Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ametric D. Sheppard

Princeton

Summary

Healthcare operations and product management expert with 18 years of experience in top organizations such as UnitedHealthcare and Aetna. Proficient in provider data systems and product lifecycle management, with a focus on cross-functional collaboration. Achievements include significant enhancements in data integrity, workflow efficiency, and customer satisfaction. Committed to excellence in healthcare service delivery and operational efficiency.

Overview

20
20
years of professional experience

Work History

Product Manager

UnitedHealthcare/Optum
08.2022 - Current
  • Manage the progression of business requirements through key technology milestones, ensuring timely and accurate delivery.
  • Collaborate with Technology Teams to validate initial feature breakdowns, ensuring alignment between requirements, feature mapping, delivery traceability, UI/UX standards, and rule classification.
  • Plan and conduct user interviews to gather insights into user needs and expectations, shaping the overall product experience.
  • Contribute to the development of solution artifacts that align with the business vision and support end-to-end traceability of requirements.
  • Resolve conflicts between stakeholder expectations and technical constraints through effective problem-solving and negotiation.
  • Lead functional and regression testing efforts to validate feature performance and quality.
  • Provide additional testing that automated tests may not cover in scope.
  • Define and maintain detailed capability-level acceptance criteria, establishing clear 'measures of success' for each feature.
  • Attend product demonstrations to verify that delivered capabilities meet defined requirements and business objectives.
  • Participates in PI Planning sessions to articulate and refine the business vision and value proposition.

Provider Data Consultant/MDA Lead, Provider Operations

UnitedHealthcare
07.2016 - 08.2022
  • Led the Migration Data Accuracy initiative, overseeing all aspects of provider network database management, including maintenance, data extraction and analysis, database optimization, peer audit coordination to reduce error rates, and enhancement of provider quality MBOs.
  • Developed and delivered training programs for OGA staff and authored comprehensive standard operating procedures to ensure consistency and compliance.
  • Championed process improvement initiatives, conducting time studies to establish team performance metrics and drive measurable efficiencies.
  • Collaborated with process owners to identify operational gaps, mobilize corrective actions, and provide weekly progress reports to leadership.
  • Managed User Acceptance Testing (UAT) for all new network implementations, ensuring system readiness and data integrity.
  • Initiated and led the Pulse Term Project, resulting in a 15% improvement in MBO performance.

Senior Network Program Specialist -Project Manager

UnitedHealth Networks
05.2015 - 07.2016
  • Collaborated with internal business units and regional partners to ensure effective program design, regulatory compliance, network assessment selection, and seamless program/product implementation.
  • Led network analysis and strategy development to support business objectives and optimize provider performance.
  • Planned and managed Provider Network events, including overseeing provider terminations across the Central Region.
  • Partnered with UHN Market Teams and cross-functional workgroups to ensure adherence to national and regional termination policies.
  • Created and maintained reports, extracted provider data for analysis, and served as a liaison between internal stakeholders to support informed decision-making.

Provider Installation/Mass Operations-Expansion Load

UnitedHealthcare
06.2013 - 05.2015
  • Executed unilateral and bilateral amendment mass projects to support new and existing product implementations, including Tricare, Compass, and Medicare, across multiple platforms such as Emptoris, Facets, NICE, and Pulse.
  • Conducted in-depth root cause analysis for maintenance projects, driving quality improvements, operational efficiencies, and process enhancements.
  • Applied established policies, procedures, and data insights to manage projects using a variety of extraction tools, databases, and internal resources.
  • Consistently met project goals and MBOs across all performance metrics, submitting escalations for deadline extensions when necessary and maintaining accurate tracking of project volumes across multiple mass project databases.

Associate Provider Installation/Econtracting

UnitedHealthcare
Richardson
02.2012 - 06.2013
  • Managed the installation and administration of assigned contracts, including structure and billing setup, eligibility data collection, database loading, and preparation of plan materials such as administrative documents and provider education resources.
  • Oversaw end-to-end provider contract and amendment loading using various databases, ensuring accuracy through rigorous auditing aligned with quality and reporting standards.
  • Served as Project Lead for all Bilateral Mass E-Contracting initiatives, fostering strong working relationships with internal business partners and ensuring timely, high-quality execution.
  • Acted as a Subject Matter Expert (SME), investigating contract-related issues and providing technical guidance and support to team members.
  • Led process improvement initiatives and authored standard operating procedure (SOP) documents to drive consistency, efficiency, and scalability in contract administration workflows.

Claim Reporting & Special Service Analyst/Claims Benefit Specialist

Aetna Healthcare
Arlington
08.2007 - 02.2012
  • Collected and validated data to ensure accuracy, accountability, and financial integrity, while resolving customer inquiries and complaints through both verbal and written communication in alignment with unit objectives.
  • Ensured confidentiality and precision in handling sensitive information.
  • Supported healthcare analytics by analyzing claims data to generate reports and provide actionable recommendations that drive business innovation, operational efficiency, and fulfillment of contractual obligations.
  • Managed end-to-end processes for assigned claims projects, including communicating financial outcomes and reporting results to internal and external stakeholders.
  • Reviewed and adjudicated claims by evaluating medical necessities, coverage eligibility, discrepancies, and cost containment opportunities.
  • Contributed to team development by assisting in the training and ongoing support of peers.

Clinical Intake Specialist

Humana Inc.
San Antonio
08.2006 - 08.2007
  • Processed service requests for outpatient HMO gated products in accordance with established procedures, ensuring accuracy and compliance with regulatory standards.
  • Performed accurate data entry and database management tasks.
  • Evaluated referrals for Case Management and Disease Management programs, supporting appropriate care coordination for Humana members.
  • Supported Utilization Management functions to ensure adherence to all applicable regulatory requirements and internal policies.
  • Acted as a liaison between the health plan and providers, offering guidance on authorization requirements and care steerage.
  • Collaborated with internal departments to resolve authorization-related issues, ensuring timely and professional service delivery for both providers and members, and facilitating access to appropriate health solutions.

Client Specialist

Humana Inc.
San Antonio
08.2005 - 08.2006
  • Handled inbound enrollment requests for Humana One’s individual health and life insurance plans, guiding customers through plan selection based on their healthcare needs.
  • Educated customers on plan details, including summaries of benefits, deductibles, coinsurance, lifetime maximums, stop-loss provisions, and out-of-pocket costs to ensure informed decision-making.
  • Completed and submitted detailed medical history surveys to underwriting for evaluation and approval, supporting accurate risk assessment and policy issuance.

Education

Health Information Technology

Brookhaven Community College
Dallas, TX
08.2025

Laredo Junior College
Laredo, TX

Huston Tillotson College
Austin, TX

Texas Health and Life Producer License -

Skills

  • Advanced analytical skills
  • Data validation
  • Root cause analysis
  • Performance optimization
  • High-volume data entry
  • Database management
  • Contract administration
  • Scheduling capabilities
  • Coordinating provider events
  • Managing dispatch workflows
  • Intake processing
  • Collaborative leadership
  • Stakeholder engagement
  • Agile planning
  • Cross-functional team alignment
  • Functional testing
  • Regression testing
  • UAT coordination
  • Quality assurance
  • Healthcare systems
  • Developing SOPs
  • Training programs
  • Capability-level acceptance criteria
  • Consistency
  • Compliance
  • Product visioning
  • Feature mapping
  • Solution architecture
  • User experience
  • Business value

Timeline

Product Manager

UnitedHealthcare/Optum
08.2022 - Current

Provider Data Consultant/MDA Lead, Provider Operations

UnitedHealthcare
07.2016 - 08.2022

Senior Network Program Specialist -Project Manager

UnitedHealth Networks
05.2015 - 07.2016

Provider Installation/Mass Operations-Expansion Load

UnitedHealthcare
06.2013 - 05.2015

Associate Provider Installation/Econtracting

UnitedHealthcare
02.2012 - 06.2013

Claim Reporting & Special Service Analyst/Claims Benefit Specialist

Aetna Healthcare
08.2007 - 02.2012

Clinical Intake Specialist

Humana Inc.
08.2006 - 08.2007

Client Specialist

Humana Inc.
08.2005 - 08.2006

Health Information Technology

Brookhaven Community College

Laredo Junior College

Huston Tillotson College

Texas Health and Life Producer License -

Similar Profiles

CREATE PROFILE
Ametric D. Sheppard