Empire BCBS
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Empire BCBS Employees
WellCare Health Plans March 2015 - Present
Health Insurance Operations Leaders in the Tampa Bay Area 2015 - Present
OmniClaim, Inc. April 2014 - March 2015
WellCare May 2012 - April 2014
Albany Medical Center June 2011 - May 2012
Connecticare, Inc. 2002 - September 2011
Empire BCBS April 1999 - June 2002
Empire BCBS 1995 - 1999
Skills
Insurance, Managed Care, Process Improvement, Medicare, Health Insurance, Healthcare, Management, Claim, Medicaid, Leadership, HMO, HIPAA, Employee Benefits, Strategy, Analysis, Account Management, Provider Relations, Health Policy, Hospitals, Healthcare Industry, Healthcare Information..., Vendor Management, Data Analysis, Program Management, Risk Management, Medical Billing, Healthcare Management, Operations Management, Team Building, Fraud, Waste & Abuse..., Claims Analytics &..., Center for Creative..., Provider Capitation &..., Medical Coding, Policy, Healthcare Consulting, Revenue Cycle, CPT, Strategic Planning, Individual Health..., Health Insurance..., Operational Excellence, Operational Strategy, Operational Streamlining
Education
Elmira College 1978 — 1980
BS, Sociology & Information Systems
Elmira College
Bachelor's of Science, Criminal Justice & Technology
Davis Vision August 2010 - Present
Avesis Incorporated April 2008 - August 2010
HayKee LLC 2007 - 2008
Davis Vision 1999 - 2006
Empire BCBS 1998 - 1999
Oxford Health Plans 1996 - 1997
Skills
Account Management, Business Strategy, Customer Retention, Customer Service, Management, New Business Development, Benefits Administration, Direct Sales, Health Insurance, Insurance, Employee Benefits, Managed Care, Project Management, Relationship Management, Sales, Sales Operations, Sales Presentations, Team Building
Education
State University of New York College at Plattsburgh 1993 — 1996
Bachelor’s Degree, Psychology
FYI Senior Living Solutions Inc. 2006 - Present
The Bristal Assisted Living June 2012 - September 2013
Filben Development 2007 - 2010
BAI Consulting 2002 - 2006
XWare Compliance 1999 - 2002
Health Care Management Services 1985 - 2002
Creative Health Concepts 1996 - 1998
Empire BCBS 1980 - 1985
Skills
Healthcare, Healthcare Management, Managed Care, Hospitals, Strategic Planning, Care Management, Long Term Care, New York State...
Education
Consortium of Geriatric Education Centers/Brookdale Center for Geriatrics and Palliative Care/Mt. Sinai School of Medicine 2011 — 2012
Certificate, Geriatric Scholar
New York University 1996 — 1996
Certificate, Health Care Risk Management
Baruch College, City University of New York (CUNY) 1976 — 1978
MBA, Health Care Administration
Ithaca College 1972 — 1976
BS, Health Services Administration
UnitedHealthcare September 2014 - Present
UnitedHealthcare 2008 - August 2014
United Healthcare 2004 - 2008
Brookhaven Memorial Hospital Medical Center 2000 - 2004
Health Plan Association of NY 1998 - 2000
Aetna 1996 - 2000
US Healthcare 1994 - 2000
Private Practice 1983 - 1994
Allen Pavillion 1990 - 1992
Empire BCBS 1987 - 1989
Skills
DRG, Managed Care, Utilization Management, Disease Management, Healthcare Information..., Healthcare Consulting, Medicine, Credentialing, Family Medicine, Provider Relations, Medicaid, Healthcare Management, Medicare, Healthcare Industry, Physicians, Health Policy, EMR, Healthcare, Health Insurance, Quality Improvement, Network Development, NCQA, HMO, Hospitals
Education
DeWitt Clinton HS 1969 — 1972
New York University
Universidad Autónoma de Guadalajara
Computershare August 1993 - Present
Empire BC/BS October 1985 - August 1993
Skills
Management, Project Management, Strategic Planning, Business Analysis, Microsoft Office, Sales, Process Improvement, Team Leadership, Strategy
Education
Rutgers University-New Brunswick 1981 — 1985
Bachelor of Arts (B.A.), Economics
Horizon Blue Cross Blue Shield of New Jersey June 2011 - Present
Horizon Blue Cross Blue Shield of New Jersey February 2008 - June 2011
Empire BCBS April 1982 - December 1989
Skills
Analysis, Health Insurance, Customer Relations, Negotiation, Customer Service, Finance, Insurance, Underwriting, Risk Management, Health Savings Accounts, Employee Benefits, Brokers, Medicare, Health Care Reform, Managed Care, Claim, Process Improvement, Healthcare
Education
Georgia State University
Master of Education (M.Ed.), Mathematics
The Ohio State University
Bachelor of Science (B.S.), Mathematics
WellCare November 2012 - Present
WellCare November 2012 - Present
Amerigroup Corporation August 2011 - November 2012
WellPoint February 2010 - August 2011
WellCare November 2008 - March 2010
WellCare March 2007 - September 2008
Medco May 2005 - March 2007
Tampa Pain Relief July 2004 - May 2005
Empire BCBS April 2000 - July 2004
Times Mirror Magazines March 1998 - February 2000
Skills
Medicaid, Health Insurance, Data Entry, PeopleSoft, Visio, Recruiting, Human Resources, HIPAA, Medicare, Onboarding, Insurance, Managed Care, Healthcare, Payroll, Healthcare Management, HRIS, Training
Education
ST. RAYMOND ACADEMY FOR GIRLS 1983 — 1987
Specialized, Business Dynamics and Secretarial Science
Monroe College
Business Administrative
Pharmacist Partners, LLC January 2012 - Present
PCS Health, Advance PCS, Caremark, CVS/Caremark 1998 - May 2012
Empire BC/BS January 1997 - January 1998
Value Rx April 1994 - 1997
Skills
Building New Ventures, Growing Market Presence, Driving Metrics and..., Managed Care, PBM, Pharmaceutical Sales, Gastroenterology, Diabetes, Pharmaceuticals, Cardiology, Asthma, Pharmacy Operations, Consultative Selling, Utilization Management, Budget Management, Pharmacy Benefit..., Pharmacy Automation, Pharmaceutical Industry, Budgets, Disease Management, Pharmacy, Strategy, Medication Therapy..., Pharmacists, Leadership, Pharmaceutics, Healthcare, Selling, Informatics, Pharmacovigilance, Strategic Planning, Clinical Pharmacology, Oncology, Medicare Part D, Clinical Research, Infectious Diseases, Healthcare Industry, Hospitals, Pharmacology, Medicaid
Education
Albany College of Pharmacy of Union University
Bachelor of Science (BS), Pharmacy
Union College
Bachelor of Science (BS), Biology/Music
Studio 219 Tenafly 1991 - Present
Art Center of Northern New Jersey at New Milford 1990 - Present
The Art Students League of NY 1989 - 2001
Empire BCBS 1979 - 1991
EmpireBlueCrossBlueShield 1975 - 1990
Parallel Planning Corporation 1976 - 1979
Harper's Ferry Company 1968 - 1976
US Navy; Applied Science Laboratory 1960 - 1968
Skills
Oil Painting, Painting, Fine Art, Printmaking, Art Education, Drawing, Acrylic, Sculpture, Art, Portraits, Figurative, Portrait Painting, Watercolor, Contemporary Art, Visual Arts, Modern Art, Canvas, Figurative Art, Galleries, Public Art, Abstraction, Curating, Studio Art
Education
Art Students League of New York 1988 — 2002
Certificate of Completion, Painting
Pratt Institute 1961 — 1966
BS, chem, audited fine art painting
WellPoint January 2014 - Present
WellPoint 2008 - Present
WellPoint 2006 - 2008
Empire BCBS 2003 - 2006
Empire BCBS 2001 - 2003
Memorial Sloan-Kettering Cancer Center 1995 - 1999
Memorial Sloan-Kettering Cancer Center 1993 - 1995
Skills
Strategic Planning, Change Management, Account Management, Program Management, Healthcare, Process Improvement, Leadership, Business Strategy, Business Analysis, Product Management, Training, Health Policy, Insurance, Management, Team Building, Contract Negotiation, Managed Care, Vendor Management, Start-ups, Team Leadership, Provider Relations, Utilization Management, Product Development, Data Analysis, Healthcare Industry, Hospitals, Health Insurance, Disease Management, Sales, Healthcare Information..., Employee Benefits, Employee Wellness..., Persuasive Presentations, Cross-functional Team..., Business Process..., Executive Management, HIPAA, PPO, Sales Management, Strategy
Education
University of Delaware 1999 — 2001
MBA, Marketing/IT
Anthem, Inc. March 2011 - May 2015
Albany Medical Center November 2010 - March 2011
WellPoint March 2010 - August 2010
WellPoint October 2006 - November 2009
Empire BC/BS 2004 - September 2006
WELLPOINT / EMPIRE BLUECROSS BLUESHIELD January 2000 - January 2004
Empire BC/BS 2000 - 2004
Federal Employee Program January 1995 - January 2000
Empire BC/BS 1995 - 2000
De MASE & ASSOCIATES January 1993 - January 1995
Skills
Healthcare Industry, PMP, Business Requirements, Business Analysis, Change Management, Process Improvement, PMO, Requirements Gathering, Health Insurance, MS Project, Project Planning, Visio, Healthcare, Requirements Analysis, Cross-functional Team..., Project Management, Program Management, Analysis, User Acceptance Testing
Education
Bethlehem Central High School
State University of New York College at Fredonia
BA, English
NYS Department of Tax & Finance January 2011 - Present
CMA Consulting September 2003 - September 2010
CMA Consulting Services September 2003 - September 2010
Empire BCBS January 2001 - May 2002
Saturn of Albany March 2000 - December 2000
The Tuttle Shuttle January 1998 - January 1999
Taco Pronto January 1993 - January 1997
Skills
Technical Support, HTML, Databases, JavaScript, Microsoft Office, Requirements Analysis, Requirements Gathering, Technical Writing, Testing
Education
Bryant & Stratton College 1998 — 2000
Associates, Information Technology
St Michael's Church March 2007 - Present
St Michael the Archangel Church 2007 - 2012
Empire BCBS November 1985 - April 2002
Eddy Visiting Nurse August 1978 - November 1985
Skills
Healthcare, Critical Care, Medicine, Palliative Care, Healthcare Management, Physicians, Clinical Research, Hospitals, Nursing, Health Education, Home Care
Education
The Sage Colleges - Russell Sage College 1978 — 1982
Bachelor of Science (BS) and MS, Nursing
St Luke's Hospital School Of Nursing 1962 — 1965
Diploma Registered Nurse, Registered Nursing/Registered Nurse
WellPoint 2009 - Present
Wellpoint 2008 - Present
WellPoint November 1998 - Present
WellPoint 2006 - 2008
Empire BlueCross BlueShield 2000 - 2006
Empire BCBS 1998 - 2000
Skills
Health Insurance, Process Improvement, Insurance, Managed Care, Strategic Planning, Management, Vendor Management, Program Management, Business Analysis, Cross-functional Team..., Account Management, Product Development, Strategy, Utilization Management, Medicaid, Medicare, HIPAA, Project Management, Disease Management, Healthcare, Healthcare Industry, HMO, Medicare Part D, Health Policy, Provider Relations, SDLC, Leadership, Claim, Network Development, Employee Benefits, Pharmacy Benefit..., Underwriting, Product Management
Education
East Stroudsburg University of Pennsylvania 1990 — 1994
BS of Science, Economics & Business Management
Davis Vision May 2013 - Present
Davis Vision August 2007 - May 2013
Davis Vision March 2010 - July 2012
Transworld Entertainment February 2005 - August 2007
WebMD Practice Services December 2001 - October 2004
WebMD Practice Services August 1997 - December 2001
Empire BCBS 1985 - 1990
Skills
SDLC, Project Management, Process Improvement, Change Management, Analysis, Leadership, Management, Program Management, Software Documentation
Education
SUNY Albany 1982 — 1985
Graduate Studies, Business Education
SUNY Albany 1980 — 1981
BS, Business Education
Monroe Community College 1978 — 1979
AAS, Executive Secretarial Science
Brockport High School 1973 — 1977
NYS Regents Diploma
Glassman & Associates January 2014 - Present
Metro Plus Health Plan June 2008 - December 2013
Adaptis Inc. January 2005 - April 2008
Saint Vincent Catholic Medical Centers 2000 - 2005
ST VINCENT CATHOLIC MEDICAL CENTERS 2000 - 2004
George Washington University 1998 - 2000
Amerihealth Insurance Plans 1995 - 2000
AmeriHealth Insurance Co of NJ 1995 - 1997
Empire BCBS 1993 - 1995
Aetna Health Plans 1990 - 1993
Skills
Medicare, Healthcare Information..., Managed Care, Healthcare, EHR, Team Building, Hospitals, Clinical Research, Disease Management, Strategic Planning, Medicaid, Employee Benefits, Change Management, Home Care, Leadership, Healthcare Industry, Healthcare Consulting, Healthcare Management, Revenue Cycle, Informatics, Insurance, Health Insurance, Process Improvement, Provider Relations, Medical Billing, Health Policy, Utilization Management, EMR, Quality Improvement, HIPAA, Program Management, Customer Service, Physician Relations, Policy, Patient Safety, Medicine, HMO, Credentialing, Physicians, Medical Compliance, Revenue Cycle Management, Network Development, Long-term Care, Practice Management, Performance Improvement, Nursing, Business Development, Case Management, Public Health, HL7
Education
The George Washington University - School of Business
MBA, Health Care Administration
New York University - Leonard N. Stern School of Business
BS, Management & Finance
Empire BlueCross BlueShield (WellPoint) April 2009 - September 2014
www.ajibarlounge.com April 2008 - June 2010
Empire BCBS May 2002 - April 2009
Blue Cross Blue Shield May 2002 - April 2009
Skills
Health Insurance, Managed Care, Insurance, Analytics, Business Analysis, Competitive Analysis, Vendor Management, Process Improvement, Data Analysis
Education
Rensselaer Polytechnic Institute 1987 — 1993
National Government Services March 2014 - Present
WellPoint 2012 - March 2014
WellPoint 2009 - 2012
Albany Medical College 2002 - 2012
WellPoint 2006 - 2009
Empire BCBS 2002 - 2006
Albany Medical College 1998 - 2002
Pulmonary and Critical Care Services, PC 1995 - 1998
Skills
Medical Education, Epidemiology
Education
Albany Medical College 1988 — 1990
MD, Doctor of Medicine
State University of New York Downstate Medical Center College of Medicine 1986 — 1988
n/a (transferred), Medicine
Cornell University 1982 — 1986
BS, Textile Biotechnology
hillsborough community college December 2004 - Present
empire blue cross blue shield October 2000 - October 2003
Empire BCBS 2000 - 2002
Bernard Hodes Group 1980 - 1987
Education
University of South Florida 2003 — 2004
MCSE
New York University 1996 — 2000
UNIX, CERTIFICATION ON UNIX SYSTEMS MANAGEMENT
IBM August 2006 - Present
Empire BC/BS 1990 - 2002
Skills
COBOL, CICS, z/OS, Mainframe, IBM Mainframe, VSAM, SOA, Software Project..., DB2, REXX, TSO, WebSphere MQ, Middleware, Websphere, Cloud Computing, MVS, WebSphere, WebSphere Application..., ISPF, JCL
Education
Columbia College 1995 — 2002
Ceridian Benefit Services October 2011 - Present
Starpoint Solutions April 2010 - March 2011
Guardian Life Insurance May 1994 - July 2010
Empire BCBS May 1994 - May 1997
Education
New York University 1990 — 1995
BS
Milano, the New School for Management and Urban Policy June 1997 - December 2012
Kaiser Foundation Health Plan June 1998 - August 2001
Empire BCBS 1996 - 1998
Chase Manhattan Corporation 1991 - 1996
Skills
Change Management, Strategic Planning, Project Management, Stakeholder Management, Business Process..., MBTI, Organizational Design, Organizational..., Executive Coaching, Organizational..., Career Development, Leadership Development, Employee Engagement, Performance Management, Human Resources, Strategy, Talent Management, Training, Management, Management Consulting, Leadership, Coaching, Workshop Facilitation, Culture Change, Employee Training, Consulting, Career Counseling, Staff Development, Program Management, Instructional Design, Conflict Resolution, Executive Development, Organizational Learning, Onboarding, Training Delivery
Education
Teachers College of Columbia University 1994 — 1996
MA, Organizational Psychology
Boston University Questrom School of Business 1987 — 1991
BS, Business Management
Empire BCBS August 2015 - Present
Mercer June 2000 - August 2015
Aetna 1994 - 2000
Alexander & Alexander (Aon) 1990 - 1993
Met Life 1988 - 1990
Skills
Employee Benefits, Health Insurance, Insurance, Benefits Administration, Strategic Planning, Customer Service, Health Savings Accounts, Management, Term Life Insurance, Sales
Education
Hofstra University 1989 — 1993
Master of Business Administration (MBA), Business Administration, Management and Marketing
Binghamton University 1984 — 1987
Bachelor of Science (BS), Marketing/Marketing Management, General
Loeb and Troper February 2013 - Present
VNSNY CHOICE Health Plans 2007 - 2013
Empire BCBS 1998 - 2004
Memorial Sloan Kettering Cancer Center September 1984 - October 1994
Skills
Managed Care, Healthcare Management, Hospitals, Healthcare, Medicaid, Medicare, Healthcare Consulting, Healthcare Information..., HIPAA, Healthcare Industry
Education
Adelphi University
MA, Community Health
NYU Robert F. Wagner Graduate School of Public Service
Master of Science (M.S.), Health Policy and Managment
3M December 2013 - Present
Loan Science, LLC September 2012 - November 2013
AMD February 2011 - August 2012
EZCORP December 2008 - August 2010
Education Finance Partners July 2007 - August 2008
EZCORP September 2000 - July 2007
AIG American General May 1999 - August 2000
Empire BCBS October 1998 - April 1999
AIG February 1998 - September 1998
Videosite Corporation May 1997 - January 1998
Skills
SQL, Java, SDLC, Agile Methodologies, Unix, Requirements Analysis, Data Warehousing, Software Development, Java Enterprise Edition, Enterprise Architecture, Web Services, Architectures, SOA
Education
Kakatiya University 1985 — 1989
B. S, Mechanical Engineering
Anthem, Inc. August 2001 - Present
Empire Blue Cross Blue Shield 2001 - 2005
Empire BCBS April 2000 - July 2001
True Technologies 1999 - 2001
Skills
Enterprise Architecture, SDLC, SOA, Data Warehousing, Solution Architecture, Application Architecture, Requirements Gathering, Requirements Analysis, IT Strategy, Websphere, DB2, EAI, Software Project..., Agile Methodologies, Data Modeling, Business Intelligence, Java Enterprise Edition, Business Analysis, Integration, PMO, Vendor Management, Business Process Design, UML, Business Requirements, Business Process, Oracle, Project Portfolio..., Java, Systems Analysis, Scrum, Agile Project Management, Visio, Web Services, ETL, Business Process..., PMP, SSRS, Program Management, Master Data Management, Database Design, Enterprise Software, Software Development, PL/SQL, SharePoint, WebSphere Application..., Weblogic, User Acceptance Testing
Education
New York University - Polytechnic School of Engineering 2007 — 2009
MSM, Technology Management
Manipal Institute of Technology 1993 — 1997
B.E, Computer Science & Engineering
Manipal University 1993 — 1997
B.E, Computer Science & Engineering
Willis July 2012 - Present
UHY Employee Benefits Consulting Services, Inc. March 2006 - June 2012
Wachovia Insurance Services March 2003 - March 2006
Marsh August 1997 - March 2003
AIG 1994 - 1997
Empire BCBS 1990 - 1994
Education
City University of New York-Brooklyn College
BS, Health Care Administration
Cigna May 2015 - Present
CIGNA Healthcare December 2006 - May 2015
Empire BCBS January 2003 - September 2005
Aetna July 1993 - November 2002
Education
Fordham University 1989 — 1993
BS, Psychology
Mercer Health & Benefits, LLC January 2002 - Present
Mercer Health & Benefits, LLC January 2002 - March 2010
Frenkel Benefits, LLC March 1998 - December 2001
Empire BCBS 1992 - 1994
Skills
Employee Benefits, Leadership, Benefits Administration, Retirement, Analysis, CRM, Strategic Planning, Management, Health Insurance, Underwriting, Business Planning, Mergers & Acquisitions, Budgets, COBRA, Health Savings Accounts, Consulting, Insurance, Recruiting, Disability Insurance, Performance Management, Strategy, Claim, New Hire Orientations, HR Consulting, Deferred Compensation, Brokers, Managed Care, Defined Benefit, Negotiation, Healthcare, Employment Law, Long-term Care, Talent Management, Life Insurance, Employee Engagement, HR Policies, Medicare, Human Resources, Administration, Employee Relations, HRIS, ERISA, Executive Pay, Term Life Insurance, Pensions, Onboarding, FMLA, System Administration, Succession Planning, Vendor Management
Education
Queens College 1988 — 1992
BA, Sociology, Labor Studies
Queens College
Bachelor of Arts, Sociology
Empire bcbs
Skills
Health Insurance, Disability Insurance, Employee Benefits, Insurance, Brokers, Health Savings Accounts, Managed Care, Underwriting, Life Insurance, Term Life Insurance, Workers Compensation, Commercial Insurance, Account Management, Medicare, Strategic Planning, Claim, Customer Service, Healthcare, Team Building, Process Improvement, Sales, Sales Management, Leadership, Property & Casualty..., Marketing, Training, Benefits Administration, Microsoft Excel, Public Speaking
Education
The Ohio State University
Bachelor's Degree
DeCare Dental January 2010 - Present
Cerasis June 2004 - October 2009
Empire Bcbs 2000 - 2004
Education
Liberty University 2011 — 2013
Associate of Arts, Business
Express Scripts April 2006 - Present
Empire BCBS January 2003 - January 2005
Magellan Health Services January 1994 - January 2003
Skills
Pharmacy Benefit..., Medicaid, Medicare Part D, Healthcare, Medicare, Disease Management, Healthcare Management, Utilization Management, Pharmacy, Health Policy, HIPAA, Health Insurance, Clinical Research, Healthcare Information..., Managed Care, Account Management, Pharmaceutical Industry, Cross-functional Team..., Process Improvement, Strategic Planning, Team Building, Hospitals, Healthcare Industry, Pharmacy Automation, Oncology, Employee Benefits, Health Care Reform
Education
University of Pennsylvania 1992 — 1994
MSW, Social Work
University of Rochester 1987 — 1991
BA, Psychology
Albany, NY December 2012 - Present
ValueOptions September 2002 - November 2012
The TriZetto Group, Inc 1997 - 2002
Empire BCBS 1983 - 1995
Skills
Healthcare, Healthcare Management, Managed Care, Medicaid, Medicare, Case Managment, Wellness, Provider Relations, Hospitals, Healthcare Information..., Nursing, HIPAA, Clinical Research, Mental Health, Quality Improvement, Healthcare Consulting, Treatment, Home Care, EMR, Inpatient, Software Documentation
Education
Purdue University
AAS, Nursing
Regent's College
Bachelor of Science (BS), Liberal Arts
Retired and enjoying life February 1998 - Present
Empire BCBS September 1983 - February 1999
Greater New York Dental Committee January 1993 - December 1998
Second District Dental Society January 1992 - January 1993
Herbert Horowitz DDS March 1947 - December 1986
NY State Academy of General Dentistry October 1982 - October 1983
NY State Academy of General Dentistry October 1982 - October 1983
Education
NYU College of Dentistry 1941 — 1944
DDS, Dentistry
Brooklyn College 1938 — 1941
BA, Chemistry, Mathematics
EmblemHealth 2005 - Present
HIP Health Plan 1999 - 2005
Prudential Healthcare 1997 - 1999
Empire BCBS 1990 - 1997
Skills
Strategic Planning, Product Development, Product Management, Marketing Strategy, Production..., New Product..., IT Management, Program Development, Project Management, Managed Care, Management, Product Launch, Healthcare, Leadership, Cross-functional Team...
Education
NYU 1988 — 1990
Masters of Public Administration, Health Planning & Policy Analysis
SUNY Albany
Bachelor of Science (B.S.), Biology, Chemistry
Empire bcbs January 1991 - Present
Skills
Staff RN, home care,..., I have worked in each...
Education
Samaritan Hospital School of Nursing
mid island animal hospital January 2013 - Present
empire bcbs September 2005 - Present
dr. peyman zandieh September 2006 - January 2009
Olympus america medical div March 2001 - July 2005
Education
animal behavior college 2012 — 2013
veterinary assistant
Hunter Business School 2005 — 2006
medical office administration