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 Inconsistent documentation, outdated information, and disconnected workflows between sales, marketing, and clinical teams contributed to inefficiencies across the organization.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 resulting in a reduction in account documentation errors by ~35%, improving data reliability for cross-functional teams

• Real-Time Access to Key Data: Enabled real-time visibility into 100% of active accounts, reducing blind spots for patient engagement by ~40%.

• Stronger Cross-Functional Alignment: Consolidated 3 siloed workflows into a single CRM system, reducing duplicated effort by 30%

Impact on Product Strategy

Beyond operational improvements, the Sales Funnel & Account Management CRM played a critical role in strengthening the Medical Management product strategy. Previously, information about group setup and elections which determine what services members are eligible for was fragmented across systems and difficult/time consuming for case managers and advocates to access in real time. This fragmentation created blind spots that limited our ability to fully support members.

By building out the Sales Funnel & Account Management, we established a single, accessible source of truth for what each group elected and how those elections impact available Medical Management services available in a case in real time. This enabled case managers and advocates to quickly understand a member’s options, tailor outreach more effectively, and make informed decisions without relying on manual lookups or cross-team handoffs.

Just as importantly, this integration unlocked the ability to automate case workflows based on group setup, ensuring that Medical Management teams focus their efforts on the most critical triggers. This alignment between sales, account configuration, and clinical operations transformed the CRM from a sales tool into a foundational component of the Medical Management ecosystem.

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: Consolidated 30+ shared inboxes into a single ticketing system, improving visibility and reducing missed requests by 50%. Also, enabled tracking of 100% of incoming requests, compared all being monitored manually.

• Operational Visibility: Real-time metric tracking for response times, request volumes, and backlog, resulting in reducing average response time by ~30% during pilot rollout.

• Tailored Departmental Workflows: Enabled creation of 5+ department-specific workflows, ensuring requests are routed correctly 100% of the time. Reduced manual triage by ~40%, freeing up team capacity for high-value tasks.

• Scalable Infrastructure: Designed to support organization-wide expansion beyond Medical Management, with capacity to handle 10x current request volume. Also Future-proofed reporting enables tracking of KPIs across multiple departments with minimal additional configuration

Impact on Product Strategy

As the Medical Management product portfolio expanded, inbound volume and complexity increased rapidly, placing significant strain on existing communication channels. With requests spread across dozens of shared inboxes and no reliable way to track ownership or status, the risk of missed referrals, delayed responses, and inconsistent member experiences grew alongside the product offering.

The custom Ticketing System was a critical enabler for scaling Medical Management responsibly. By centralizing all inbound requests into a single system, we ensured that no referral is lost, every request is tracked from intake to resolution, and members receive timely, accountable responses as volume continues to grow.

Equally important, the system introduced data visibility that previously did not exist. For the first time, we can measure where volume is coming from, which request types are driving demand, and how quickly teams are responding. All insights that now inform staffing decisions, capacity planning, and future product investment.

Finally, by automating manual routing, categorization, and prioritization workflows, the ticketing system reduces administrative burden and allows Medical Management teams to focus on what matters most: delivering high-quality support to members. In doing so, the platform transformed operational intake from a bottleneck into a scalable, data-driven foundation for the Medical Management.

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: Centralized 100% of vendor information into a single accessible repository eliminating information silos and providing a single source of truth for stakeholders.

• Aligned Ownership: Defined ownership for ~95% of vendor accounts, resolving ambiguities that previously caused delays in issue resolution and increased response speed to vendor inquiries by ~40%, by allowing users to self serve.

• 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.

Impact on Product Strategy

The Vendor Relationship Management (VRM) system became a critical foundation for delivering effective Medical Management services because group elections directly determine which vendor partners and internal products can be used to support a member. Prior to this work, access to approved vendors, contract details, and engagement guidelines was fragmented or held by a small number of individuals, creating delays, uncertainty, and unnecessary escalations during active cases.

By centralizing vendor relationships within the VRM system, both Medical Management and Account Management teams now operate from a shared, approved list of vendor partners aligned to group elections. This ensures that members are consistently connected to the right vendors based on what their group has elected, reducing risk, improving compliance, and enabling faster, more confident decision-making during care delivery.

The system also serves as a living knowledge repository, housing vendor-specific guidelines, escalation paths, and engagement best practices directly within the same environment where cases are managed. Previously, support teams had little visibility into how to navigate vendor-specific nuances and often had to escalate questions upward, slowing down member support. With VRM, this information is now immediately accessible at the point of need, empowering teams to act independently and efficiently.

Ultimately, the VRM system transformed vendor management from a hidden dependency into a scalable, transparent capability, strengthening alignment between account configuration, medical management execution, and member experience while supporting the organization’s ability to grow and diversify its Medical Management offerings.

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, increasing early intervention opportunities by ~60%, and allowing timely support for patients at the start of their treatment journey.”

• Prevention of Treatment Delays: By proactively identifying patients prior to treatment initiation, we decreased the number of delayed treatments by ~40%, improving overall care timeliness and outcomes.

• Enhanced Member Experience: Collaboration with business partners has led to the creation of a more tailored member experience, ensuring 100% of high-risk patientsreceived personalized follow-up support, up from ~75% before the initiative

Impact on Product Strategy

In the years following the COVID-19 pandemic, the Medical Management products experienced a significant increase in oncology cases. Many members had delayed routine care during the pandemic, resulting in a rise in later-stage cancer diagnoses and more complex treatment plans. As a result, oncology cases were often identified only after problems emerged, such as treatment delays, authorization issues, or breakdowns in care coordination, driving a sharp increase in escalations and reactive interventions.

The Oncology Patient Program represented a critical adaptation of existing Medical Management products to meet this heightened and evolving need. By shifting identification earlier in the patient journey and enhancing coordination between systems, vendors, and nurse case managers, the program moved oncology support from a reactive model to a more proactive, preventative approach.

Strategically, the program strengthened Medical Management’s ability to respond to post-pandemic utilization trends, demonstrated agility in adapting products to changing member needs, and reinforced oncology as a priority focus area within the broader product portfolio.

Jan 2024 - May 2025

Strategic Context

Medical Management had emerged as a high-value, fast-growing product line, delivering increasing value to both clients and the members we serve. However, our ability to demonstrate, defend, and scale that value was limited by the absence of a standardized analytics and reporting. While member volume and billing scaled successfully, we lacked a cohesive way to tell a unified story about impact, outcomes, and ROI.

During a record sales year, our account management team faced repeated requests to demonstrate Medical Management's value to justify billing and secure renewals. The data existed somewhere, but it had to be manually compiled and could not be delivered promptly, creating risk during critical client conversations. Internally, expansion and investment decisions depended on ad hoc data requests to other teams, slowing responsiveness and limiting strategic agility. To support sustainable growth, Medical Management needed to evolve its approach to support client conversations, guide internal decision-making, and reinforce its position as a scalable, high-impact product.

The Problem

Organizational growth outpaced the existing approach to analytics, leaving leadership without reliable, standardized insights. Data integrity issues were common, requiring extensive manual validation before any analysis could be trusted. Inconsistent KPI definitions across teams prevented alignment on success metrics and made cross-program comparisons unreliable.

Reporting was largely reactive and manual. Ad hoc requests took days to complete, delaying decisions and limiting the ability to respond to emerging trends. Each new analysis required custom data pulls and validation, making it difficult to evaluate program performance, member outcomes, or resource allocation at scale.

Without a unified analytics foundation, leadership lacked visibility into underperforming programs, volume trends, and optimization opportunities. Value was difficult to articulate consistently to clients, creating risk during renewals. Decision-making relied heavily on intuition rather than evidence, constraining the ability to iteratively improve and scale Medical Management sustainably.

Delivery Approach

I treated this as both an organizational capability-building challenge and an infrastructure design problem. The challenge wasn't just building dashboards, it was translating disparate stakeholder needs into a cohesive analytics framework that could scale.

Discovery revealed a paradox:teams were drowning in data but starving for answers. Leaders would request "everything we have on diabetes outcomes," then spend days manually filtering spreadsheets down to the three numbers that actually mattered for their decision. Through interviews across distinct teams, each with different operational contexts and analytical maturity. I mapped what questions leaders were actually trying to answer, not what reports they thought they wanted. The real problem wasn't data access, it was knowing which questions to ask.

Design principles prioritized meaningful metrics over comprehensive coverage. Stakeholders initially wanted comprehensive dashboards tracking every available data point. But when I asked "What decision would you make differently if this number changed?", we quickly identified the pivotal KPIs that would genuinely inform strategic choices, the metrics that would justify continued investment and guide scaling decisions. This meant ruthlessly cutting vanity metrics in favor of actionable intelligence that could demonstrate business value to clients and support the case for expansion.

Rollout was structured as iterative validation across teams with distinct needs. I implemented the framework in waves, testing with each department, gathering feedback on what drove real decisions versus what looked impressive, and refining before moving to the next group. When we hit blockers—data gaps, technical limitations, or capability constraints—I worked with data teams and stakeholders to problem-solve, often building training to bridge skill gaps rather than accepting "we can't access that" as final. The goal was sustainable adoption that would genuinely change how decisions were made and enable evidence-based scaling, not elegant reports that sat unused.

I ensured processes and team structure were in place to continue scaling and producing consistent reporting. As reporting platforms expanded, we built a dedicated team that could facilitate and expand on these capabilities in the future.

Key Decisions

Standardization of Metrics: During initial discussions, stakeholders requested access to as much data as possible, believing comprehensive information would enable better decisions. The tradeoff: flexible exploration of raw data versus streamlined standardized reporting. We prioritized a focused set of standardized metrics, accepting reduced control, stakeholders could no longer dig through raw data themselves, in exchange for speed and consistency. They also gave up some flexibility by relying on us to set report parameters as part of the standardization. Working directly with leadership, I established a governance framework identifying measurement blind spots and defining pivotal KPIs supporting both operations and strategy, focusing on member impact stories, cost savings, billable hours, and case volumes.

Data Integrity as Foundational Requirement: Teams were making strategic decisions based on data they didn't trust, spending significant time manually verifying numbers because years of inconsistent data entry had eroded confidence in reported metrics. The tradeoff: quick dashboards versus foundational trust. We strengthened data integrity at the source before building reporting layers, systematically tracing data lineage with each team, validating sources and assembly logic, and implementing systematic validation processes. This traded the immediate gratification of new dashboards for the foundational trust required to actually use them, reducing manual verification effort and enabling teams to act on insights with confidence.

Rejecting Vanity Metrics for Performance-Aligned KPIs: Teams initially tracked individual case counts as a productivity measure, but these numbers created noise without driving strategic value and risked misinterpretation. The tradeoff: familiar activity metrics versus outcome-aligned performance measures. We shifted focus to billable hours, the performance metric team members were actually evaluated against and that directly tied to business value. This eliminated tracking that didn't move the needle and aligned reporting with how performance was actually measured, ensuring analytics reflected what mattered for both team members and the business.

Storytelling-Based Reporting for Client Value Articulation: Medical Management wasn't effectively communicating the value we delivered, leading to frequent off-cycle requests for impact clarification from clients and our sales team. Past responses were addressed one-by-one, resulting in inconsistent messaging. The tradeoff: continued custom but manual reports versus standardized proactive communication. Through multiple iterations, we developed narrative-driven reporting approaches that framed insights around member impact, cost savings, and health outcomes rather than raw metrics. This created a compelling, proactive storytelling approach that reduced off-cycle client reporting queries, strengthened renewal materials, and enabled our teams to demonstrate impact without manual translation work.

Team Building to Support Sustainable Analytics Capability: As reporting scaled, teams spent increasing time manually compiling reports. The tradeoff: continued manual effort versus investing in dedicated analytics capacity. We invested in hiring and training analysts who could assume ownership of reporting, consistently produce quality reports, build new reporting as needed, and handle ad-hoc requests. This ensured the platform remained relevant and utilized over time, prevented regression to manual processes, and created organizational capacity to respond to new analytics needs as Medical Management scaled.

Impact

Business Outcomes:

• Established reporting cadence used to show value to clients and secure retentions

• Provided functionality required to make decisions around product expansion prioritizations

Operational Improvements:

• ~40 hours/month reduction in time spent validating data across teams through strengthened data integrity and dedicated analytics team

• 15+ custom dashboards delivered for stakeholders across 4 departments

• Ad hoc report turnaround reduced from 5 days to under 4 hours for delivery

Strategy Evolution / Iterations

Progressive Automation to Reduce Manual Overhead: As reporting volume increased, so did the frequency of manual refresh requests and demands for updated data. We discovered the extent of this burden when we sat in on a process call and observed teams cycling through data refreshes repeatedly throughout their workflow. By building in automated dashboard refreshes, stakeholders always had access to current data without waiting for manual updates. We opted to automate client-facing reports in a later phase to run as groups approached renewal dates, reducing last-minute reporting requests and ensuring consistent, timely client communication. The lesson: not all reporting needs automation from day one, prioritize automating repetitive, time-sensitive tasks once the underlying reporting is validated and stable.

Matching Tools to Use Cases: As we launched new reports, stakeholder requests for features were constrained by software limitations. We learned that different software has distinct strengths and weaknesses that make it better suited for specific use cases. While organizational pressure existed to consolidate everything into one platform for simplicity, this multi-platform strategy allowed us to leverage the right technology for each reporting need rather than accepting one-size-fits-all limitations. The key was maintaining consistent data definitions and visual standards across platforms so that stakeholders experienced coherence even when reports were generated from different systems.

Mar 2019 - Dec 2019

Overview: In our endeavor to enhance product 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, the system facilitated rapid identification of members with specific medical needs, enabling ~30% more members to be identified as needing timely interventions.

• Streamlined Billing Process: Automation of billable hours tracking cut manual billing time by ~50% and reduced billing errors by ~10%

Improved Line of Sight: The system increased transparency into ongoing tasks, enabling leadership to reallocate resources ~20% more efficiently and handle ~30% more cases per month without adding headcount, supporting both scalability and optimized team performance.

Impact on Product Strategy

The Patient Advocacy Relationship Platform was a foundational investment in the long-term scalability of the Medical Management product portfolio. Prior to its implementation, advocacy work was managed almost entirely on paper, making information difficult to locate, impossible to report on reliably, and heavily dependent on manual escalation to identify members in need of support. This approach fundamentally limited our ability to scale the product or build complementary offerings.

By centralizing advocacy workflows into a single digital platform, we established the first system of record for patient advocacy operations. This shift enabled consistent documentation, improved visibility into ongoing work, and created the ability to generate meaningful reporting capabilities that were essential for demonstrating impact and planning future growth.

Just as importantly, the platform allowed us to integrate data from the data warehouse and begin automatically identifying members through claims data, rather than relying on downstream escalations. This transition from reactive to proactive identification laid the groundwork for more timely interventions, improved member outcomes, and more sophisticated Medical Management products over time.

Ultimately, the Patient Advocacy Relationship Platform transformed advocacy from a manual, paper-based process into a scalable, data-driven capability, serving as a critical building block for expanding Medical Management services and supporting future innovation.