Project Management Change

PROJECT MANAGEMENT EXECUTIVE

Process Improvements Team Leadership Revenue Generation

CPM Certified project management leader with a solid background leading and delivering technical projects within established timelines and budgets. Adept at working cross-functionally and with IT to track, monitor and assess project requirements. Process improvement expert with a background delivering significant revenue growth while securing enhanced service quality, cost efficiency and enhanced patient experience. Leader of cultural shifts in operations and influencer of key decisions pertaining to strategic initiatives, operating model and operational execution. Excel at resolving long-term issues, transforming, and improving structures, systems and procedures, along with change management stewardship to ensure seamless transition. Skilled in restructuring teams and reengineering organizational processes to reach goals and elicit high-performance.

• Requirements Gathering

• Needs Assessments

• Status Tracking & Reporting

• Contract Negotiations

• Business Process Reengineering

• Change Management

• Productivity Improvements

• Revenue Enhancement

• Cost Control & Budgeting

• Project Planning & Implementation

• Communication & Influence

• Project Outcome Evaluation

Professional Experience

02/2022 – 02/24 • Knipper Health • Lakewood, NJ

Knipper Health is a leading force in the healthcare industry, serving the pharmaceutical, biotechnology, & medical device industries for more than 35 years. Our mission is to help our clients manage their brands anywhere in the product life cycle for enhanced patient well-being.

Program Manager – Client Services

Accountable for managing a base of clients, acting as the primary client contact for ongoing business. Focused on the on-going execution of client programs and partners with Account Management on implementations of new programs.

• Serve as the day-to-day contact for all activities surrounding the scope of business with the client.

• Responsible for fully executed new and existing projects to completion.

• Perform annual reviews of all client jobs and identified and updated existing Business Rules as required.

• Track the progress of in-process projects by conducting internal team meetings and monitoring operational area progress.

• Interacted with all members of all functional areas to maintain efficient processes. Driving business growth and profitability through strategic project management, operational streamlining and performance management, contributing to bottom - line revenue. M ICHAEL C ACCIAGUERRA

Hackettstown, NJ 07840 973 - 896 - 3834 ******@*****.*** https://www.linkedin.com/in/michaelcacciaguerra

• Report to the Associate Director, Client Services on program/project deliverables, impact on expected work completion dates and any potential problems or issues as they arise. 01/2021 – 04/2021 • Medocity • Parsippany, NJ

The leading cloud-based enterprise platform enabling continuous digital care to transform management of chronic and complex conditions.

Operations Manager

Direct responsibilities included building and managing the client issue management process, providing support to the implementations team, account management as well as providing support and oversight to all other Operational functions as required.

• Developed monitored and reported on SLA's and KPI's.

• Responsible for client issue management process including updating maintaining the Medocity Ticketing management system.

• Conducted team meetings and weekly update meetings to discuss objectives and deliverables.

• Maintained SLA and KPI's, ability to implement, manage while recommending and identifying measure to maximize customer satisfaction levels.

• Wrote playbook on how to handle different types of requests and issues. 01/2018 – 12/2019 • MAGELLAN HEALTH • Scottsdale, AZ (Remote) A for profit managed Pharmacy Benefit Management (PBM) focused on special populations complete pharmacy benefits and other specialty areas of healthcare.

Director, Project Operations

Played key role in planning, directing, and measuring deliverables of large-scale, cross-departmental projects and strategies. Aided executive leadership team on priority initiatives designed to improve operations and meet key client deadlines as well as provide project management planning, execution and reporting to project teams. Recruited to head up project to streamline and simplify the claims adjustment process, driving initiatives for automation and centralization as well as improved tracking. Collaborated with 40+ stakeholders to determine requirements and strategize on ideation and execution.

• Worked closely with Subject Matter Expert (SME) to design and develop process/solution to capture claim adjustment requests, record them in queue, send to correct department and provide visible project status updates.

• Formed project team comprising one analyst, and IT resource, a Medicare D specialist and a paper claims representative, leading a team of 4 throughout project.

• Reported comprehensive project statuses to leadership teams, advising and consulting on issues requiring swift resolution and developing report and key performance indicators (KPIs) related to project expenses and forecasted benefits. 04/2016 – 01/2018 • CVS / CAREMARK • Irving, TX (Remote) The pharmacy benefit management (PBM) subsidiary of CVS Health, headquartered in Woonsocket, Rhode Island. Manager of Client Implementation, Pharmacy Benefit Management Services (PBM) Project managed client implementations, steering every step of the process to ensure contracts are assigned and timelines are developed to facilitate clients in getting prescriptions to their employees. Drove resolution and status of routine to complex client requests through effective and timely communication to meet/surpass client expectations. Achieved high quality and client satisfaction through delivering on accuracy, responsiveness, and reliability.

• Managed implementations of two unique clients requiring differing benefits from the usual offerings, more detailed feedback to cross-functional teams and complex relationship management.

• Quarterbacked overall implementation process for each assigned client for new business and supporting major changes to existing clients.

• Tracked progress of implementation, assessing project plan, conducting weekly update calls, and maintaining action log throughout project.

• Partnered with sales and operations to manage opportunities for

• new/existing assignments, including transitioning client to Account Team for the on-going relationship and support.

• Liaised with internal partners to deliver customer requirements with timely and accurate documentation employing management reporting tools.

• Responsible for overseeing process changes, creating documentation (SOPs) and training material, and ensuring adoption of new system.

• Change management Implementation of overall digital transformation overhaul. Company acquisitions and mergers.

• Worked with IT and Operations to facilitate sessions, focus groups, change management assessments, 1998 – 2015 • EXPRESS SCRIPTS (FORMERLY MEDCO HEALTH SOLUTIONS) • Franklin Lakes, NJ AFortune 100 $100B pharmacy benefit management (PBM) organization in the United States. Senior Manager, Retail Network Strategies (2012 – 2015) Served as primary liaison for clients, guiding them through retail pharmacy market dynamics and opportunities to reduce prescription drug costs leveraging narrow and/or performance-based retail pharmacy networks. Recognized as Subject Matter Expert (SME) for CMS network regulatory requirements and retail pharmacy processing variations affecting client performance goals.

• Negotiated contract rates, terms and language for large retail chains, franchises, and independent pharmacies, achieving compliant network builds upon go-live, resulting in high client satisfaction. Increased compliance 40%.

• Served as Product Lead for network compliance to Centers of Medicare and Medicaid Services “Any Willing Provider” regulations. Evaluated pharmacy networks compliance on a state-by-state basis ensuring project fulfillment.

• Devised solution to prescription discount card processing, capturing missing claims.

• Conducted opportunity analyses, documenting business requirements, and steering cross functional discussions to increase CMS Star ratings for PDPs. Gathering

• Managed in-depth Project Plan resulting in successful implementation of client network system requirements for adjudication platform.

• Educated clients on Medicare D processes and clauses necessary for margin calculations. Senior Manager, Retail Pharmacy Support (2003 – 2012) Steered pharmacy call center operations, collaborating cross-departmentally to resolve escalated issues, overseeing a team of 12 analysts and senior analysts in rectifying disputes for over 65,000 pharmacies. Exhibited exceptional leadership skills to facilitate adherence to department’s financial and industry relationship building goals.

• Executed high-level relationship management functions with key providers and clients including adjudication adherence processes, policy requirements and issue resolution. Resulting in an annual cost reduction of $800,000.

• Delivered retail pharmacy Fraud Waste and Abuse oversight, decreased over-all client drug spend cost by $420,000 and improved client Star ratings.

• Spearheaded IT product solutions for Maximum Allowable Cost cases resulting in turn-around time reduction from 30 days to 2 days, operational savings of $370,000, in depth reporting functionality and analysis of market trends in real time.

• Standardized Pharmacy remittance statements from paper mailings to 835 electronic file transfers in compliance with NCPDP standards, resulting in a $600,000 cost savings.

• Directed third party vendor for all retail pharmacy out bound calling campaigns. Created the campaign SOP, trained participants and mentored the supervisor, established project goals and objectives. Developed and presented management reports based on call data statistics.

Education

BACHELOR OF ARTS, INTERNATIONAL BUSINESS, MINOR IN FINANCE • Ramapo University, Mahwah, NJ Technology Skills

MS Excel MS Access MS Power Point MS Visio MS Project MS Word MS Outlook QuickBooks POS (Point of Sale Adjudication Platform) Remedy SharePoint Six Sigma Black Belt Trained PEGA Platform

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