Patricia Crowe
Indianapolis,IN
Summary
Payer-domain product and delivery leader with deep experience in health plan operations, claims, prior authorization, provider data, and enterprise platform integrations. Leads discovery, roadmap prioritization, and delivery governance across onshore and offshore teams, with executive reporting, risk control, and disciplined release management for Medicaid, Medicare Advantage, and commercial programs.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Associate Director, Healthcare PMO
Cognizant Technology Solutions Corp.
06.2026 - Current
- Established governance and measurement frameworks with executive reporting that enhanced delivery control, ensuring initiatives remained on schedule and within budget.
- Directed program KPI, risk, change, test/defect, and release governance, overseeing automated testing, environment readiness, and deployment checkpoints to minimize production incidents; documented options with tradeoffs and implementation impacts for senior client and internal stakeholders.
- Direct payer and Medicare/Medicaid programs end to end, analyzing client business objectives and translating them into scoped, estimated, and prioritized solution recommendations for executive decision.
- Structured daily hybrid collaboration across 35+ onshore and offshore team members, mentoring leads on accountability and automation-enabled delivery.
- Facilitated remote collaboration by participating in virtual meetings and managing project updates.
Program Manager
Availity, LLC
09.2019 - 06.2026
- Owned end-to-end delivery for enterprise payer and provider accounts on a national health information network, aligning client priorities, delivery capacity, quality commitments, and account outcomes.
- Led discovery sessions with payer stakeholders across operations, compliance, engineering, and product to map business processes, identify gaps in configurations and integrations, and define enhancement scope.
- Defined performance measures and portfolio KPIs aligned to business objectives; monitored post-implementation adoption, operational performance, and client experience indicators to drive continuous improvement.
- Automated and standardized repeatable delivery workflows through SOPs, knowledge management assets, and escalation playbooks, reducing process variance and establishing scalable best practice.
- Delivered subject matter expertise to Compliance, Legal, Engineering, Product, and client leaders on regulated initiatives, shaping solution estimates and identifying account growth opportunities.
- Executed remote tasks to support project continuity and communication.
Adjunct Professor and Curriculum Designer, Information Technology
Indiana Wesleyan University
08.2019 - Current
- Designed 4 online IT courses, expanding program offerings by 20% and increasing learner engagement by 30%, achieving a 95% student satisfaction rate.
- Taught undergraduate and graduate courses for Indiana Wesleyan University classrooms and online sections.
- Developed syllabi, lesson plans, and assignments aligned with university curriculum standards.
- Facilitated student discussions, lectures, and learning activities in faith-based settings.
- Conducted online classes from home
Senior IT Quality Manager
Roche
05.2018 - 09.2019
- Led FDA 510(k) submission delivery for the cobas i601 diagnostics platform, coordinating Regulatory, Quality, Launch, and senior stakeholders.
- Authored 21 CFR Part 11 SOPs and owned validation risk, change, and remediation planning, strengthening release discipline and audit readiness for regulated systems.
- Led global middleware deployment integrating 500+ clinical laboratory analyzers with COTS products, ensuring compliance with GxP and FDA requirements through rigorous review of interfaces, data flows, and validation controls.
- Collaborated with cross-functional teams in a virtual environment to enhance project communication and coordination.
District Operations Manager, Digital Transformation
Equian, LLC
Indianapolis, IN
11.2016 - 05.2018
- Led digital transformation and implementation for Medicaid and Medicare Advantage accounts, translating payer requirements into scalable operating solutions through effective requirements management and solution structuring.
- Monitored account performance and collaborated with Sales and Finance on value modeling, profitability, and budget considerations to drive account growth; managed vendors to enhance platform reliability.
- Oversaw daily operations for the district, ensuring efficient service delivery for Equian healthcare payment integrity teams.
- Organized daily workflows among claims review and provider service teams to enhance efficiency. across claims review and provider service groups.
- Monitored compliance with Equian policies, client requirements, and audit standards.
Manager, Clinical Quality and Healthcare Informatics
MDwise, Inc.
Indianapolis, IN
07.2014 - 11.2016
- Led HEDIS performance measurement for Indiana Medicaid health plan, overseeing data collection, reporting, and monitoring of key quality indicators to enhance member and provider outcomes.
- Supported CAHPS improvement and state QI compliance, partnering with clinical, provider, and operations teams on member experience interventions.
- Produced utilization and staffing analytics that informed organizational efficiency strategy; led provider network data integrations, achieving consistent delivery of performance metrics.
Utilization Management Nurse
Advantage Health Solutions
Indiana
08.2010 - 07.2014
- Collaborated with practices, hospitals, and medical directors to resolve authorizations, ensuring documentation met CMS, state, and accreditation standards.
- Adjudicated prior authorization and inpatient requests against evidence-based medical necessity criteria, enhancing understanding of payer utilization management and claims workflows.
- Oversaw clinical and business operations for 10-provider primary care practice, managing billing, coding, and insurance verification processes.
Education
Doctoral Coursework - Healthcare Administration
Liberty University
Master of Science - Computer and Information Technology
Purdue University
Bachelor of Science - Business Management
Indiana Wesleyan University
Technical Certificate - Nursing
Ivy Tech Community College
Skills
- Payer domain expertise
- Product consulting
- Platform delivery
- Project Delivery Oversight
- Governance and compliance
- Stakeholder Engagement
- Payer domain expertise
- Product consulting
- Platform Optimization
- Delivery DevOps
- Data Analytics
- Leadership development
Personal Information
Title: Payer Product & Platform Consultant | Claims, Benefits & Provider Operations | Facets Ecosystem | DevOps & Release Governance
Certification
- Lean Six Sigma Black Belt Professional (LBBP), Management and Strategy Institute
- Dataiku Generative AI Practitioner Certification
- Context Engineering Certification
- Kiro Certification
- Certified Billing and Coding Specialist
- Licensed Practical Nurse (LPN)
Timeline
Associate Director, Healthcare PMO
Cognizant Technology Solutions Corp.
06.2026 - Current
Program Manager
Availity, LLC
09.2019 - 06.2026
Adjunct Professor and Curriculum Designer, Information Technology
Indiana Wesleyan University
08.2019 - Current
Senior IT Quality Manager
Roche
05.2018 - 09.2019
District Operations Manager, Digital Transformation
Equian, LLC
11.2016 - 05.2018
Manager, Clinical Quality and Healthcare Informatics
MDwise, Inc.
07.2014 - 11.2016
Utilization Management Nurse
Advantage Health Solutions
08.2010 - 07.2014
Doctoral Coursework - Healthcare Administration
Liberty University
Master of Science - Computer and Information Technology
Purdue University
Bachelor of Science - Business Management
Indiana Wesleyan University
Technical Certificate - Nursing
Ivy Tech Community College