Project Management Business Intelligence

Jamie Johnson

623-***-**** *************@*****.*** linkedin.com/in/jamie-johnson-90286124 Glendale, AZ 85310 Experienced business leader with over 20 years of progressive responsibility in healthcare operations, pharmacy benefit management

(PBM), analytics, project management, and strategic execution. Demonstrated success in leading and delivering complex, cross- functional initiatives that drive performance optimization, regulatory compliance, and measurable business outcomes. Proven expertise in PBM and Insurance operations, including claims adjudication, formulary strategy, and regulatory reporting. Skilled in transforming complex clinical and operational data into actionable insights through advanced analytics, SQL, Excel, and business intelligence tools such as Looker and Power BI. Recognized for driving innovation in pharmacy operations and streamlining formulary and claims workflows to enhance efficiency and alignment with industry standards. Adept at managing full project lifecycles—from scope definition and stakeholder engagement to execution and delivery—ensuring strategic alignment with enterprise objectives and long-term growth.

AREAS OF EXPERTISE

Product Implementation Product Integration Stakeholder Management Business Process Mapping Audit Cross-Functional Collaboration System Implementation SaaS Strategic Planning Organizational Leadership Presentation Facilitation Conflict Resolution Schedule Coordination Data Management Project Management Process Improvement Data Analysis TECHNICAL SKILLS

Looker Salesforce JIRA Pivot Tables Microsoft Office Google Suite Toad Adobe Software Saas Wrike Tableau SQL ICD9 and ICD10 Web Platform UAT Testing Zoom Webex Big Data Analysis Scribe AI Learning PROFESSIONAL EXPERIENCE

AO Globe Life Phoenix, AZ

Life and Health Producer Oct 2024 – Apr 2025

• Conducted in-depth client consultations to assess needs, effectively presenting tailored solutions that aligned with client goals and highlighted cost-saving advantages.

• Created and maintained strong client relationships, leveraging interpersonal skills to build trust and ensure satisfaction throughout the application process.

Self-Employed Phoenix, AZ

Virtual Assistant May 2024 – Oct 2024

• Provided high-level executive administrative support, including precise data entry, sales presentations, comprehensive report generation, and database oversight using Excel and project management platforms.

• Created impactful PowerPoint presentations for the sales team, aligning content with business goals to support client engagement and strategic initiatives.

Cigna Phoenix, AZ

Operations Advisor Mar 2023 – May 2024

• Evaluated and prioritized enterprise technology requests to support PBM operations (Express Scripts) along with Cigna Insurance, aligning IT initiatives with organizational strategy to improve infrastructure planning, regulatory compliance (HIPAA), and resource allocation.

• Led enterprise-wide ideation and problem-solving sessions across departments, introducing automation solutions and driving operational innovation, particularly within pharmacy operations team, formulary management, and prior authorization workflows.

• Developed end-to-end process maps and implemented automation using tools to streamline operations, reduce manual input in PBM functions, and increase overall team productivity.

• Collaborated with IT teams and business users to design wireframes and prototype interfaces for internal PBM systems and Cigna Insurance side, leveraging iterative user feedback to enhance system usability, adherence to HIPAA standards, and functional efficiency.

• Directed QA testing, monitored adoption metrics, and facilitated continuous improvement strategies. Ensured successful rollout and high adoption of automated PBM systems while proactively resolving technical and compliance-related issues to maximize ROI and user satisfaction. Cigna Phoenix, AZ

Lead Operations Analyst, Communications Mar 2020 – Mar 2023

• Designed and implemented scalable clinical workflows to support large-scale drug formulary mapping, ensuring alignment with state and federal regulations while enhancing data accuracy and operational efficiency.

• Directed internal and external communications for high-impact PBM initiatives, delivering regulatory reports, executive presentations, and strategic updates customized for leadership, compliance, and sales teams.

• Leveraged Looker, Toad, Salesforce, InDesign, and SQL to manage, analyze, and visualize large volumes of formulary and claims data—improving transparency, accessibility, and real-time decision-making across clinical and operational teams.

• Led initiatives to convert complex clinical datasets into clear, consumer-facing materials, increasing patient engagement and improving understanding among diverse stakeholder groups, including non-technical audiences. Cigna Phoenix, AZ

Lead Operations Analyst, Librarian Mar 2017 – Mar 2020

• Analyzed and implemented enhancements to pharmacy workflows, resulting in significant reductions in error rates and processing times, and supporting overall performance improvement.

• Created comprehensive training manuals and standard operating procedures (SOPs) aligned with industry’s best practices, strengthening workforce development and enabling scalable operations.

• Performed in-depth audits of pharmacy operations, delivering data-driven insights that supported executive decision-making and contributed to cost-saving initiatives. Cigna Phoenix, AZ

Quality Review Audit Lead Analyst Nov 2015 – Mar 2017

• Conducted comprehensive audits of pharmacy contracts (facets, IFP, commercial standard), ensuring compliance with regulatory standards while identifying potential financial discrepancies.

• Established a robust training program for new hires and offshore team members, resulting in increased onboarding efficiency and improved team productivity.

• Acted as a liaison during client Q&A sessions, addressing concerns and validating entries through real-time testing to enhance customer confidence and satisfaction. IASIS Healthcare Phoenix, AZ

Claims Resolution Coordinator Jan 2015 – Nov 2015

• Designed and delivered comprehensive compliance training sessions on HIPAA and ICD-10 coding, ensuring strict adherence to regulatory standards.

• Conducted extensive training on AZ Medicaid services and managed claims processes to ensure accurate and efficient service delivery.

Cigna Phoenix, AZ

Business Lead Analyst Cigna Phoenix, AZ Sept 1997 – April 2014

• Managed and mentored a team of analysts responsible for accurate claims processing across Medicaid, Medicare, workers' compensation, and life insurance lines, improving team performance and meeting key operational metrics.

• Led cross-functional training on compliance, fraud, and appeals, strengthening organizational knowledge and reducing regulatory risk.

• Conducted quality assurance audits and collaborated with legal and government teams to ensure claims accuracy, regulatory compliance, and arbitration readiness.

• Utilized data analysis tools to detect and investigate claims fraud, reducing risk and improving process integrity. EDUCATION

Associates of Arts,

Paradise Valley Community College - Phoenix, AZ

2018

Contact this candidate