MICHAEL L. TRACY
Cranberry Township,PA
Summary
Results-driven Chief Operating Officer drives performance improvements and leads strategic initiatives. Skilled manager of cross-departmental activities with adaptive communication of organizational objectives. Develops and executes innovative strategies for stimulating growth and service quality.
Overview
22
22
years of professional experience
Work History
Chief Operating Officer - EnGen
HIGHMARK INC.
Pittsburgh, PA
01.2020 - 10.2023
- Full accountability for all Highmark health plan and enGen technology operations functions across five unique platforms with focus on overall performance of operations for 4.4M member book of business (Commercial, ACA, Medicare Advantage, Medicaid, & BPO Services)
- Created and implemented strategic technology roadmap designed to improve customer experience and reduce overall operating cost using AI/Machine Learning, omni channel customer service, and key vendor partnerships
- Partnered with leadership team to form operational captive organization and global enterprise footprint
- Drove cost optimization and reduced market pricing by developing captive model allowing for multiple operational models to meet customer needs
- Achieved 20% reduction of SG&A cost for technology operations through effective automation, process improvement, and implementation of standard operating model
- Reduced overall call volume by 15% through use of predictive analytics designed to provide members and providers with information in advance of outreach
- Partnered with commercial and federal markets to drive growth strategies and achieve desired blended operational & clinical operating model focused on health outcomes
- Resulted in 5% reduction in medical cost and improved pricing in marketplace.
Senior Vice President of Operations
HIGHMARK INC.
Pittsburgh, PA
03.2016 - 01.2020
- Full accountability for all Highmark operational functions and results across five unique platforms including domestic and global staffing
- Develop and track successful policies, methods, and processes
- Created strategy and implementation of operational excellence model with focus on overall performance of operations for 4.4M member book of business (Commercial, ACA, Medicare Advantage, & BPO)
- Provide training and development of staff
- Oversee global sourcing management, profit & loss, ROI, and cost savings
- Collaborate with colleagues daily in successful completion of various enterprise initiatives
- Drive cost optimization by developing and implementing successful operational excellence model
- Implemented quality, production, and inventory standards for all functions
- Employed structured metric-based reporting and analysis process to effectively evaluate, monitor, and drive efficiencies
- Achieved 25% reduction of SG&A cost for operations through effective automation, process improvement, and implementation of a standard operating model
- Lead team to 4+ STARS rating through implementation of new service and appeals process and infrastructure
- Designed and executed successful guardrail process to identify typical operational standards for new product sales & RFP's
- Partnered with Highmark Health Solutions to successfully migrate Independence Blue Cross, Blue Cross Blue Shield of MN, Blue Cross Blue Shield of ND, and Blue Cross Blue Shield of WY onto Highmark legacy platform.
Vice President of Operations
HEALTHCARE MANAGEMENT SYSTEMS (HMS)
Irving, TX
10.2013 - 03.2016
- Full accountability for all HMS legacy operations and results across seven unique platforms including domestic and global staffing
- Develop and track successful policies, methods and processes
- Managed and monitored performance of five direct reports and 1,200 indirect reports with responsibility for overall performance
- Provide training and development of staff
- Oversaw global sourcing management, profit & loss, ROI and cost savings
- Collaborate with colleagues daily in successful completion of various projects and assignments
- Drove cost optimization and revenue growth by developing and implementing successful corporate strategies
- Implemented quality, production, and inventory standards for all functions
- Achieved 20% reduction of SG&A cost for operations through effective automation of inventory processing and off shoring of processing when suitable
- Employed structured metric-based reporting and analysis process to effectively evaluate, monitor and drive efficiencies and cost savings within claims organization
- Designed and executed successful guardrail process to identify typical operational standards for new product sales & RFP's
- Successfully developed and promoted two direct reports from senior manager to directorial roles
- Created and spearheaded productive training program/material for all functions
- Influential in maintaining operational readiness through implementation of impact assessment, staffing model and funding process
- Increased recoveries and revenues by 12%.
Senior Director of Claims & Call Center Operations/Workforce Management
UNITEDHEALTH GROUP
Various Locations
01.2010 - 10.2013
- Served as Senior Director for 1,000+ person commercial claims & call center operations organization and 75+ person workforce and capacity management group accountable for all claims operations inventory management for 3000+ claims processors
- Senior leadership of all claims operations and results across several processing platforms including domestic and global staffing of 750+ employees
- Oversaw inventory and workforce management for more than 3,000 employees across Commercial, Medicare and Medicaid business lines
- Evaluated, monitored, and drove efficiencies and cost savings within claims organization through implementation of structured metric-based reporting and analysis procedure
- Improved performance and overall organizational results of two separate underperforming United Healthcare acquired entities operations successfully exceeding expectations in quality, inventory and cost metrics within less than 12 months
- Accomplished 30% decrease in SG&A cost for operations through successful automation of claims inventory payment and off shoring of claims processing when deemed appropriate
- Implemented and centralized Medicare and Medicaid Workforce Management program
- Achieved reduction in aged inventory from 30% of over aged threshold to less than 5% of overall aged inventory as direct result of taking inventory management from front line operations staff and implementing defined process.
Director of Operations
UNITEDHEALTH GROUP
Various Locations
01.2002 - 01.2010
- Directed operations for Medical Cost Impact group
- Complete ownership of cost analysis, capacity planning and funding of medical initiatives for claims and customer service operations
- Oversaw identification and execution of medical cost analysis and funding totaling $20 million annually
- Provided training and guidance to direct operations teams through employment of impact assessment process ensuring accurate determination of employee staffing needs for various operational initiatives
- Designed Best in Class Impact Assessment, Staffing Model and Funding Process successfully implemented across multiple operational areas outside of Claims and Customer Service Operations
- Instrumental in 60% of direct reports achieving promotional opportunities within greater UnitedHealth care Organization through high quality staff development and mentoring.
Education
University of North Carolina At Charlotte
Charlotte, NCSkills
- Operations/Operational Management
- Corporate Strategy Development
- Policy/Procedure Implementation
- Process Design & Improvement
- Productivity/Efficiency Improvement
- Customer Experience
- Healthcare Claims Strategy/Operations
- Cost Optimization
- ROI/P&L Accountability
- Revenue & Profit Growth
- Reporting & Analysis
- Workforce Management
- Domestic & Global Staffing
- Inventory Management
- Program Development
- Cross-Functional Collaboration
- Client Engagement
- Goal Setting
- Acquisition Integration
- Executive Leadership
- Strategic Planning
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Judge a man by his questions rather than his answers.
Voltaire
Timeline
Chief Operating Officer - EnGen
HIGHMARK INC.
01.2020 - 10.2023
Senior Vice President of Operations
HIGHMARK INC.
03.2016 - 01.2020
Vice President of Operations
HEALTHCARE MANAGEMENT SYSTEMS (HMS)
10.2013 - 03.2016
Senior Director of Claims & Call Center Operations/Workforce Management
UNITEDHEALTH GROUP
01.2010 - 10.2013
Director of Operations
UNITEDHEALTH GROUP
01.2002 - 01.2010
University of North Carolina At Charlotte