Dynamic professional with extensive experience at CIGNA HealthCare, excelling in contract negotiation and strategic planning. Proven track record of generating over $1 billion in savings through innovative procurement strategies. Adept at team leadership and staff development, fostering collaboration to drive operational efficiency and achieve organizational goals.
Overview
39
39
years of professional experience
Work History
ADJUNCT PROFESSOR
Manchester Community College
Manchester, CT
01.2005 - Current
Instructor in the Department of Sociology teaching, Introduction to Sociology (SOC 150), Criminology (SOC 250) and Juvenile Delinquency (SOC 310).
Successfully developed and delivered comprehensive course material in statistical technique and quantitative reasoning as essentials tools for answering empirical questions about crime and justice with a special focus on socio-economic, gender, cultural and racial factors.
Taught basic judicial process, rules of evidentiary procedure, and cultural diversity and inclusion.
2011 initiatives include the development & implementation of two (2) new Sociology courses for the Spring 2012 semester.
Has worked as an adjunct professor continuously since 2003.
CATEGORY MANAGEMENT DIRECTOR: PHARMACY, AVIATION AND ENTERPRISE OPERATIONS
Began in 2007 as an individual contributor category negotiator with incremental promotions that lead to my latest promotion to Category Director in 2019. This promotion brought additional commodity scope which includes Pharmacy Operations & Technology, Aviation, Health Delivery Services, Payment Integrity, Medical Licensed Content and Clinical Supplies.
Guides, develops, and mentors a team of 15 highly experienced Category Management and Strategic Sourcing (CMSS) team members in the Enterprise Operations/ Pharmacy category who serve as strategic negotiators, trusted advisors, costs analysts, and strategic sourcing points of contact for all Cigna segments under which these commodities fall a combined spend accountability in excess of $2.0B annual spend.
Developed and implemented comprehensive strategies to improve operational processes and organizational efficiency.
Collaborated with senior leadership to set long-term objectives for the company.
Recruited, trained, supervised, evaluated, and mentored staff members.
Conducted regular meetings with department heads to review progress on strategic initiatives.
Identified opportunities for improvement in operational performance metrics.
Reviewed internal reports and identified areas of risk or potential cost savings.
Managed multiple projects simultaneously while ensuring deadlines were met.
Developed and implemented strategic plans to maximize organizational efficiency, effectiveness, and profitability.
Directed the design of data analytics solutions for complex business challenges.
Coordinated with stakeholders across multiple departments to develop innovative strategies for problem solving.
Conducted market research to identify new opportunities for growth and development.
Analyzed financial performance metrics and identified areas for improvement.
Oversaw budgeting processes and ensured fiscal responsibility was maintained throughout the year.
Lead cross-functional teams in developing creative solutions to challenging problems.
Monitored industry trends and made recommendations on how they could be leveraged by the organization.
Collaborated with executive leadership team to develop long-term objectives that would drive success.
Promoted a culture of collaboration among staff members through regular communication, feedback, and recognition.
Leads, mentors and develops the Sourcing team that is primarily responsible to conceive and implement multiple concurrent procurement strategies to a diverse matrix partner landscape within Cigna's Enterprise Operations landscapes which include services provided to Cigna's Commercial Medical, Individual, Senior, Marketing, International, Group and Supplemental segments.
Key accomplishments include As a category manager, mentored and guided four direct reports who carried an average of 25-30 projects each year that generated savings in excess of $40M per year while maintaining an individual caseload of 15-20 projects per month that resulted in $45M in savings each year.
As an individual contributor, executed against a project caseload is comprised of an annual average of one hundred twenty-five (125) individual SCM projects with several different organizations across Cigna's enterprise with a combined value of $2.0B with incremental achieved savings of $962 million in through 2023.
Worked with several internal matrix partners to develop and implemented a fluid operational category strategy process that leverages existing operational and account management partnerships to identify and develop key leverage points for various renewal negotiation strategies.
Negotiated several long-term agreements and programs with Business Process Outsourcing (BPO) suppliers across the Service organization, generating $17M in savings while increasing operational efficiencies.
Devised and led enterprise contracting strategy to align over 13 Clearinghouse Service arrangements with the future business strategy, resulting in preferred contractual terms and $20M in savings (2013-2015).
Completed forensic contractual analysis across various pre-payment claim services to better align service arrangements into preferable business solutions over the term of the agreements resulting in 5.3 million in savings.
Coached and mentored new sourcing leads through the sourcing process lifecycle including RFI/RFP development, supplier negotiations, contractual methodologies, and project strategy development.
Developed contractual agreements that contributed to increased profits by improving terms, services, and price base for Individual segment services resulting in $5.2 million in savings.
SUPPLIER BUSINESS PROJECT MANAGER
CIGNA HealthCare-Service Operations
Bloomfield, CT
01.2007 - 01.2010
Accountable to develop and manage supplier relationships, contracts, service level agreements, and implement business recommendations for streamlining and improving service delivery.
Accountable to effectively matrix with various organizations including Operations, Information Technology (IT), Sourcing, CIGNA Information Protection (CIP), Legal, and External Suppliers.
Recent accomplishments include: Established centralized supplier governance and change management policy, procedures and process for Service Operations.
Expanded Business Process Outsourcing, Claim Rework, and Total Quality Management services offshore resulting 5.4 million in savings.
Contract strategy development and negotiations for Clearinghouse Services, which resulted in $4 million in savings.
Completed pricing concessions and Service Level Agreement restructuring for various supplier relationships including Mailroom and Identification Cards.
Led end to end process flow mapping and pain point analysis to identify business improvement opportunities.
Completed Six Sigma Green Belt Training and Project Delivery for Benefits Legislation improvements.
Led COBRA Services Request for Proposal (RFP) and project business analysis.
Conducted various external entity quarterly business review and supplier assessments for Clearinghouse, ID Card Fulfillment and Paper Mailroom (EMR) services.
Staff management of business specialists supporting various compliance, invoice, and supplier reconciliation operations.
RECOVERY INVESTIGATIONS LEAD
United Health Care/ Ingenix Recovery Services
Hartford, CT
01.2005 - 01.2006
Responsible to investigate allegations of fraud and abuse by reviewing medical claims, performing Internet research, conducting interviews, analyzing data, and internal proprietary databases to track, analyze, and conduct investigations.
Accountable to effectively partner with legal and compliance organizations, recommending case strategies, executing strategies to bring cases to timely, successful closure and complying with Federal and State Prompt Pay Laws.
Identified and recovered 3.1 million in overpayments to various NY registered dieticians as a result of improper use of physician-level billing codes.
Developed new statistical queries designed to identify possible double billing and 'ghost refill' practices by internet pharmaceutical companies.
Developed new Standard Operating Procedures for recovery case processing and prioritization.
ADJUNCT PROFESSOR
Goodwin College
East Hartford, CT
01.2003 - 01.2005
Instructor in the Department of Sociology & Human Services with a focus on teaching classes such as Community Organization & Advocacy (HSR 105), Introduction to Human Services (HSR 101), Studies in Alcohol and Drug Abuse (HSR 120) and Contemporary Social Problems (SOC 110).
Responsible to prepare and administer lectures as well as written examinations based on institutional requirements.
Act as a faculty advisor to students in the Human Services curriculum.
Developed and introduced course curriculum for Contemporary Social Problems (SOC 110) as part of the Human Services degree program.
Facilitated and taught Cognitive Behavioral Treatment (CBT) modality as an effective way of treating patients who suffer from alcoholism.
Implemented Rational Emotive Behavioral Treatment (REBT) modality into Studies in Alcohol and Drug Abuse (HSR 120) as an effective way treat anger as a byproduct of alcoholism.
SPECIAL INVESTIGATOR
State of Connecticut Department of Public Health & State Marshal Commission
Hartford, CT
01.2000 - 01.2005
State Marshall Commission: Responsible to draft and implement investigational protocol, conduct investigations into complaints made against CT State Marshals in areas such as business practices, statutory/ regulatory violations.
Accountable to gather evidence, conduct interviews, and evaluate case evidence as it pertains to statutory law and regulatory practices.
Conducted financial audits of client fund accounts and prepared investigative reports accordingly with recommendations for dismissal or prosecution.
Established and taught State Marshal Code of Ethics to new and existing CT State Marshals.
Established State Marshal financial audit procedures.
Acted as departmental prosecution in matters designated for hearing before the State Marshal Commission.
Department of Public Health: Responsible to conduct all aspects of preliminary investigations of CT Licensed practitioners as identified in CGS Chapter 348.
Accountable to conduct interviews, lead 50 concurrently running investigations, field inspections, gathering evidence, and preparing investigative reports for litigation.
Acted as the Department liaison to Connecticut's sixty-five professional licensure organizations including CT Medical and Dental associations.
Attended sessions and addressed members on matters concerning standards of practice as related to state law.
Recruited licensed professionals to act as consultants in ongoing departmental investigations.
Successfully investigated approximately 968 cases in sixty-five different licensure disciplines, including State of Connecticut v Dr Enrico Khu and State of Connecticut v Wade Funeral Home et al.
MILITARY POLICE OFFICER, MM2
U.S. Navy
Naval Base Norfolk, U.S.
01.1987 - 01.1997
Assigned to the Master at Arms Division.
Responsibilities included preliminary and secondary investigations of criminal activity reported to Naval Base Norfolk Police Department.
Duties were conducting interviews, recording statements, gathering and processing evidence, arresting accused offenders, preparing preliminary case files for court martial or other disciplinary actions.
Trained as a subject matter expert in domestic crisis resolution and served as a Fire Team Investigator aboard USS Dwight D Eisenhower (CVN 69) from 1988-1995.
Actively served in Operations, Desert Shield, Desert Storm and Kuwaiti Liberation (2 tours).
Education
B.A. - CRIMINAL JUSTICE, SOCIOLOGY
Central Connecticut State University
New Britain, CT
M.S. - CRIMINOLOGY
Central Connecticut State University
New Britain, CT
M.A. - EDUCATION: CURRENTLY PURSUING CERTIFICATION IN SECONDARY EDUCATION