Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Work Preference
Software
Timeline
GeneralManager
Deborah Leininger

Deborah Leininger

Chesapeake,VA

Summary

I am a seasoned healthcare IT leader with a history of driving organizational success through visionary and ethical leadership. Proficient in navigating the ever-changing healthcare landscape, I possess a strategic mindset that drives the development of innovative solutions and continuous improvement initiatives. With a solid foundation in data governance and cost data analysis, I excel in making data-driven decisions and fostering a culture of critical thinking and strategic development.

My expertise extends to program, project, and process management, where I excel in project planning, budget management, and stakeholder communication. I have a talent for building and leading high-performing teams, driving success in new market implementations and existing platform migrations. My technical acumen and critical thinking skills enable me to effectively oversee EDI claims management, encounters processing, and application development, ensuring compliance with regulatory requirements and cybersecurity standards.

I am versed in governance and audit compliance management, possessing in-depth knowledge of regulatory requirements such as HIPAA, PHI, and CMS. With experience in SOX, SOC1 and SOC2 compliance, I am adept at managing external audits, mitigating findings, and negotiating vendor contracts. Additionally, I bring expertise in IT service management and delivery, leveraging the ITIL framework and ServiceNow administration to optimize incident, problem, and change management processes.

My proficiency extends across a diverse technology stack, including Office 365 applications, SQL, Facets, Pega, ServiceNow, Jira, Confluence,, Edifecs, EIDS, Optum, Tableau, Snowflake, Workday, Salesforce and various cloud platforms. Committed to continuous learning and enthusiastic about driving organizational excellence, I am prepared to deliver impactful results in healthcare IT leadership roles. My strong leadership skills complement my technical aptitude, making me an asset in driving success in complex healthcare IT environments.

Overview

15
15
years of professional experience

Work History

Sr. Engineering Manager/Interim Director, IT Claims Pre-Adjudication and Encounters

Elevance Health
Norfolk, VA
11.2017 - 12.2023
  • 20 million budget oversight
  • Identify and drive the necessary process improvement efforts to enhance the member experience, HEDIS and STARS ratings
  • Strategic Cross-functional collaboration with Health Plan Leadership to drive member satisfaction and drive retention efforts
  • Lead a product development team focused on new concept implementations
  • Recruited, hired, and empowered a high-performing leadership team built on the foundation of accountability, teamwork, employee investment, and the ability to recognize the natural strengths in others while instilling the confidence to challenge the status quo, innovate, and drive automation
  • Leadership oversight for 10+ agile teams totaling 150+ on and offshore team members, including managers, team leaders, systems architects, advisors, engineers, analysts, scrum masters, and project managers supporting Pre-Adjudication efforts
  • Established and maintained collaborative relationships with key business partners and health plans
  • 100% success rate for all audit reviews and mitigation efforts
  • Implemented Active Directory and or Single Sign-On authentication for all applications within my scope
  • Planned and executed annual projects while maintaining profit and loss (P&L) responsibility
  • Developed technology plans and forecasts for enterprise application upgrades or replacements with complexity consideration mandated by the Government Business Division
  • Oversight for strategic planning, budget development, and management of multiple cost centers across various lines of business with careful consideration of government regulatory requirements
  • Protect the integrity of HIPAA and PHI data through adherence to security regulations, data de-identification, and archive and purge best practices
  • Strategic oversight of end-to-end claims (pre-and post-adjudication and Encounters) projects and implementations, ensuring timely deliveries within scope and budget
  • Engaged strategic vendors to provide critical resources or the technology solutions necessary to meet the ever-changing business needs
  • Identified opportunities for talent development for all levels under my organization
  • Serve as a 24x7x365 escalation path, providing solutioning and knowledge transfers to operations support as needed for service interruption
  • Drove root cause analysis and a remediation path forward
  • Cultivated a culture of decision-making based on metrics and sound data
  • Manage multiple domains and enterprise-wide suite of applications
  • Oversight includes technical debt, yearly maintenance, patching and upgrades, licensing, application support, access provisioning, audit compliance, and governance
  • Drive large, complex projects through effective cross functional collaboration and communication. Project prioritization was dependent on state mandates and health plan requirements.
  • Developed and implemented engineering strategies to ensure product quality, reliability, and cost targets were met.
  • Analyzed customer feedback to drive continuous improvement in product design and development process.
  • Provided technical leadership by mentoring junior engineers on best practices for software development life cycle.
  • Managed a team of engineers responsible for designing, developing, testing and supporting products.
  • Defined multi-year technical roadmap for engineering projects from concept through completion.
  • Reviewed code changes to ensure they meet standards for performance, scalability, security and maintainability.
  • Conducted regular meetings with stakeholders to review project status updates and discuss any potential risks or opportunities.
  • Identified areas of improvement within the engineering department by analyzing metrics such as throughput time or defect rates.
  • Led efforts to develop new products from concept through launch while meeting customer requirements.
  • Ensured compliance with industry standards throughout all stages of product development.
  • Collaborated with senior management on strategic planning initiatives related to technology investments.
  • Implemented automated testing frameworks that improve accuracy while reducing manual effort required during QA cycles.
  • Performed root cause analysis investigations into reported incidents in order to identify underlying causes quickly.
  • Participated in regular reviews of existing systems architecture in order to identify areas where improvements can be made.
  • Facilitated continuous improvement initiatives with successful changes affecting operations.
  • Advised business partners about engineering concerns for in-development projects.
  • Organized data and modeled information for use in key decision-making.
  • Assisted in development of corporate plans and managed infrastructure upgrades, equipment replacements and building modifications.
  • Ensures disaster recovery and business continuity plans are implemented, monitored, and updated regularly

Stability Manager - Enterprise File Exchange Operations

Anthem, Inc.
09.2016 - 11.2017
  • My objective was to increase the stability of file exchange applications, decrease MTTR (mean time to resolution), manage and minimize P1 and P2 incidents to closure, perform root cause analysis, and establish metrics that tell a story
  • Success was based upon the following achievements: Meet with business partners to determine pain points in file exchange processes
  • Establish expectations from both sides around communication, gaps, and continual improvement
  • This would include a meeting cadence, additional reporting and monitoring of open issues, and frequent updates
  • Redefine the incident management process for the EFX team to include logging time to resolution and SLA monitoring as well as action items for close to threshold and breeches
  • Create and publish system availability messages to internal and external business partners
  • Create and publish critical metrics around system availability and other EFX KPIs
  • Facilitate weekly outage meetings and drive remediation efforts and root causes.

Operations and Production Support Manager, Enterprise File Exchange

Anthem, Inc.
09.2016 - 09.2017
  • Installed an enterprise-wide Center of Excellence support team providing 24/7 customer support for Medicare, Medicaid and commercial Electronic File Exchange efforts
  • Developed a Playbook that houses all file exchange procedures
  • This playbook contained process improvement guidelines and standard operating policies aligning with ITIL Best Practices
  • This introduced processes and standards for Incident, Problem, Change, and Request Management
  • Define a blueprint used as a guide for services delivered to our partners
  • This blueprint was used to educate our offerings to business partners while adhering to SLAs
  • Recruit and hire the positions necessary for the Center of Excellence success
  • 30% increase in Production Support and Operations first contact resolutions
  • Reduced Request Management acknowledgements from 14 days to 24 hours
  • Developed metrics and reporting for the various facets of the File Exchange Team.

Director, IT Service Delivery and Support Services

Verizon, The Cellular Connection
03.2014 - 11.2015
  • As the Director of Service Delivery, I built an end-to-end delivery team that included Service Desk, Desktop Services, Field Services, and Asset and Inventory Management
  • My initial objective was to complete an in-progress ServiceNow implementation effort that was off track and over budget
  • Architecture and strategic roll-out plans were based on module dependencies, corporate strategy, business needs, and maturity
  • Taking a phased approach and within six months, my team and I successfully rolled out Request Management, Incident Management, Problem Management, Change Management, Operational Technology Management, Project Management, Demand Management, the Service Catalog, CMDB, Runbook Automation, Reporting, Asset Management, Root Cause analysis while linking multiple suites which define an end-to-end visibility in the life cycle of service delivery in the technology space
  • Through ongoing education, iterative progress, and continual improvement while maintaining SLA's accelerating time to value and user experience, assisting in user adoption.

Education

Business Administration

Kent State University

Lorain County Community College
Elyria

Associates - Business Administration And Management

ESI Business College
Elyria, OH

Skills

  • EDI 837/835 Claims Management for Medicare and Medicaid
  • Encounters Management
  • Healthcare Economics
  • HIPAA and PHI Compliance
  • Agile Methodologies
  • Software Development Life Cycle Process
  • ITIL v4 Fundamentals
  • Six Sigma Greenbelt
  • Service Now Implementation/Administration
  • Department Budget Management
  • Annual Planning
  • Creative Approach to Problem Solving
  • Critical Thinking and Strategy Development
  • Data Driven Decision Making
  • Service Delivery Mentality
  • Manager and Team Lead Progression/Development
  • Resource Management and Professional Development
  • Resource Capacity Planning and Allocation
  • Business Continuity Planning
  • Disaster Recovery Planning
  • Audit Compliance
  • External Audit Walkthroughs
  • External Audit Findings Mitigation
  • Formal Organization Mentor
  • Business Relationship Management
  • Project Management
  • Product Management
  • Operations Support
  • Risk Assessment
  • Root Cause Analysis
  • Incident and Problem Management
  • Change Management
  • Release Management
  • Request Management
  • Cost Data Analysis
  • Operational Reporting
  • Metrics and Key Performance Indicators
  • Process/Procedure Documentation Governance
  • Technology Integration
  • Code Review Oversight
  • Test Automation
  • Requirements Analysis
  • 24/7 Technical Support

Certification

  • SAFe Agilist Certification
  • SAFe Scrum Master Certification
  • ServiceNow Administrator
  • Six Sigma Green Belt
  • ITIL v4
  • HDI Support Center Director
  • Kepner - Tregoe Project Management
  • PMP - Project Management Professional

Accomplishments

GBD IT TechForum 2.0 Content Manager/Facilitator

Anthem, Inc.

Aug 2021 – Dec 2023

In addition to my day-to-day management responsibilities, I was asked to lead a talent engagement and employee development program sponsored by our newly appointed GBD CIO. Eight developmental opportunities were identified, resulting in four core competency programs. TechForum 2.0, Leadership Level Up, Bits & Bytes, and IT Time provided training opportunities for all GBD IT Associates, regardless of experience.

Work Preference

Work Type

Full Time

Important To Me

Company Culture

Software

Pega, SQL, Edifecs, OTVM, Facets, ServiceNow

Timeline

Sr. Engineering Manager/Interim Director, IT Claims Pre-Adjudication and Encounters

Elevance Health
11.2017 - 12.2023

Stability Manager - Enterprise File Exchange Operations

Anthem, Inc.
09.2016 - 11.2017

Operations and Production Support Manager, Enterprise File Exchange

Anthem, Inc.
09.2016 - 09.2017

Director, IT Service Delivery and Support Services

Verizon, The Cellular Connection
03.2014 - 11.2015

Business Administration

Kent State University

Lorain County Community College

Associates - Business Administration And Management

ESI Business College

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Deborah Leininger