Product Management Change

KELE GEISLER

(***) *** – **** **********@*******.*** Grand Junction, CO 81505 www.linkedin.com/in/kelegeisler

Portfolio & Program Leader HealthCare Operations Consultant Change Management

Dynamic healthcare professional with extensive consulting expertise in program and operations management. Proven strengths in product management, resource allocation, and organizational change. Skilled in building client relationships, negotiating provider contracts, and navigating compliance across Medicaid, Medicare, and commercial sectors. A subject matter expert in portfolio planning and development, with a track record of leading large, cross-functional teams to deliver innovative solutions and exceptional client value.

Core Competencies

·Provider Contracting and Configuration

·Market Liaison

·Business Process re-engineering

·Business requirements and solutions

·High-Profile Account Management

·Payer Relations

·End to end integration

·Strong communications and facilitation skills

·Operations Leader

·Conflict Resolution

United HealthCare Technology • Minnetonka, MN • 09/2021 - 12/2024

Director, Technology Program & Portfolio Management

Successfully drove investment performance to meet financial targets and maximize ROI. Collaborating with capability leads, conducted in-depth cost-benefit analyses and oversaw the financial performance of $173M within a $500M program portfolio budget. Ensured the timely and high-quality delivery of monthly executive reports, equipping key stakeholders with precise insights that informed strategic decision-making.

oLed stakeholders’ financial reviews to track progress, address risks, and make necessary adjustments to the portfolio

oDrove outcomes without direct authority, engaging team members in a cross-functional environment

oLed capability portfolio through collaborative partnership with capability teams, finance, CIOs, business leaders

Led the prioritization and implementation of business requirements for monthly executive reporting, including training, creating a high-level user guide, providing one-on-one coaching to capability leads

oBuilt trusted relationships with business/technology leaders to exceed targeted outcomes

oResponsible for tools, templates, enhancements, and reporting of the overall program as part of role

United HealthCare Technology • Minnetonka, MN • 01/2021 - 09/2021

Agile Transformation Leader

Led the transformation of teams into product-focused organizations using agile methodologies, partnering with leaders to simplify processes and adopt product practices empowering teams. Facilitated organizational change, training, and mentoring on Agile ceremonies and product teaming.

oFacilitated, demonstrated, and mentored required organizational changes, agile ceremonies, backlog refinement, product teaming, role descriptions and training

oCommunicated in simple terms based on audience understanding of concepts – Meet teams where they are

oServed as functional manager to Product Consultants in matrix organization

oDemonstrated ability to build relationships with business/technology leaders to achieve outcomes

OptumCare Strategic Platform • Minnetonka, MN • 04/2020 -01/2021

Sr. Capability Manager Provider Network Management

Served as a Product Manager and subject matter expert and primary liaison between business, Care Delivery Organization, technical teams, gathering and prioritizing requirements to support critical needs. Drove requirements, represented customer needs to both business and technical teams effectively removing barriers to drive and maintain progress, while utilizing strong negotiation and conflict resolution skills.

oPrimary liaison between business, Care Delivery Organization, and technical teams, responsible for gathering, documenting, and prioritizing business requirements in support of critical needs utilizing multiple tools. Ex: Facets, ServiceNow, MACESS, and multiple portals based on Care Delivery Organization (CDO)

oProduct Manager role serving as Voice of the customer to the team, on behalf of the business — Represent capabilities and features with business and technology teams

Optum Advisory Services, Consulting • Eden Prairie, MN • 02/2013 – 04/2020

Managing Director

Responsible for high-quality results, client satisfaction, and profitability. I managed a diverse consulting bench, overseeing staff recruitment, development, resource allocation to align skills with project needs and maximize efficiency. I facilitated integrated planning across workstreams, identifying new business opportunities and driving continuous improvement. My responsibilities also included optimizing team performance, maintaining a high standard of client service, ensuring that all engagements met strategic objectives while fostering a collaborative environment for successful project execution.

oLed Client and Consulting integrated work team consisting of thirty (30) resources to drive continuous quality and claim operational improvement centered around operational efficiencies and effective data analysis reporting. Included recruitment of staff and change management activities. Allowing 50% improvement in claims vph within 90 days

oSold, and implemented Medicaid Program provider and vendor operational improvements, provider contract loads, implementation of an intake, budget, workforce management changes, creation of training operational playbooks and governance process to manage day-to-day inventories within Qnxt. Through system-analysis and process simplification team achieved savings annually of $500,000.00 in costs via reduction in four (4) FTEs and streamlined processes

oDirected cross-departmental teams through implementation of a start-up commercial health plan utilizing Agile methods with operational oversight of workloads, milestones, cost containment plans, performance reporting performance against key program milestones. Defined system configuration parameter priorities for Facets and Macess platforms, training materials and schedule, managed development operations

oManaged ICD-10 Remediation for Provider Network and Delegated Vendor work streams (Process Design, Contract changes and Procedures/Requirements). Led work stream documenting business process requirements, created traceability for testing and development, identified gaps and recommended best practices

oFacilitated Clinical Policy assessment for compliance with ICD-10 readiness. Developed recommendations for clinical policies impacted by ICD-10 changes

oLed practice growth focusing on creation of new tools and development of an operational benchmarking service offering.

oExceeded sales of $1.5 million and managed revenue targets by 10% over the last five (5) years

oConsistently excelled at Manager Effectiveness ratings of over 95% based on annual employee surveys

oOwned, communicated, and improved overall operational staffing and recruitment process for all consultants within the practice. Worked directly as a liaison between sales and staff to maximize effective placement of resources based on their individual development plans and current skillsets

Rocky Mountain Health Plans • Grand Junction, CO • 02/2002 – 02/2013

Manager of Contracting and Configuration, 2002 – 2013

Direct oversight of the provider contract configuration/implementation process within Facets responsible for personnel and workforce management and development. Developed quality assurance audits and cross-departmental feedback loops resulting in 98% efficiency with internal Audit and Provider Relations staff. Implemented cross-departmental workgroups to resolve contracting and configuration issues that included the business and technology partners. Responsible for leading multiple cross-departmental initiatives including implementation of State Medicaid ASO project, Self-funded TPA agreement, CHP+ contracting expansion initiative, Behavioral Health vendor selection and implementation.

oDesigned and communicated day-to-day staff process workflows including policies and procedures related to Provider Network Management for all products. Utilized tools such as Facets, Macess, SharePoint, and reporting portals

oDeveloped and maintained contract templates utilized for all contract negotiations

oOversaw annual review of contract rates by region and implemented rate changes as applicable

oPrepared, communicated, and represented documentation for regulatory and compliance audits

oPartnered in contract negotiations and contract writing and created policy guidelines for contracting workflow

Supervisor of Claims Specialty Teams/Documentation & Training Specialist 2001 - 2001

oSupervised and directed workflow for fourteen-member multi-specialty claims team consisting of Third-Party Liability/Subrogation, Coordination of Benefits, Behavioral Health Delegated vendors, and Medicare processes

oFacilitated cross-departmental team for subrogation process including representation from Claims Leadership and Attorneys and worked with both members and providers to resolve subrogation cases

oDeveloped documentation and training for Claims Examiners by translating departmental objectives to effective workflows, redesigning the paper claims manual into user-friendly online format, and creating comprehensive support resources based on audit, metrics, and feedback

Health Net • Irvine, CA 1998 - 2001

Provider Oversight Auditor

oEvaluated delegated groups policy guidelines ensuring compliance with State, and other regulatory requirements

oPerformed oversight for various group audits of Independent Physician Association (IPA) facilities, medical groups, and individual physician practices and clinics

Bachelor of Arts; Social and Behavioral Science Colorado Mesa University; Grand Junction, CO

Product Management Training – Agile/Product Management

Agile Certifications : SAFe 5 Agilist, CSM Certified Scrum Master, CSPO Certified Scrum Product Owner, CLP Certified LeSS Practitioner

Certified Professional Coder Certification – Expired

Tool Proficiency; Aha!, Rally/CA Agile, ServiceNow, facets, microsoft office

SKILLS / EXPERIENCE PROFILE

Education and Certificates

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