Heather GARDINER
Summary
Customer focused, project oriented and versatile leader with 25+ years of healthcare industry experience in government business, pricing configuration, management, project management, business process improvement, compliance, business development and operations. A proven track record in process improvement, customer relationship management, proposal development, data analysis, quality management, and administering change across various levels with the Medicaid lines of business.
Overview
13
13
years of professional experience
Work History
Business Consultant, Pricing Configuration Management
Elevance Health
06.2014 - Current
- Support post-migration activities. Responsible for researching pricing automation fallout reports to determine root cause and collaborating with business partners to resolve, updating pricing automation rules, and making updates to the exclusion table.
- Support system migration of California Medicaid. Responsible for analyzing provider data to identify corrections needed for contract reimbursement, creating pricing automation rules and user testing.
- Pillar Lead of Contracting and Pricing on BREEZE sub-project under Provider Data Lifecycle Modernization project. Responsible for documenting and prioritizing user stories, process design, process re-engineering and facilitating discussions with project team and business owners
- Team lead for three markets, responsible for supporting manager in day-to-day functions, monitoring inventory and metrics, escalating and resolving issues, providing feedback, guidance, and coaching to team members, and acting as key contact for business partners.
- Established and maintained relationships with key stakeholders for growth opportunities and successful partnerships.
- Support key initiatives such as new business implementations, market re-bids and business expansions to ensure successful implementation
Process Expert II, Provider Data Organization
Anthem
10.2010 - 06.2014
- Played a key leadership role on the project team responsible for outsourcing Medicaid Provider Data Operations. Successfully sourced these functions, achieved steady state performance levels within four months, and effectively reduced provider data update cycle time by approximately 50% within six months after the go-live date.
- Responsible for tracking and reporting performance metrics to ensure team's adherence to operational metrics and goals, creating department dashboards, and reporting performance metrics to senior leadership for both Medicaid Business Support and Enterprise Provider Data Management areas.
- Proactively addressed inventory issues by working with leadership to effectively manage resource allocation and capacity across seven Medicaid states.
- In the absence of department director, provided oversight and leadership of Medicaid Provider Data team and served as the key point of contact for internal and external business partners
- Supported change management efforts during the implementation of multiple projects and initiatives.
Education
Bachelor of Science - Health Information Management
Western Governors University
06.2025
Skills
- Analytical and Critical Thinking
- Auditing
- Claims Processing
- Data Analysis
- Documentation
- Healthcare Reimbursement
- Issue Resolution
- Medicaid Expertise
- Medical coding knowledge
- Problem-Solving
- Process Improvement
- Regulatory Compliance
Timeline
Business Consultant, Pricing Configuration Management
Elevance Health
06.2014 - Current
Process Expert II, Provider Data Organization
Anthem
10.2010 - 06.2014
Bachelor of Science - Health Information Management
Western Governors University
Similar Profiles
Brittany OwensBrittany Owens
Customer Service Representative at Elevance HealthCustomer Service Representative at Elevance Health
Arthur LeeArthur Lee
Data Entry Specialist at Elevance HealthData Entry Specialist at Elevance Health
Rikki RamirezRikki Ramirez
Prior Authorization Specialist at Elevance HealthPrior Authorization Specialist at Elevance Health
Ibukun AkinadeIbukun Akinade
NA at Elevance HealthNA at Elevance Health
Neeraj GargNeeraj Garg
<ul><li>Company Overview: Group Company of PUIG, Spain</li><li>Team Leadership & Process Excellence: Organised the transformation of the Finance & Accounts function, establishing performance-driven goals, and embedding a culture of accountability and continuous improvement. Drove operational efficiency through process redesigns, SOP implementation and optimal resource deployment, leading to measurable improvements in turnaround time and accuracy.</li><li>Strategic Partnering with CXOs: Acted as a key advisor to the CEO, CFO, and other CXOs on business planning, pricing strategies, and business model pivots to support scale-up and profitability. Contributed to investor communications with data-backed insights to enhance stakeholder confidence and secure strategic funding.</li><li>Cross-Functional & Global Stakeholder Management: Functioned as the strategic finance business partner to cross-functional heads and the PUIG global finance team, aligning local execution with global financial strategies and compliance requirements.</li><li>ERP Transformation & System Automation: Led end-to-end ERP reimplementation to address system gaps, enforce role-based controls, and automate core finance processes—resulting in enhanced data accuracy, faster reporting and improved internal controls.</li><li>Costing, Inventory & Profitability Optimization: Designed and implemented plant-level costing models to ensure accurate COGS determination. Improved inventory management across pricing, consumption tracking, and aging analysis—enabling better working capital control and cost efficiency.</li><li>Manufacturing Finance & Statutory Compliance: Supervised end-to-end accounting for manufacturing operations and ensured full statutory compliance.</li><li>Financial Reporting, MIS & Profitability Analytics: Delivered accurate and timely monthly MIS reports, including P&L, Balance Sheet and KPI dashboards with deep-dive variance analysis across stores, business verticals, and geographies. Supported board-level decision-making through insightful presentations on financial health and business performance.</li><li>Budgeting, Forecasting & Business Planning: Led the Annual Operating Plan (AOP) and rolling forecasts, ensuring alignment with strategic objectives and market dynamics. Monitored key financial metrics to enable business decisions and proactive cost management.</li><li>Statutory, Internal & Tax Audit Management: Finalized standalone and consolidated financials under Ind AS and IFRS, ensured timely group reporting and compliance with international standards. Delivered clean and timely closures of statutory, tax, and internal audits in coordination with Big 4 auditors. Strengthened audit readiness through pre-audit diagnostics and rectification of recurring control gaps.</li><li>Regulatory Compliance & Risk Management: Ensured end-to-end compliance which includes ROC, RBI, FEMA, Income Tax, GST, Transfer Pricing, DTAA, and Customs. Reviewed cross-border contracts and transactions to ensure arm’s length pricing, accurate TDS application, and proper documentation under Transfer Pricing regulations.</li><li>Commercial Negotiation & Contract Governance: Led commercial negotiations and structured deals with vendors and franchisees. Reviewed key business contracts to ensure financial viability, risk protection, and compliance with regulatory standards.</li><li>Treasury & External Commercial Borrowing (ECB): Managed fund planning and liquidity management including ECB drawdowns, bank negotiations, and interest optimization. Improved working capital cycles through proactive cash flow forecasting and receivables control.</li><li>Internal Controls & Governance Framework: Led organization-wide reviews of internal control systems, identified process gaps, and redesigned or implemented over 40 SOPs and IFCs. Established a governance structure for financial discipline, risk mitigation, and policy compliance across departments.</li></ul> at Kama Ayurveda Pvt. Ltd. & PUIG India Pvt. Ltd.<ul><li>Company Overview: Group Company of PUIG, Spain</li><li>Team Leadership & Process Excellence: Organised the transformation of the Finance & Accounts function, establishing performance-driven goals, and embedding a culture of accountability and continuous improvement. Drove operational efficiency through process redesigns, SOP implementation and optimal resource deployment, leading to measurable improvements in turnaround time and accuracy.</li><li>Strategic Partnering with CXOs: Acted as a key advisor to the CEO, CFO, and other CXOs on business planning, pricing strategies, and business model pivots to support scale-up and profitability. Contributed to investor communications with data-backed insights to enhance stakeholder confidence and secure strategic funding.</li><li>Cross-Functional & Global Stakeholder Management: Functioned as the strategic finance business partner to cross-functional heads and the PUIG global finance team, aligning local execution with global financial strategies and compliance requirements.</li><li>ERP Transformation & System Automation: Led end-to-end ERP reimplementation to address system gaps, enforce role-based controls, and automate core finance processes—resulting in enhanced data accuracy, faster reporting and improved internal controls.</li><li>Costing, Inventory & Profitability Optimization: Designed and implemented plant-level costing models to ensure accurate COGS determination. Improved inventory management across pricing, consumption tracking, and aging analysis—enabling better working capital control and cost efficiency.</li><li>Manufacturing Finance & Statutory Compliance: Supervised end-to-end accounting for manufacturing operations and ensured full statutory compliance.</li><li>Financial Reporting, MIS & Profitability Analytics: Delivered accurate and timely monthly MIS reports, including P&L, Balance Sheet and KPI dashboards with deep-dive variance analysis across stores, business verticals, and geographies. Supported board-level decision-making through insightful presentations on financial health and business performance.</li><li>Budgeting, Forecasting & Business Planning: Led the Annual Operating Plan (AOP) and rolling forecasts, ensuring alignment with strategic objectives and market dynamics. Monitored key financial metrics to enable business decisions and proactive cost management.</li><li>Statutory, Internal & Tax Audit Management: Finalized standalone and consolidated financials under Ind AS and IFRS, ensured timely group reporting and compliance with international standards. Delivered clean and timely closures of statutory, tax, and internal audits in coordination with Big 4 auditors. Strengthened audit readiness through pre-audit diagnostics and rectification of recurring control gaps.</li><li>Regulatory Compliance & Risk Management: Ensured end-to-end compliance which includes ROC, RBI, FEMA, Income Tax, GST, Transfer Pricing, DTAA, and Customs. Reviewed cross-border contracts and transactions to ensure arm’s length pricing, accurate TDS application, and proper documentation under Transfer Pricing regulations.</li><li>Commercial Negotiation & Contract Governance: Led commercial negotiations and structured deals with vendors and franchisees. Reviewed key business contracts to ensure financial viability, risk protection, and compliance with regulatory standards.</li><li>Treasury & External Commercial Borrowing (ECB): Managed fund planning and liquidity management including ECB drawdowns, bank negotiations, and interest optimization. Improved working capital cycles through proactive cash flow forecasting and receivables control.</li><li>Internal Controls & Governance Framework: Led organization-wide reviews of internal control systems, identified process gaps, and redesigned or implemented over 40 SOPs and IFCs. Established a governance structure for financial discipline, risk mitigation, and policy compliance across departments.</li></ul> at Kama Ayurveda Pvt. Ltd. & PUIG India Pvt. Ltd.