & Provider Services
02.2014 - 09.2017

Associate Director Claims

UnitedHealth Care Claim & Provider Services
09.2012 - 02.2014

Board Member

United Way of Deschutes County
01.2009 - 12.2010

Director, Operations Claims and Sr. Manager Ops

Premera Blue Cross Operations
09.2006 - 09.2012

MBA - Masters of Business Administration

Arizona State University

Bachelor of Business Administration and Management - undefined

Mesa State University

MIS - Masters in Information Systems

Roosevelt University

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