Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Christine Gamino

Bradley,Illinois

Summary

With a proven track record at Cigna, I enhanced operational efficiency and stakeholder satisfaction through expert project management and strategic planning. My ability to mentor and implement Six Sigma methodologies showcases my blend of leadership and analytical thinking, driving significant improvements in cross-functional communication and process optimization. Operations professional with solid background in streamlining processes and enhancing operational efficiency. Known for effective team collaboration and achieving results in dynamic environments. Skilled in process optimization and problem-solving, with reliable and adaptable approach to changing needs.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Operations Specialist

Cigna
11.2022 - 10.2024
  • Conducted risk assessments for potential projects, mitigating possible issues before they arose.
  • Streamlined workflow processes for increased productivity and reduced operational costs.
  • Mentored junior staff members, providing guidance on career growth opportunities within the organization.
  • Assisted in the development of annual budgets, carefully monitoring expenses throughout the year to maintain financial stability.
  • Collaborated with cross-functional teams to develop innovative solutions addressing complex challenges.
  • Conducted thorough analyses of operations to identify areas for improvement and recommend solutions.
  • Business Asset and Claim Pricing SME for PRAS Delivery Support Leadership teams including Pega Business Acceptance Testing teams and Pega Business Rules and Configuration Team.
    • Claim pricing support for Pega EPS and EBH Project Delivery teams.
    • Assist BRC Quality Support team in reviewing and analyzing escalated Service Now tickets.
    • Identify and analyze production issues for EPS claims including Client data, Provider data, EPS Contract and Rate Sheet selection and Reprice requests from Proclaim.
    • Assist with reporting needs utilizing SOBI, TOAD and Hue.
    • SME for EPS Efficiency Project including claim reporting and analysis of EPS Workbaskets and processes, Business processes and Stand Alone NetworX Pricer pricing.
    • Provided EPS Overview training and EPS Contract.
    • Proficient with multiple systems including Proclaim, PPN, Facets, Payer Solutions, SANP/Optum, HCPM, ePro, OneView, TruCare and CED.
    • Work with multiple matrix partners across the Pega projects including NetOps, HCPM Provider Selection, Prepay, ServiceOps, PRAS Solutioning, Delivery, DevOps, and Architect teams, Proclaim Delivery, and IT.
    • Experienced user in Microsoft Office including Power Point and Excel V Look Ups and Pivot Tables and Power Point.
    • Identify, analyze, and assess issues in claim pricing assets including Pega (EPS, MRC2, ECCE, PYSL), Stand Alone NetworX Pricer (SANP), and Optum Rate Manager.
    • Identify issues and processes to assist Network and Service Operations business partners with Pega Workbaskets and event code workflows.
    • Serve as a quality subject matter expert for our assets business users including Network Operations and Service Operations.
    • Monitor Pega assets to identify and trend risks, issues, and opportunities.
    • Liaison between business partners and agile delivery teams for system enhancements
    • Create presentations on team’s current work for various audiences.

Operation Advisor

Cigna
11.2020 - 11.2022
  • Provided training and mentorship to junior staff members, contributing to overall team success.
  • Analyzed data trends to identify opportunities for improvement in operational performance metrics.
  • Ensured compliance with industry regulations, minimizing risk exposure for the organization.
  • Improved operational efficiency by streamlining processes and implementing new workflow strategies.
  • Collaborated with various departments to develop integrated solutions addressing organizational challenges.
  • Coordinated cross-functional teams for successful project execution and timely delivery of services.
  • Business Asset and Claim Pricing SME for PRAS Delivery Support Leadership teams including Pega Business Acceptance Testing teams and Pega Business Rules and Configuration Team.
    • Claim pricing support for Pega EPS and EBH Project Delivery teams.
    • Assist BRC Quality Support team in reviewing and analyzing escalated Service Now tickets.
    • Identify and analyze production issues for EPS claims including Client data, Provider data, EPS Contract and Rate Sheet selection and Reprice requests from Proclaim.
    • Assist with reporting needs utilizing SOBI, TOAD and Hue.
    • SME for EPS Efficiency Project including claim reporting and analysis of EPS Workbaskets and processes, Business processes and Stand Alone NetworX Pricer pricing.
    • Provided EPS Overview training and EPS Contract.
    • Proficient with multiple systems including Proclaim, PPN, Facets, Payer Solutions, SANP/Optum, HCPM, ePro, OneView, TruCare and CED.
    • Work with multiple matrix partners across the Pega projects including NetOps, HCPM Provider Selection, Prepay, ServiceOps, PRAS Solutioning, Delivery, DevOps, and Architect teams, Proclaim Delivery, and IT.
    • Experienced user in Microsoft Office including Power Point and Excel V Look Ups and Pivot Tables and Power Point.
    • Identify, analyze, and assess issues in claim pricing assets including Pega (EPS, MRC2, ECCE, PYSL), Stand Alone NetworX Pricer (SANP), and Optum Rate Manager.
    • Identify issues and processes to assist Network and Service Operations business partners with Pega Workbaskets and event code workflows.
    • Serve as a quality subject matter expert for our assets business users including Network Operations and Service Operations.
    • Monitor Pega assets to identify and trend risks, issues, and opportunities.
    • Liaison between business partners and agile delivery teams for system enhancements

Agile Project Owner

Cigna
12.2019 - 05.2020
  • Managed day-to-day business operations.
  • Developed and maintained strong relationships with clients, resulting in repeat business and referrals.
  • Oversaw daily operations, ensuring all tasks were completed accurately and efficiently by team members.
  • Increased customer satisfaction by implementing efficient business processes and providing exceptional service.
  • Writing User Stories and Business rule for the CCMI payment system
    • Ensuring the business rules delivered meet the business requirements
    • Responsible for the scrum teams development of the product backlog
    . Excellent interpersonal skills and have a demonstrated ability to work cross-functionally with other departments to collaborate, facilitate, and resolve issues and be able to develop customized solutions to meet business requirements.
    • SME for system development and enhancement projects for the application for CCMI
    • Manage schedule risks, issues, decisions, and dependencies related to the deliverables of the team
    • Work with team members to ensure products are working and production
    • Liaison between business partners and agile delivery teams for system enhancements

Operation Advisor

Cigna
02.2017 - 12.2019
  • Provided training and mentorship to junior staff members, contributing to overall team success.
  • Analyzed data trends to identify opportunities for improvement in operational performance metrics.
  • Improved operational efficiency by streamlining processes and implementing new workflow strategies.
  • Root cause analysis for accuracy, efficiency, and escalating issues appropriately for CCMI fallout
    • Support post implementation CCMI, FFVRDS, and PDM releases to identify issues, root cause, and determine workarounds for any post release production defects
    • Meet bi-weekly with IT to review aging CCMI and ODS CSC tickets for prioritization and status updates
    • Partner with Product Owners to refine Service Requests and update User Stories in Rally with acceptance criteria and examples
    • Scrum team member of newly formed team to develop robot automation process for CCMI transactional fallout resolution
    o SME for current soft automation and manual CCMI transactional fallout
    o Participate in daily stand up calls, refinement and PI planning sessions
    o Attend requirement and demo sessions
    • Attend Pre-release CCMI and PDM requirement and process modeling sessions to provide direction and support of current and changing business processes
    • Attend CCMI PI Planning sessions to provide SME support
    • Oversight of baseline team SOP’s to ensure they are updated and maintained as business process changes are made in a timely and accurate manner

Senior Project Specialist

Cigna
01.2014 - 01.2017
  • Improved project efficiency by implementing streamlined processes and optimizing resource allocation.
  • Identified potential roadblocks early in the planning phase through diligent research, allowing time to develop contingency plans effectively.
  • Enhanced stakeholder satisfaction by maintaining clear communication channels and providing regular updates on project progress.
  • Subject Matter Expert on AIMS Pricing Program
    -Agile training
    -Writing EPICs and Business Scenarios for AIMs project
    -FARM project learning of DOFR's and writing mapping services
  • Service Operations/Business Lead for the External Claim Pricing (ECP) Project
    - Developed Business Requirements
    - Created/developed new testing initiative (FCO Testing) and process - plans for expanded engagement of
    -Process rolled out nationally as BAT Testing Program

Education

High School Diploma -

Herscher High School
Herscher, IL
06-1988

Skills

  • Operational Efficiency
  • Planning and coordination
  • Cross-Functional Communication
  • Project Management
  • Process Planning
  • Process Documentation
  • Improvement plan knowledge
  • Six Sigma Methodologies
  • Problem-Solving
  • Analytical Thinking

Certification

  • [Year Month]

Timeline

Operations Specialist

Cigna
11.2022 - 10.2024

Operation Advisor

Cigna
11.2020 - 11.2022

Agile Project Owner

Cigna
12.2019 - 05.2020

Operation Advisor

Cigna
02.2017 - 12.2019

Senior Project Specialist

Cigna
01.2014 - 01.2017

High School Diploma -

Herscher High School

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Christine Gamino