May 2025 – Present

Overview: Facing increasing demand and the growing complexity of our sales and medical management processes, we identified critical gaps in our CRM setup. The existing system lacked reliable, real-time data, creating delays and blind spots for our medical management products, many of which rely on up-to-date account insights to successfully engage patients. Inconsistent documentation, outdated information, and disconnected workflows between sales, marketing, and clinical teams contributed to inefficiencies across the organization.

To address these issues, we launched a cross-functional initiative to design a new solution for the sales funnel and account management environment within our CRM system. This effort aimed not only to streamline sales workflows and improve documentation but also to ensure critical information would be consistently accessible to the medical management team, supporting better care delivery and product performance.

The project involved working closely with the sales team to map workflows and pain points, auditing the legacy CRM to identify breakdowns, collaborating with the medical management product teams to define key data needs, and aligning the marketing function to optimize campaign tracking through the updated funnel.

Results: This project is on track to deliver a more scalable, integrated environment that benefits multiple parts of the organization:

• Improved Sales & Account Workflows: A simplified, user-friendly interface tailored to real-world workflows makes it easier for teams to document and manage accounts consistently.

• Real-Time Access to Key Data: Medical management teams can now rely on accurate, timely account information, enabling more targeted patient engagement and reducing clinical blind spots.

• Stronger Cross-Functional Alignment: By tying sales, marketing, and clinical operations into a shared system of record, the organization is better equipped to scale and adapt to increasing volume and complexity.

June 2025 - Present

Overview: As our Medical Management products expanded, so did the volume and complexity of email communication. With over 30 shared inboxes, excluding others departments we plan to onboard, the organization faced major challenges managing inbound requests. We lacked visibility into response status, trends, and team capacity. There was also no way to track volume, categorize messages, or collect meaningful data to inform planning.

To solve this, we launched a project to build a custom ticketing system tailored to our workflows and reporting needs. A previous off-the-shelf solution failed to meet our requirements, costing time and resources. This new solution is being designed from the ground up to support real-time tracking, custom routing, and department-specific workflows, starting with Medical Management and expanding from there across the organization.

The effort includes mapping existing inbox workflows, identifying common request types, defining KPIs, and collaborating with stakeholders to build a flexible, scalable tool that meets both day-to-day and strategic needs.

Results: This project is set to streamline communication and unlock critical insights:

• Centralized Management: A single platform replaces dozens of inboxes, enabling better tracking and accountability.

• Operational Visibility: Real-time metrics around volume, response time, and resolution will inform staffing and planning.

• Tailored Departmental Workflows: Teams can customize routing, categorization, and priority settings to match their needs.

• Scalable Infrastructure: Built for long-term use and organizational growth, with cross-functional input baked into the design.

Aug 2024 - Jun 2025

Overview: In addressing the challenges of fragmented knowledge, dispersed information, and decentralized management of vendor relationships, we recognized the critical need for a comprehensive Vendor Relationship Management (VRM) system. The initial management structure, characterized by compartmentalized knowledge across multiple teams and lack of centralized storage for vendor-related documents, hindered effective collaboration and decision-making. Furthermore, the absence of a designated individual managing vendors led to ambiguity and inefficiencies in vendor relationships required to connect members with specialized care. To overcome these obstacles, we embarked on developing a VRM system aimed at consolidating vendor information, streamlining communication, and establishing clear ownership of vendor relationships within the organization. Additionally the solution had to be accessible from both computer and mobile devices

Results: The implementation of the VRM system has yielded transformative results, addressing longstanding challenges and fostering improved vendor relationship management:

• Single Source of Truth: The VRM system serves as a centralized repository for all vendor-related data and documents, eliminating information silos and providing a single source of truth for stakeholders.

• Aligned Ownership: By establishing clear ownership of vendor relationships within the organization, the VRM system has enhanced accountability and coordination, leading to more effective vendor management.

• Enhanced Collaboration: Streamlined communication and access to vendor information have improved collaboration across teams, facilitating informed decision-making and proactive engagement with vendors.

  Overall, the VRM project has not only addressed existing pain points but has also laid the foundation for more efficient and strategic vendor management practices, driving value and resilience across the organization.
  

Jun 2023 - Feb 2024

Overview: In response to emerging challenges in oncology patient management, characterized by delayed identification post-treatment initiation and increased competition from specialized oncology carve-out vendors, we recognized the urgent need for proactive intervention and tailored support. The absence of a mechanism to identify oncology patients early in their treatment journey posed risks of delayed care and suboptimal member experience. To address these challenges, we implemented updates to standard plan language aimed at early identification of oncology patients, collaborated with existing business partners to enhance the member experience post-handoff to nurse case managers, and leveraged/adapting technical resources such as our CRM system to build out a custom path for these cases and software acquired via an M&A strategy. This initiative sought to improve the timeliness of patient identification, minimize delays in treatment, and ensure that oncology patients receive the necessary resources and support throughout their journey.

Results: The implementation of the Oncology project has yielded significant benefits, addressing key challenges and improving patient outcomes:

• Early Identification: The pre-note requirement facilitated early identification of oncology patients, enabling timely intervention and support initiation post diagnosis.

• Prevention of Treatment Delays: By proactively identifying patients prior to treatment initiation, the project has helped prevent delays in treatment approval and subsequent care delivery.

• Enhanced Member Experience: Collaboration with business partners has led to the creation of a more tailored member experience post-handoff to nurse case managers, ensuring that patients receive personalized support and resources aligned with their needs.

Jan 2024 - May 2025

Overview: The imperative for the Medical Management Reporting Platform stemmed from our organization's rapid growth trajectory, which outpaced our existing infrastructure for data analytics and reporting. It became increasingly evident that without robust reporting mechanisms, we were operating in the dark, lacking the essential insights needed to gauge our impact on members and make strategic decisions to scale our offerings. Consequently, this endeavor transcended Iteratively refining reporting; it entailed the development of a foundational infrastructure and determining pivotal KPIs to support our burgeoning needs, and building out a team to facilitate.

Results: Through concerted collaboration and a commitment to innovation, the Medical Management Reporting Platform has evolved into a cornerstone of our operational excellence, empowering us to navigate complexities with confidence and agility.

• Strengthening of data integrity, ensuring accuracy and reliability in decision-making processes.

• Creation of tailored reporting solutions, catering to the diverse needs of stakeholders.

• Attainment of clear insights into departmental and product performance, facilitating strategic adjustments.

• Introduction of storytelling-based reporting, effectively showcasing our value proposition to clients and bolstering retention efforts during renewal cycles.

Mar 2019 - Dec 2019

Overview: In our endeavor to enhance healthcare services, we identified a critical gap in our existing system: the lack of an efficient mechanism to identify and track members already being assisted. Prior methods of identifying such members were manual and relied heavily on other departments, often leading to delayed or missed opportunities for assistance. Additionally, the manual process of tracking work completed and billable time hindered scalability in the face of growing product demand.

To address these challenges, we embarked on developing a custom CRM system empowered by machine learning AI. This system aimed to automate the identification of members requiring assistance, streamline billing processes, and provide visibility into ongoing tasks, thereby enabling better support for our client groups and members.

Results: The implementation of the custom CRM system yielded significant results across multiple dimensions:

• Quicker Alerts to Members: By leveraging machine learning AI, the system facilitated rapid identification of members with specific medical needs, enabling timely intervention and support.

• Streamlined Billing Process: Automation of billable hours tracking streamlined the billing process, reducing manual effort and minimizing errors.

• Improved Line of Sight: The system provided enhanced visibility into ongoing tasks, enabling better allocation of resources and supporting scalability.

  Overall, the custom CRM system not only addressed existing challenges but also paved the way for enhanced efficiency, effectiveness, and scalability of our healthcare services.