Manager Medical

JOHN GIGLIO, MBA

New York, NY

516-***-**** *********@*****.***

STRATEGY AND OPERATIONS LEADER BUSINESS RELATIONSHIP DEVELOPMENT

Results-driven strategic thinker, leader, and team builder with extensive experience supporting operations across the healthcare and finance sectors. Adept at leveraging acuity for translating data to relatable information, delivering on consultative advice, and driving remedial action. Capacity for negotiating and managing all aspects of the contract life cycle, implementing operational solutions with cost savings results.

Strategic Planning Data Analysis Procurement Inventory Control Contract Management Negotiation

Competitive Bid Management Cost Containment Continuous Improvement Business Process Efficiencies Compliance Performance Management Remediation Communication Cross Functional Collaboration

Partnerships Strategic Relationship Development and Management Stakeholder Engagement

EXPERIENCE

EmblemHealth, New York, NY

Director of Strategy Business Relationship Manager - Procurement 11/2015 - 08/2020

Implemented Procurement guidelines and controls for purchasing, approval hierarchy, contract bid and award process at EmblemHealth and its subsidiaries, ConnectiCare (CCI) and Advantage Care Physicians of NY (ACPNY), in compliance to corporate policies, through formal group presentations.

•Set up an inventory control system for medical supplies at three of 36 medical centers run by ACPNY.

•Managed the construction bid process that included contractors, architects, and designers for the remodeling of four floors at the corporate headquarter building, and two medical centers.

•Coordinated the printing bid process and brough affiliates in line with the same vendor, realizing savings of $700k in year one.

•Oversaw the Business Relationship and Strategy Category Management team, for procurement strategy development, risk management, and budgeting, advocating on behalf of the business stakeholders by providing strategic consulting level support and guidance.

•Interfaced with the business and suppliers to develop strategies aligned with individual department operational and spending needs, the overall organization operation and financial goals, and contracts written within budget and compliant.

•Orchestrated competitive bid events, negotiated agreements, and targeted aggressive savings based on established budget projections by applying financial management principals to ensure responsible decisions were made. Realized savings were $12M for 2016, $19M for 2017, and $23M for 2018.

•Realized savings of approximately $250K per quarter for 2019 and 2020, mostly for CCI.

•Aligned procurement and sourcing strategy for Connecticare, AdvantageCare Physicians (36 medical offices) and EmblemHealth business units.

Lead Healthcare Operations Specialist Director Finance Planning and Analyst Healthcare Operations 04/2011 - 11/2015

Directed the contract support and analytics team, including negotiations, implementation, and monitoring for the divisions under Healthcare Operations.

●Analyzed $400M+ to provide timely, accurate information, enabling management of delivery system.

●Realized $500M worth of medical and administrative cost savings as a team over a period of four years.

●Developed and managed the operations and capital budget for the divisions under Healthcare Operations, and Marketing. Built and maintained quarterly and yearly forecast.

JOHN GIGLIO, MBA *********@*****.*** Page Two

●Monitored business performance, analyzed variances to budgets or forecasts. Provided senior management and business partners’ insight into trends along with recommend cost savings strategies.

●Performed analyses for 93 cost centers totaling over $500M.

●Analyzed financial opportunities and proposed cost containment solutions to senior management by designing and implementing financial performance reports; saved over $50M.

●Partnered with senior management to identify opportunities and improve processes. Led sponsored projects to reduce administrative cost and drive results for operational excellence. Developed metrics, to analyze and monitor improvement of business performance after implementation of new processes.

●Assisted on realigning Management Span of Control. Projected savings of $100M.

Affinity Health Plan, Bronx, NY

Finance Analyst 07/2007 - 04/2011

Designed, developed, and implemented financial and member related reports used for benchmarking performance by service category and Lines of Business. Developed metrics utilizing Excel, Access, and SQL to include member premium revenue, cost, utilization per thousand, HCC risk score, and other KPIs.

●Assisted with financial planning including developing operational budget, monitoring and reporting variance, and creating financial metrics for the management team.

●Working with actuary on creating and submitting to Medicare actuarially sound premium bids for three consecutive years

●Spearheaded Hierarchical Condition Category (HCC) risk score optimization initiatives to enhance Medicare premium revenue. Risk scores increased from an average of $730k in 2009 to $1.2M in 2010, a 39% increase in member revenue dollars.

●Led project to outsource Medicare related functions previously performed in-house. Realized savings of $150K in the first year.

●Managed a team accountable for two organizational CMS compliance audits.

ADDITIONAL RELEVANT EXPERIENCE

Health First, Inc., New York, NY

Analyst Project Manager – Finance Analysis Senior Analyst – Finance Analysis

Health Insurance Plan of Greater New York, New York, NY

Assistant Director – Contract Implementation/Analysis Manager - Contract Analysis

EDUCATION

Master of Business Administration (MBA), Finance, Adelphi University, Garden City, NY

Bachelor of Business Administration (BBA), Communication, Adelphi University, Garden City, NY

ADDITIONAL RELEVANT INFORMATION

●Project Management Certificate, Pace University, New York, NY

●Six Sigma Green Belt Certificate, Villanova University

●Coursework: sixty credits towards an accounting degree

●Microsoft (MS) Office, GeoAccess, SAS SQL, Hyperion/SmartView

●Bilingual: Fluent in English and Spanish

●Member, National Society of Hispanic MBAs

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