Schawn Pedersen
QUALITY OPERATIONS LEADER
Phoenix,AZ
Summary
Results-driven operations leader with a proven track record of surpassing department goals and driving organizational success. Skilled in implementing innovative products and tools to improve performance metrics and reduce costs. Strategic thinker experienced in turning underperforming departments into top revenue producers, cultivating strong customer relationships, and promoting operational excellence through effective communication and problem-solving. Tech-savvy innovator with hands-on experience in emerging technologies, dedicated to advancing technology and boosting productivity in fast-paced environments.
Overview
23
23
years of professional experience
1
1
Certificate
Work History
Snr. Director, Coding & Quality Compliance
Matrix Medical Network
02.2019 - Current
- Built and led high-performing teams through strategic mentorship, professional development, and a positive, engaging work culture—resulting in increased retention, improved morale, and consistently delivering a Net Promoter Score (NPS) above 92%.
- Spearheaded the development and implementation of the organization’s first-ever Clinical Documentation Improvement (CDI) program. Successfully presented the strategic plan to the Executive Leadership Team, securing approval and necessary resources. Recruited clinical staff and designed a comprehensive education and training program to support Clinical Services and ensure long-term program success.
- Provided financial leadership and oversight for a $6M operating budget, maintaining strict fiscal discipline.
- Led oversight of three departments to evaluate and redesign workflows, optimizing clinical efficiency and ensuring clinicians operated at the top of their scope. Successfully streamlined operations, reduced staffing redundancies, and improved processes—resulting in $1.2M in organizational savings.
- Consistently delivered Gold Standard performance with over 95% accuracy year-over-year across all medical coding metrics, reinforcing organizational reputation and ensuring compliance and protection for both the company and its clients.
- Partnered with a vendor to develop a modern medical coding SaaS platform, replacing a legacy system; implemented data segregation and enabled offshore coding operations, driving $1.4M in annual cost savings.
Vice President, Network Operations
SOLERA HEALTH
01.2017 - 01.2018
- Collaborated with senior management to develop strategic initiatives and long term goals for this start-up organization.
- Directed efforts to increase number of active organizations in the Diabetes Prevention Network by 35% resulting in a 43% expansion of site locations.
- Developed and implemented a Quality Effectiveness program to measure and report on Network Partner performance; established regular communication to ensure transparency.
- Established the infrastructure and reporting to forecast partner demand based upon member outreach and engagement initiatives coupled with health plan membership potential.
- Brought together three fragmented departments comprising 14 FTEs into a single, highly functioning, self-directed work team.
- Streamlined processes for onboarding and implementing new network partners of all sizes (Departments of Health, Health Systems, Grocery Store Pharmacies, Independent Pharmacies, small and large independent delivery models).
- Worked closely with COO to support projects and functions that may have overlap with operational and quality systems to deliver efficient, effective and accurate reporting.
- Developed client communications tailored to a range of audiences, from senior health care executives to key influencers and other partnership stakeholders.
Director, Coding and Quality Compliance
MATRIX MEDICAL NETWORK
01.2012 - 01.2017
- Successfully developed and implemented an industry best-in-class Computer Aided Coding (CAC) Tool and supporting coding audit program to improve efficiency by 54% and reduce direct operating costs by $1.2M annually.
- Consistently exceeded financial Client Service Level Agreements (SLAs) for department coding accuracy of 95% and supported numerous client audits of performance.
- Achieved a 22% reduction in employee turnover by developing a Pay-for-Performance program encompassing both financial and non-financial incentives to reward exceptional work product (productivity and accuracy) in the Coding department.
- Matrix contracts with health plans to provide in-home clinical services through a network of employed Nurse Practitioners.
- Facilitated cross-functional collaboration for improved decision-making processes within the organization.
- Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.
- Spearheaded successful product launches that resulted in increased brand visibility and customer acquisition.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
- Increased company revenue by streamlining processes and implementing cost-saving measures.
- Negotiated favorable contracts with vendors for reduced costs and improved service quality.
- Revolutionized customer service protocols, significantly improving customer satisfaction ratings.
Senior Manager
MOSS ADAMS, LLP
01.2007 - 01.2012
- Project management of Independent Review Organization (IRO) audits for medical group practices placed under Corporate Integrity Agreement (CIA) by the Office of Inspector General (OIG).
- Spearheaded the development and implementation of projects to analyze internal controls and revenue cycle assessments for small and large physicians practices.
- Analyzed data from medical chart audits and revenue reports to identify compliance gaps and optimize operational efficiency and reduce external audit risk.
- Established strong relationships with clients and stakeholders, ensuring long-term partnerships, and both new and repeat business.
- Designed and executed standardized policies and procedures, enhancing operational effectiveness.
- Provided strong leadership to enhance team productivity and morale.
- Directed cross-functional teams to successfully meet project milestones, consistently delivering high-quality outcomes on time and within scope
Team Lead, Reimbursement
MCKESSION SPECIALTY
01.2005 - 01.2006
- Collaborated with pharmaceutical companies to develop strategic product launch and market access plans, ensuring successful reimbursement of new drugs by health plans and maximizing member adoption.
- Managed communication with the health plan to provide updates on member reimbursement and progress, ensuring alignment and support for the successful launch of new products.
- Held regular development sessions with team members, resulting in improved performance metrics and increased internal promotions.
Senior Sales Consultant
NOVARTIS PHARMACEUTICALS
01.2003 - 01.2005
- Successfully promoted pharmaceutical products to physicians across diverse specialties, including cardiovascular, gastrointestinal, and internal medicine. Demonstrated expertise in driving market share growth through consultative selling, clinical knowledge, and relationship building.
- Surpassed monthly sales targets by 5%–8%, demonstrating consistent high performance.
Education
Bachelor of Science - Business Management
University of Phoenix
Phoenix, AZSkills
Strong understanding of healthcare systems, including public, private, and integrated care models
Proven experience collaborating with healthcare providers and Managed Care Organizations (MCOs)
Skilled in developing strategic partnerships to drive organizational growth and service expansion
Deep understanding of value propositions to align services with stakeholder and organizational needs
Effective problem solver with a track record of implementing practical, data-informed solutions
Experienced in operations management, streamlining processes to improve efficiency and outcomes
Demonstrated ability to lead and manage cross-functional teams to achieve performance targets
Strong people management skills, including mentoring, coaching, and performance development
Skilled in staff management, including recruitment, supervision, and capacity-building initiatives
Proficient in coordinating complex projects from planning through execution and evaluation
Excellent verbal and written communication skills for internal and external stakeholder engagement
Competent in budget management, financial planning, and cost control strategies
Certification
Certified Professional Coder, American Academy of Professional Coders, 2000 - Current
Military Experience
United States Air Force, Fire Protection, Flight Line Specialist
Accomplishments
- Implemented a proprietary Computer Aided Coding (CAC) program to reducing manual coding time by 50% and accelerating revenue cycle turnaround by 18 days.
- Achieved 8% production improvement by introducing ECLAT's SaaS platform for medical coding and auditing.
- Used Microsoft Excel to develop a comprehensive Pay for Performance program to encompass multiple metrics and account for variances in hours worked.
- Directed a team of 60+ coders and auditing professionals, achieving 98% coding quality scores consistently over a 12-year period.
- Managed multiple teams, Coding, Audit, Care Center, Quality Improvement, and Medical Records to include more than 85 team members.
Timeline
Snr. Director, Coding & Quality Compliance
Matrix Medical Network
02.2019 - Current
Vice President, Network Operations
SOLERA HEALTH
01.2017 - 01.2018
Director, Coding and Quality Compliance
MATRIX MEDICAL NETWORK
01.2012 - 01.2017
Senior Manager
MOSS ADAMS, LLP
01.2007 - 01.2012
Team Lead, Reimbursement
MCKESSION SPECIALTY
01.2005 - 01.2006
Senior Sales Consultant
NOVARTIS PHARMACEUTICALS
01.2003 - 01.2005
Bachelor of Science - Business Management
University of Phoenix