Armendina Dominguez
Milwaukee,WI
Summary
Accomplished Process Improvement Director with a proven track record at Elevance Health, specializing in strategic planning and leadership. Expert in leveraging Salesforce CRM and fostering cross-functional team collaboration to drive significant improvements in Medicare/Medicaid managed care. Achieved transformative business outcomes through innovative product design and market research, demonstrating a confident approach to complex project management and risk mitigation.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Process Improvement Director
Elevance Health
Milwaukee, WI
05.2022 - Current
- Develop plans to improve performance to be incorporated enterprise wide in Medicaid and Medicare
- Responsible for implementing large-scale project/program management for managed care, product development, customer care, digital, enrollment, reporting, sales, marketing, provider data, B2B and Salesforce CRM
- Executive level management of program operating budgets, allocating resources, maximizing productivity and profitability
- Monitor all managed care functional areas in Medicare/Medicaid project implementation team performance by developing reports, measuring outcomes, and supporting department goals
- Displayed advanced interpersonal skills and communicated with credibility across business and management levels
- Set aggressive targets for employees to drive company success and strengthen motivation
- Planned, created, tested, and deployed system life cycle methodology to produce high quality systems to meet and exceed member and provider experience
- Leveraged data and analytics to make informed decisions and drive business improvements
- Vendor management oversight of supplemental benefits product development, marketing strategy, sales training material and member experience journey
Business Change Director
Elevance Health
Milwaukee, WI
04.2019 - 05.2022
- Government Business Implementation Process Redesign, transform healthcare management methodologies to support corporate projects, programs and initiatives
- Monitor Medicare/Medicaid project implementation team performance by developing reports, measuring outcomes, and supporting department goals
- Leading IT and healthcare business stakeholders on implementing, integrations, new products on nationwide existing or new Medicaid Markets, Medicare Advantage and Medicare Group Retiree Solutions programs, Duals, SNPs
- Identify and align impacted business areas and resources on operational goals, needs and execution plans
- Lead efforts to identify best managed healthcare practices, project healthcare governance activities, NCQA, CMS
- Compile and present summary reports for Executive level management and leadership
- Manage timelines and deliverables to migrate Medicare/Medicare products onto different system platforms
- Consulting with downstream areas including Encounters, Enrollment, Vendors, Regulatory Reporting, Utilization Management, Provider Data, Customer Care, Membership Data Design, IT, Delegated Risk, to provide guidance on operational government business division deliverables
Business Change Manager
Elevance Health
Milwaukee, WI
01.2018 - 04.2019
- Managed Healthcare, Government Business Implementation Process
- Redesign strategic execution plans for clinical cost and managed healthcare initiatives
- Acted as the pharmacy business integration led high profile integration efforts
- Detected workforce collaboration use cases and problems from employees and business partners through interviews, focus groups and surveys
- Performed business analysis to identify requirements and impacts for organizational objectives
- Identified timelines and actions necessary to integrate services and solutions
- Monitors Medicare/Medicaid implementation team performance by developing reports, measuring outcomes, and supporting department goals
Network Relations Consultant Sr
Elevance Health
Milwaukee, WI
08.2015 - 01.2018
- Developed and maintained positive relationships with the Medicaid/Medicare /Commercial provider community by periodic on-site visits, communicating administrative or program-related changes, and resolution of provider issues
- Researches, analyzes, and recommends resolution for contract dispute, non-routine claim issues, billing questions, refund/recoupment inquires and other practices
- Coordinates communication process with all groups on issues related to administrative and medical policies, reimbursement, and provider utilization patterns
- Consult with Internal Resolution Unit and Business Analyst on overpayment recovery query requirements for WI Health
- Oversees activities related to the development and maintenance of the provider delivery system and portal interfaces
- Supervise processes for communication and complaint resolution between physicians, hospitals, members, and the public
Education
Bachelors - Healthcare Management
Concordia University
WisconsinSkills
- Policies & Procedures
- Strategic planning
- Leadership
- Team building
- Product Design
- Sales/Marketing Research
- Integrations
- JIRA
- Smart Sheets
- MS Project
- Product Development
- Strategic business planning
- Project management
- Risk management
- Salesforce CRM
- B2B
- Research and analysis
- Financial modeling
- Mergers and acquisitions
- Cross-functional team leadership
Certification
Scrum Master Certified (SMC)
Scrum Alliance - Issued April 2020 - Expires April 2025
Credential ID 001064837
Timeline
Process Improvement Director
Elevance Health
05.2022 - Current
Business Change Director
Elevance Health
04.2019 - 05.2022
Business Change Manager
Elevance Health
01.2018 - 04.2019
Network Relations Consultant Sr
Elevance Health
08.2015 - 01.2018
Bachelors - Healthcare Management
Concordia University