Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Eddie Hashemi

Summary

An accomplished executive in managed healthcare, I possess extensive experience driving value-driven initiatives and strategies resulting in increased revenue and enhanced quality. With a proven track record as a Strategic Director, I excel in leveraging innovative approaches to foster organizational growth and success. My expertise spans business operations, sales, marketing, and quality assurance, allowing me to build strong relationships and bridge operational gaps, ultimately driving tangible results and contributing to overall success.

Overview

19
19
years of professional experience
1
1
Certification

Work History

PROGRAM DIRECTOR, NATIONAL DUALS GROWTH

ELEVANCE HEALTH, ANTHEM BLUE CROSS, CA
01.2022 - Current

Responsible for strategically expanding the DSNP and cross-sell portfolio in the West and West Central regions, leading to significant sales growth. I spearheaded the enhancement of community activities in California, resulting in strengthened broker and provider relationships. Additionally, I implemented and managed omni-channel programs focused on retention and acquisition, yielding a 15% increase year-over-year. I successfully addressed challenges such as resource allocation, capacity management, and lead quality issues, ultimately achieving a remarkable 400% surge in year-over-year sales in California in 2023.


  • Successfully established the national task force that led to sales growth across all regions with an additional 25 new broker partnerships in west and west central regions in 2023.
  • Responsible for implementing, enhancing and managing programs with an omni-channel strategic focused on retention and acquisition of commercial transition members into Medicare. The program yielded a 15% increase YOY for both age-in and retiree members.
  • Mitigated challenges of capacity leveling, and broker engagements to support community events in California while extending community presence and improved organizational support for outbound activities.
  • Played a pivotal role in introducing multicultural and diversity programs, identified and developed relationships with brokers and providers especially those capable of supporting outbound call activities in multiple languages and introduced supplemental programs to onboard brokers willing to support these community activities.
  • Improved Telesales support scope by introducing programs to onboard new vendor call centers to increase outbound calls and provide additional language support.
  • Implemented programs focused on broker stratifications, provider engagement, and collaborations, along with high-level strategies for creating a hybrid engagement model to improve member experience.
  • Initiated, managed, and mentored centralized and standardized national sales lead requirements with an enterprise approach, resulting in data quality improvement, and streamlining monthly prospect lists leading to growth and retention.

NEW BUSINESS IMPLEMENTATION, OPERATIONS, AND INTEGRATION PROGRAM LEAD

CENTENE CORP. WOODLAND HILLS, CA
01.2015 - 01.2022

Responsible for spearheading enterprise strategic programs associated with the integration and onboarding of acquired health plans as part of new business, expansion, and migration. Collaborated and partnered with various departments such as EBOS, IT, finance, and health plan leadership to drive results, establish program structures, manage deliverables, and oversee project managers and executive reporting.

Additionally, while at Health Net of California/Centene Corp. in Woodland Hills, I served as an Account Consultant/Senior Project Manager. In this role, I managed the CalPERS account, comprising over 35,000 active members. I played a critical part in acquisition, retention, and account performance guarantee initiatives and led process improvement, data, and analytics projects.

  • Led cross-functional teams in the successful integration and onboarding of acquired health plans, resulting in seamless migration and end-to-end rollout.
  • Developed and implemented action plans to address impacted areas, fostering effective communication, stakeholder engagement, and project plan management activities.
  • Provided high-level oversight of project managers, project plans, and executive reporting, ensuring timely and transparent communication of program status and milestones.
  • Established synergy between acquired health plan business units and IT departments to identify requirements, mitigate risks, and plan timelines effectively.
  • Directed multifunctional partnerships, including on-shore and offshore resources, to drive process improvement, data analytics, and account performance initiatives.
  • Spearheaded the evaluation and enhancement of reporting protocols and capabilities, uncovering hidden gaps and opportunities to maximize reporting efficacy.
  • Prioritized and managed a Business Process Improvement portfolio, effectively tracking success measures and driving performance objectives.

Early Career

BANKING AND MORTGAGE INDUSTRY (2005-2013)
01.2006 - 01.2015

With over 15 years of professional experience in banking and mortgage industries, I have successfully overseen high-risk projects and regulatory compliance programs while driving business controls protocols in the following organizations:


Bank of America in Agoura Hills, CA, | Assistant Vice President, Business Controls

Pennymac Inc in Moorpark, CA, | Senior Business Consultant


In these roles, I managed high-risk projects related to business process controls and financial reconciliations of legacy systems influenced by the Bank of America acquisition, led technology, business, and configuration management teams, and directed a team responsible for Sarbanes-Oxley audit compliance readiness.


  • Successfully managed high-risk projects related to business process controls and financial reconciliations of legacy systems influenced by the Bank of America acquisition.
  • Led technology, business, and configuration management teams to ensure the successful implementation/release of highly-sensitive customer mortgage reconciliation applications.
  • Drove programs to assess current technology processes, resulting in a significant reduction of state and federal compliance requirements and achieving Sarbanes-Oxley audit compliance readiness.

Education

Master of Business Administration (MBA) -

Keller Graduate School of Management

BS. Technical Management -

DVU

Skills

  • Strategic Initiatives & Enterprise Roadmapping
  • Business Transformation & Crisis Management
  • Staffing & Performance Measures
  • Leadership & C-Suite Consulting
  • Agile Project Management & DevOps
  • Enterprise Risk Management & Change Management
  • P&L Management & KPI Establishment
  • Coaching & Mentoring for Productivity
  • Creative Problem Solving & Continuous Improvement

Industry Expertise

  • Medicare and Medicare Advantage
  • Commercial Transitions
  • Duals/Medi-Medi
  • LTSS
  • Telehealth
  • Commercial Sales
  • Multichannel (Field, Broker, Telesales, DTC)
  • Vendor/Client Implementations Management
  • Data, Demographics and Analytics
  • OEP, AEP and Community Outreach
  • Claim Systems
  • Invoicing Processes
  • Performance Guarantees
  • Staff Development

Certification

  • Certified Project Management Professional, PMP (Active)
  • Certified Scrum Master, CSM (Active)
  • Life, Health & Accident Agent (Active)

Timeline

PROGRAM DIRECTOR, NATIONAL DUALS GROWTH

ELEVANCE HEALTH, ANTHEM BLUE CROSS, CA
01.2022 - Current

NEW BUSINESS IMPLEMENTATION, OPERATIONS, AND INTEGRATION PROGRAM LEAD

CENTENE CORP. WOODLAND HILLS, CA
01.2015 - 01.2022

Early Career

BANKING AND MORTGAGE INDUSTRY (2005-2013)
01.2006 - 01.2015

Master of Business Administration (MBA) -

Keller Graduate School of Management

BS. Technical Management -

DVU
Eddie Hashemi