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Reduced 73,000+ claims aged 90+ days to 13,000 under 30 days in six months; achieved 99% payment processing within 20 days, later held at 15-day averages.

Led coordination-of-benefits optimization generating $2.5M in savings at a 6.1 return on investment; modernized the digital workplace, cutting labor utilization 35% monthly.

Delivered Coordination of Benefits enhancements improving quality, production, and NPS, expanding coverage tracking into behavioral health; a companion effort added ~$1M across 150 projects.

Delivered a low-upkeep, non-IT-dependent exclusion-filter solution on budget and deadline, lowering cost per filter and reducing provider abrasion.

Built an analytics-based routing system directing work to specialized teams via business rules with automated assignment, retiring the legacy work-assignment tool.

Partnering with clinical operations, raised facility audit True Positive Rate to 14% (E&I) and 27% (M&R) and sustained it against a fixed transformation benchmark.

Led operational transition from legacy MHS to HealthRules as UAT Lead; stabilized the claims system via SQL crosswalk validation, regression testing, and defect triage.

Led training analysis and enablement for a major clinical-systems eligibility transformation, translating complex eligibility logic and configuration changes into role-based operational guidance.

Replaced legacy claims processing with a configurable, rules-driven platform, improving auto-adjudication and cutting manual touches without IT dependency.

Led an acquisition integration that absorbed a mid-course GE to Allscripts pivot enterprise-wide via a structured ten-step methodology, retiring the legacy system.

Directed Optum Virtual Care within the national Epic instance across all 50 states, expanding to Primary Care and Behavioral Health for the NavigateNOW / Virtual Primary Care launch.

Integrated five core source systems into an enterprise data warehouse, operational data store, and clinical-ops store, with RAPS/encounter and ICD-10 feeds.

Architected the L&D Communications Site, Change in Motion, and Provider Network ServiceNow Center; designed enterprise onboarding and blended-learning curriculum for HealthRules and GuidingCare across claims, configuration, provider network, and clinical operations.

Created three functional teams from the ground up and directed 60+ staff across Claims, Appeals, Correspondence, Account Management, Coding, and Quality.

Designed hybrid training for appeals and call-center teams and implemented the organization's first full appeals/call-center SOP structure, improving accuracy and communication.

Launched a peer-to-peer physician engagement model off a CMS risk-model shift, trained 95% of regional Practice Performance Managers, and drove a 20% immediate engagement lift.

AI-powered Executive Advisor SaaS platform (USPTO Class 042, Serial #99883010), built on the proprietary Cost-to-Revenue Method™.

Architected a multi-tenant operations platform for small businesses, replacing point-solution sprawl with one operating system.

Built the Healthcare Revenue Cycle Training Platform, featuring proprietary simulator environments (RevCycleSim, ClaimsLab Pro, PayerSim Pro) for hands-on medical billing and payer-operations training.

Cost-to-Revenue Method™, Operational Translation Sprint™, and Change Impact Crosswalk™, the frameworks underlying every Discipline Lab Advisory engagement.