Christopher Amadon
Fond du Lac,WI
Summary
Accomplished, flexible, and results-driven business leader with nearly 25 years of experience in leadership roles across Operations, Operations Support, Provider Operations, and Information Technology at Anthem. Successfully led organizational change while consistently delivering high-quality results for the provider community, customers, and business stakeholders. Focus on developing effective partnerships based on Core Values, ensuring timely delivery of priority work with high customer satisfaction. Experienced leader who has effectively partnered to deliver strong results across both Commercial and Government business.
Overview
25
25
years of professional experience
Work History
Staff VP Provider Ops Strategy
Elevance Health
05.2022 - Current
- Hired and managed employees to maximize productivity while training staff on best practices and protocols.
- Spearheaded cross-functional initiatives across departments to achieve business goals for bottom-line profits.
- Aligned organizational objectives with company mission to increase business growth and integrate work strategies.
- Cultivated a high-performance culture within the organization by setting clear expectations for employees at all levels, providing regular feedback, and recognizing achievement.
- Collaborated closely with various department heads on strategic planning initiatives to ensure alignment between corporate goals.
- Introduced process improvements that reduced operational costs while maintaining high-quality standards across all departments.
- Drove digital transformation efforts within the organization by implementing advanced technology solutions that streamlined workflows and improved customer experience.
- Established Health Solutions Response Team for optimization of rework requests across Health Solutions
- Supported both Commercial and Government lines of business for claims sweeps
- Managed successful change across multiple business platforms while focusing on quality
- Collaborated with various Elevance areas to improve team efficiency and eliminate roadblocks
- Increased automation of adjustment first pass from 70 to 80 percent
Supported Carelon pull-through - Formed a successful operating model across internal and external teams
- Recently, responsible for Health Solutions Provider Operations QA.
- Oversaw business-wide changes to modernize procedures and organization.
Director Systems Support and Program Management
Anthem, Inc.
10.2011 - 04.2022
- Effectively led talented group of Process Experts and Business Analysts who provided testing, business requirement and process improvement support for Medicare Advantage, Medicare Supplement, EGR, and Part D Pharmacy Plans. This accountability included cross-functional support for Claims, Enrollment, Billing, eBusiness and Customer Service while partnering with various Benefit Configuration, Provider, EDI and IT support organizations.
- Led and successfully directed Claims Pends, Root Cause and Workforce Management for Pricing Configuration Management across end state platforms and legacy claim systems.
- Reduced average processing time across multiple functions and established higher quality targets year over year.
- Established and created Health Solutions Response Team to centralize and optimize Health Solutions rework requests across all of Health Solutions.
- Led Reporting and Data Analytics and Documentation teams for Medicare Claims Operations.
- Adept at managing successful change across multiple platforms and business organizations in highly regulated environment while ensuring focus on quality.
- Partnered closely with multiple Business Support, IT, Compliance and Product areas to deliver on multiple discretionary and mandated projects and initiatives.
- Supported successful multi-year migration of Medicare Advantage and Medicare Supplement processing from multiple Commercial platforms to GBD Facets and Medisys.
- Led implementation of discretionary and mandated project work, SSCR and lights-on related work across GBD Facets, WGS, Central Facets and CS90 for Medicare Claims Operations.
- Provided leadership and relationship management to ensure work delivery was successfully completed regardless of ultimate responsibility of work deliverables.
- Managed off shore testing relationship to assist in delivery of testing deliverables.
- Developed and implemented work intake processes to support post-implementation work for GBD Facets.
- Monitored specific programs' adherence to established schedules and operating budgets.
Director Business Systems Implementation
Anthem, Inc.
10.2009 - 10.2011
- Proven experience leading successful change in a virtual and matrixed environment.
- Demonstrated strong ability and initiative to drive efforts in a collaborative manner while achieving positive results for both internal and external Customers.
- Responsibility included coordination of Operations Support activity for Claims, Customer Service, eBusiness, Reporting, Documentation, and Enrollment Billing across all platforms and products for GBD Operations.
- Work types supported are project, migration, SSCR, and lights on item plus user acceptance testing across numerous applications.
- Past experience with System Migrations, extensive experience with AEP, and working in a heavily regulated environment.
- Overall Operations Support lead and primary point of contact for Medicare Product Launch activities across multiple functional areas. Responsibilities included serving as escalation point and briefing Executive management on status of open issues and deliverables.
Manager Business Systems Implementation
Anthem, Inc.
03.2007 - 10.2009
- Led group of Reporting Analysts, Business Analysts and Process Experts. Team also provided support for Provider database updates on Senior Facets.
- Vendor support included relationship management for ACS and TriZetto (Senior Facets).
- Supported successful inventory reduction of MA PFFS business on Senior Facets and ultimate stabilization of the platform.
- Supported successful exit from CMS Sanction.
- Teams were responsible for production support, small system change request, and Plan of Record activity for Senior Operations.
- Recognized for my contributions as member of Service Operations Blue Chip Development Program.
Program Director
Anthem, Inc.
07.2006 - 03.2007
- Provided overall Program support for MA PFFS business.
- Established community of practice for other Program Directors within PMO around requirements process.
- Primary point of contact for Enterprise Program Management Office.
Manager of Information Technology
Anthem, Inc.
09.2003 - 07.2006
- Responsible for relationship and facilitating activities with Blue Cross Blue Shield of South Carolina, PegaSystems, and EDS systems for BCBSWi.
- Coordinated activities with Operations, Finance, Legal, and Executive staff for management of projects, implementation of system changes and identification of system issues.
- Responsibilities included provider data management and benefit coordination support.
- Responsibilities also included the development of regression testing and enhanced release management processes with Blue Cross Blue Shield of South Carolina.
Senior Market Research Analyst
WellPoint, Inc.
05.2003 - 09.2003
- Established research methodology and designed format for data gathering.
- Examined and analyzed statistical data for the Provider Study and Medical Associates Study.
- Prepared report and graphic illustrations of findings for Cahps/HEDIS, and presented findings.
- Coordinated activities with vendors.
Regional Operations Supervisor
Blue Cross Blue Shield of Wisconsin
11.2000 - 09.2003
- Coordinated claims processing for Local Claims, ITS Home, and Adjustment areas.
- Monitored performance of staff, provided feedback to staff and recommended salary adjustments for staff to upper management.
- Prepared and analyzed statistics to enhance claims processing to ensure goal achievement for both Claims (ITS and Local) and Adjustments.
- Handled irate customer and group situations.
- Additionally, served as Privacy Contact for HIPAA, and served as Testing Lead for PegaSystems implementation.
- Supervised Customer Service, Provider File, and Benefit File.
Team Leader Regional Operations
Blue Cross Blue Shield of Wisconsin
09.1999 - 11.2000
- Trained and scheduled, assigned and audited the work of associates involved in the Customer Service and Suspense functions in order to ensure consistency, uniformity, and understanding.
Education
Bachelor of Arts - Psychology
University of Wisconsin - Madison
Madison, WI05.1999
Skills
- Leadership
- Organizational Knowledge
- People Management
- Process Management
- Operating Systems
- Relationship Management
- Communication
- Flexibility and Achieving Change
- Program development and implementation
Affiliations
- Board Member, Jim and Mary Gescheidle Scholarship Fund (2006- Present)
- Board Member, Fond du Lac Travel Baseball (2012- Present)
- Alumni, Leadership Fond du Lac
- Alumni, Blue Chip Development Program
Timeline
Staff VP Provider Ops Strategy
Elevance Health
05.2022 - Current
Director Systems Support and Program Management
Anthem, Inc.
10.2011 - 04.2022
Director Business Systems Implementation
Anthem, Inc.
10.2009 - 10.2011
Manager Business Systems Implementation
Anthem, Inc.
03.2007 - 10.2009
Program Director
Anthem, Inc.
07.2006 - 03.2007
Manager of Information Technology
Anthem, Inc.
09.2003 - 07.2006
Senior Market Research Analyst
WellPoint, Inc.
05.2003 - 09.2003
Regional Operations Supervisor
Blue Cross Blue Shield of Wisconsin
11.2000 - 09.2003
Team Leader Regional Operations
Blue Cross Blue Shield of Wisconsin
09.1999 - 11.2000
Bachelor of Arts - Psychology
University of Wisconsin - Madison
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