Anthony Chimienti
Cameron Park,CA
Summary
Energetic self-starter with over 10 years of Program Management and Business Analytics experience. Well-versed in networking, strategic planning, complex problem-solving and cross-functional communication. Decisive leader ready to leverage background in program management to expand organizational success.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Clinical Program Manager
Blue Shield of California
El Dorado Hills, California
11.2021 - Current
- Serving the Medi-Cal population in Los Angeles County, oversee the Enhanced Care Management Network Providers and manage the development as well as implementation of reporting, payment, contracting, auditing, eligibility, and delivery of new or existing internal/external programs and products
- Engage with local and state agencies around ECM program and perform Quarterly Provider Audits as well as report Quarterly to DHCS in accordance with program requirements.
- Develop and implement clinical program plans, goals, objectives, policies and procedures.
- Collaborate with stakeholders to identify needs and develop strategies for improving patient care outcomes.
- Monitor program performance metrics and develop corrective action plans when needed.
- Manage the Justice Involved population of Focus from initiation to delivery.
Senior Program Manager
Blue Shield of California
El Dorado Hills, California
04.2019 - 11.2021
- Responsible for managing Lifestyle Medicine Wellvolution programs from initiation through delivery and monitor for continuous improvement
- Operationalized programs based on claims, eligibility, and various lines of business (Medi-Cal, Medicare, FEP, IFP, CS)
- Created and maintained operational policies, procedures, and processes for effective program operations.
- Monitored the performance of program operations against established benchmarks.
- Analyzed financial data related to program operations and identified areas of improvement.
- Managed vendor relationships to ensure quality services and timely delivery of products.
Senior Business Analyst - Voice Channel
Blue Shield of California
El Dorado Hills, California
09.2015 - 04.2019
- Analyzed, designed, and developed business solutions for Smart Communications application (Thunderhead)
- Supported applications such as Verint, Avaya, Salesforce, Sharepoint, JIRA, CS Admin, VDI, and IVR
- Analyzed existing systems and processes, identified gaps and recommended improvements.
- Developed business process models to identify and document customer requirements.
- Conducted stakeholder interviews to understand user needs and preferences.
- Reviewed system design specifications for completeness, accuracy, consistency, traceability and usability.
- Smart Communications Project lead for Digital Transformation.
Senior Health Coach
Blue Shield of California
El Dorado Hills, California
10.2013 - 09.2015
- Developed health and wellness program for all Blue Shield of California CalPERS members
- Provided 1:1 health consultation for eligible participants to reduce or eliminate high-risk behaviors such as Diabetes, Hypertension, COPD, CHF, CAD, Asthma, and Hyperlipidemia
- Conducted weekly one-on-one sessions with clients to review progress against established goals.
- Provided education around the importance of healthy eating, physical activity, sleep, stress management, and other lifestyle factors.
- Developed individualized nutrition plans based on client's health goals and preferences.
- Managed 'Top Loser' weight loss incentive program for CalPERS members.
Wellness Program Coordinator
Verizon Wireless
Rancho Cordova, California
05.2009 - 09.2013
- Coordinated Corporate Wellness accounts for Northern California locations and assisted in leading a comprehensive wellness program
- Developed and implemented a comprehensive wellness program for employees.
- Conducted health risk assessments and provided individualized coaching to participants.
- Advised senior management on best practices for implementing effective strategies for promoting employee wellbeing initiatives.
- Collaborated with Human Resources department to ensure compliance with applicable laws and regulations related to workplace health and safety standards.
Clinical Health Educator
Kaiser Permanente
Rancho Cordova, California
04.2003 - 05.2009
- Primary responsibilities included Group counseling and teaching chronic disease classes to Kaiser Permanente members
- Provided health education services to the community on preventive healthcare, nutrition, and lifestyle choices.
- Organized health promotion campaigns and events for the public with an emphasis on disease prevention.
- Developed educational materials such as pamphlets, handouts, and videos to raise awareness about health-related topics.
- Collaborated with local organizations to coordinate resources and support for health-related programs in the area.
Education
Master of Arts - Kinesiology
Fresno Pacific University
01-2011
Bachelor of Science - Psychology
Santa Clara University
01-2001
Skills
- Strategic Planning
- Medi-Cal/Medicare
- Program performance analysis
- Partnership Development
- Systems Optimization
- Vendor Relationship Management
Certification
Lean Six Sigma Green Belt Certified
Activities
- NCAA Division 1 Soccer Scholarship Athlete, National Finalist 1998 & 1999
- Professional Athlete, United States Beach Soccer National team 2005-2013
Timeline
Clinical Program Manager
Blue Shield of California
11.2021 - Current
Senior Program Manager
Blue Shield of California
04.2019 - 11.2021
Senior Business Analyst - Voice Channel
Blue Shield of California
09.2015 - 04.2019
Senior Health Coach
Blue Shield of California
10.2013 - 09.2015
Wellness Program Coordinator
Verizon Wireless
05.2009 - 09.2013
Clinical Health Educator
Kaiser Permanente
04.2003 - 05.2009
Master of Arts - Kinesiology
Fresno Pacific University
Bachelor of Science - Psychology
Santa Clara University