TRACEY PIZZA
North Tonawanda
Summary
Strategic healthcare operations leader with 20+ years of experience driving enterprise provider and claims configuration, compliance, and system optimization within managed care organizations. Proven record of leading cross-functional teams, overseeing complex configuration initiatives, and partnering with executive leadership to support regulatory compliance, operational excellence, and business growth. Deep expertise in Facets configuration, claims pricing, provider network setup, performance governance, and resource management. Recognized for building high-performing teams, implementing scalable solutions, and delivering measurable results in fast-paced, highly regulated environments.
Overview
26
26
years of professional experience
Work History
Director, Provider Configuration
Fidelis Care New York
Getzville
09.2017 - Current
- Provide enterprise-level leadership for provider contract and claims pricing configuration supporting compliance, operational integrity, and new line of business growth.
- Serve as executive point of contact for claims processing and provider network configuration, advising senior leadership on system capabilities and risk mitigation.
- Drive strategic planning, prioritization, and execution of cross-functional initiatives requiring Configuration Services expertise.
- Lead departmental budgeting, resource planning, and performance management aligned to organizational objectives.
- Establish governance, metrics, and accountability frameworks to ensure quality, timeliness, and regulatory compliance.
- Act as subject matter expert for complex claims configuration and pricing scenarios impacting enterprise operations.
- Build and sustain a high-performing, collaborative leadership culture focused on measurable results and continuous improvement.
Manager, Central Configuration Department
Fidelis Care New York
Getzville
09.2007 - 09.2017
- Managed enterprise Facets configuration operations supporting claims, provider contracting, and strategic initiatives.
- Evaluated and approved business requests based on feasibility, system compatibility, and operational impact.
- Directed prioritization and execution of configuration work across multiple functional teams.
- Led large-scale strategic initiatives involving cross-departmental stakeholders and executive sponsorship.
- Developed operational processes and controls to improve efficiency, accuracy, and scalability.
- Partnered with business and IT leadership to deliver enterprise solutions.
Senior Business Analyst
Fidelis Care New York
Getzville
02.2003 - 09.2017
- Led system requirements development and implementation support during enterprise platform conversion.
- Translated business strategy into system configuration and operational requirements.
- Coordinated testing and deployment activities to ensure operational readiness and risk mitigation.
EDI Coordinator / Claims Processor
Fidelis Care New York
Getzville
09.1999 - 02.2003
- Supported claims operations and system optimization initiatives; recognized for accuracy and throughput.
Skills
- Healthcare Operations Leadership
- Provider & Claims Configuration
- Facets System Expertise
- Regulatory Compliance
- Strategic Planning & Execution
- Budget & Resource Management
- Performance Metrics & Governance
- Cross-Functional Leadership
- Process Optimization
- Risk Mitigation
Websites
Executive Capabilities
- Healthcare Operations Leadership
- Provider & Claims Configuration
- Facets System Expertise
- Regulatory Compliance
- Strategic Planning & Execution
- Budget & Resource Management
- Performance Metrics & Governance
- Cross-Functional Leadership
- Process Optimization
- Risk Mitigation
Timeline
Director, Provider Configuration
Fidelis Care New York
09.2017 - Current
Manager, Central Configuration Department
Fidelis Care New York
09.2007 - 09.2017
Senior Business Analyst
Fidelis Care New York
02.2003 - 09.2017
EDI Coordinator / Claims Processor
Fidelis Care New York
09.1999 - 02.2003