Gina M. Sahagian
Saunderstown
Summary
Dynamic leader with extensive experience in program management and team development. Demonstrated ability to optimize workflows and enhance operational efficiency. Expertise in financial analysis and cross-functional collaboration, driving strategic initiatives that achieved significant cost reductions and improved vendor performance.
Overview
22
22
years of professional experience
Work History
Managing Director, Total Cost of Care Program Management
Blue Cross & Blue Shield of Rhode Island
03.2025 - Current
- Delivered operational and strategic leadership for Total Cost of Care program management.
- Integrated operational expertise into Total Cost of Care team to enhance productivity.
- Developed a team of vendor implementation managers skilled in EPMO processes and outcome measurement.
- Collaborated with clinical and contracting departments to identify and implement cost reduction solutions.
Managing Director, Commercial Segment Operations
Blue Cross & Blue Shield of Rhode Island
01.2021 - 03.2025
- Managed staff of 25+ implementation managers, enrollment specialists, account managers, and support agents.
- Directed end-to-end eligibility and billing functions for Commercial markets from start to finish.
- Oversaw client implementation teams for new business and annual renewals of varying complexity.
- Developed a Salesforce-based platform for onboarding and renewals, documenting workflows and user guides.
- Executed transitions of enrollment and billing functions between offshore vendors without disruption.
- Monitored offshore vendor performance against KPIs and SLAs to ensure accountability.
- Developed long-term business strategies that enhanced innovation and operational efficiency.
- Facilitated cross-functional team alignment with corporate goals to drive organizational success.
Director, Employer Segment Operations
Blue Cross & Blue Shield of Rhode Island
01.2018 - 01.2021
- Established high-performing team of client implementation managers from inception.
- Developed workflows and standard operating procedures to enhance implementation accuracy.
- Facilitated client steering committee meetings, guiding decisions to meet strict timelines.
- Streamlined eligibility intake by optimizing 834 file process, boosting client and vendor engagement.
- Coordinated activities with other departments to expedite work and improve collaboration.
Director National Accounts/Employer Segment
Blue Cross & Blue Shield of Rhode Island
06.2013 - 01.2018
- Fully executed all client RFPs including assignment of tasks, compilation and assurance of internally consistent responses, financial accuracy, and timely and professional delivery.
- Responsible for the construct, documentation and implementation of interplan arrangements between BCBSRI and other Blue Cross plans estimated at $15M annually.
- Accountable for ensuring the multi-year implementation of the Association’s Value-Based mandate was implemented in a client-friendly manner with minimal billing impacts.
- Minimized client abrasion resulting from claims and billing initiatives through self-funded oversight and the development of accurate financial models.
- Oversaw the continued implementation of a Broker Payment/Bonus Program including challenging payment system modifications and internal/external communication.
- Strategic development of competitive, annual Large Group and Small Group product portfolios.
- Managed the delivery and effective implementation of marquee client with 15,000+ members.
- Managed internal staff of up to 8 individuals with an annual budget of $700K.
Lead Product Manager
Blue Cross & Blue Shield of Rhode Island
06.2012 - 06.2013
- Company Overview: http://www.litwareinc.com/
- Prepared and submitted responses to all Employer Group RFPs for distinctive accounts such as the State of Rhode Island, Gilbane and Care New England.
- Developed processes, procedures and databases to increase the efficiency and accuracy of the RFP process.
- Responsible for representing Sales and Marketing during the implementation of provider payment reform.
- Http://www.litwareinc.com/
Client Consultant
Park Row Associates
Providence
06.2008 - 06.2012
- Assisted clients in developing effective healthcare insurance strategies including benefit design, client contribution and financial impact analyses.
- Analyzed and interpreted competitive bids and requests for proposals.
- Monitored industry developments, regulations and health cost trends.
Actuarial Director
Blue Cross & Blue Shield of Rhode Island
Providence
01.2004 - 01.2005
- Managed actuarial staff of 20 analysts/$1.5M budget and directed related projects at Rhode Island’s largest health insurer.
- Successfully prepared and submitted $350 million Medicare Advantage rate filings to the Centers for Medicare & Medicaid Services and Individual rate filings to the State of Rhode Island Office of the Health Insurance Commissioner.
- Directed annual preparation of $1.6B corporate financial forecast.
- Directed calculation of $150 million corporate claim accrual and oversaw year-end audit by PricewaterhouseCoopers LLC.
- Managed calculation of quarterly Large and Small Group rating factors.
- Calculated, recommended and defended market segment price and utilization trends to management, Board of Directors and state and federal regulators.
- Prepared and delivered financial presentations to the executive staff and Board of Directors.
- Directly influenced corporate business planning through the development of financial models and the presentation of scenario results to senior management.
Education
Master of Business Administration -
Bryant University
Smithfield, RIBachelor of Arts - Mathematics
Boston College
Chestnut Hill, MABusiness Analytics Certification -
Bryant University Executive Development Center
Smithfield, RIHealth Insurance Associate -
America’s Health Insurance Plans
Skills
- Solid decision-making
- Project leadership
- Program management
- Workflow optimization
- On- and offshore vendor management
- Analytical thinking
- Problem-solving abilities
- Risk analysis
- Financial and business acumen
- Team development and mentoring
- Cross-functional collaboration
- Consensus building
- Proven communication and presentation skills
- Steadfast commitment to excellence
- Proficiency in Microsoft suite
Accomplishments
- Successful implementation of marquee client with 15,000+ insured members including project planning, issue triaging and resolution, and executive reporting.
- Development of competitively priced Large and Small Group product portfolios with the appropriate concern for underlying medical cost and utilization trends.
- Modifications to self-funded client contracts which allowed for the billing/recoupment of key claim components estimated at $15M+ annually.
- Strategic conversion of self-funded accounts from per contract to per claim Consortium Transfer Pricing allowing for more competitive administrative expense quotations.
- Business Lead for the implementation of the Blue Cross Association’s national Value-Based mandate consistent with federal and state regulations allowing for annual self-funded billing of $10M+.
- Design and development of a detailed financial analysis of BCBSRI Interplan fees to determine best national solution for BCBSRI and our clients.
- Preparation of the corporate financial forecast representing $1.6B in annual premium.
- Collaborated on published Report to National Association of Insurance Commissions/American Academy of Actuaries Supplement Insurance Work Group.
Community Service
- The Autism Project, Board Member and Treasurer, 01/01/15, 12/31/24
- Caritas House Residential Adolescent Treatment Center, Board Member, 01/01/09, 12/31/15
- United Way Southern New England, Loaned Executive Program
Timeline
Managing Director, Total Cost of Care Program Management
Blue Cross & Blue Shield of Rhode Island
03.2025 - Current
Managing Director, Commercial Segment Operations
Blue Cross & Blue Shield of Rhode Island
01.2021 - 03.2025
Director, Employer Segment Operations
Blue Cross & Blue Shield of Rhode Island
01.2018 - 01.2021
Director National Accounts/Employer Segment
Blue Cross & Blue Shield of Rhode Island
06.2013 - 01.2018
Lead Product Manager
Blue Cross & Blue Shield of Rhode Island
06.2012 - 06.2013
Client Consultant
Park Row Associates
06.2008 - 06.2012
Actuarial Director
Blue Cross & Blue Shield of Rhode Island
01.2004 - 01.2005
Master of Business Administration -
Bryant University
Bachelor of Arts - Mathematics
Boston College
Business Analytics Certification -
Bryant University Executive Development Center
Health Insurance Associate -
America’s Health Insurance Plans
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