Product Manager Development

Billie Lynn Mikulski

Product Development and Management, Business Analysis

Contact information

** ********* ***, ***********, ***** ad81ff@r.postjobfree.com +1-203-***-****

Professional summary

Senior Product Manager with 19 years of extensive expertise in product development and management, specializing in strategic planning and compliance management at Anthem Blue Cross and Blue Shield. Demonstrates exceptional skills in data analysis, market research, and stakeholder engagement, driving innovative program strategies and solutions. Passionate about advancing product enhancement and operational excellence, ensuring impactful and timely delivery of new and existing products.

Employment history

Senior Product Manager

IngenioRx a division of Anthem Blue Cross and Blue Shield, Work at Home — Nov 2021 - Dec 2022

Managed the Cost Relief Program for ASO and Standalone Fully Insured, as well as Fully Insured Integrated business, for employees who qualify for certain non-needs-based drug cost share assistance.

Responsible for creating, updating marketing collateral, and delivering training presentations for the Cost Relief Program. Responsible for supporting and managing product development, product enhancement, compliance, and operational updates related to the Cost Relief Program.

Subject Matter Expert for sales, account management inquiries, and issues related to the Cost Relief Program.

Collaborate with team leads to ensure that Cost Relief solutions are properly addressed and delivered in a timely manner. Crafted and refined marketing materials, delivered training presentations, driving program awareness and adoption across multiple business lines.

Senior Product Manager

Anthem Blue Cross and Blue Shield, Wallingford, Connecticut — Jan 2016 - Jun 2021

Supported the development and implementation of new/existing products/portfolios across multiple segments. Supported multiple product portfolios, including the design and implementation of new product designs and networks.

Responsible for supporting and representing products on various projects and benefit initiatives. Supported customization and maintenance inquiries.

Provided product support for Large Group Commercial Central States (KY, OH, IN, VA, MO, and WI) and North East States (CT, NH, and ME) migration from legacy ACEs platform to WGS platform.

Assisted with developing product support tools for Sales and benefit builders to select Large Group products and ensure selections and builds are accurate and timely.

Supported and managed benefit modification and simplification for enterprise-wide migration strategy. Researched and analyzed benefit design and products against enterprise standards, along with recommendations for consistent state decision-making. Partnered and built relationships with sales, provider networks, underwriting, actuarial, medical management, legal, CBS, Doc Gen (SOB/SBCs), CEP, RPA, and EBA partners.

Product Manager

Anthem Blue Cross and Blue Shield, Wallingford, Connecticut — Oct 2014 - Dec 2015

Supported the evaluation of existing products and reviewed competitors data to improve the existing products.

Assisted with reviewing marketing materials for HMO/POS/PPO products to ensure they were compliant with regulatory directives and state/federal laws and policies.

Supported the central product development team with the customization exception process (CEP) database, CPGs, and making modifications to state guidelines within the CEP database.

Assisted the product development team with coordinating and reviewing marketing materials.

Supported product managers with performing analysis of Competitive Intelligence from marketing materials.

Network Provider Relations Specialist / Product Development Support

Anthem Blue Cross and Blue Shield, North Haven, Connecticut — Jan 2011 - Apr 2014

Assisted and supported the design and implementation of new products within existing market/product lines. Primary duties included: Evaluation of the existing products and competitor’s data to improve the existing products and make recommendations for new products.

Assisted with coordinating presentations, communications and implementation of all phases of the product development. Assisted with ensuring that all HMO/PPO products where compliant with regulatory directives and state/federal laws and policies. Led the Medicare Advantage Online Store project for the product development team, where the 2013 and 2014 product offering were successfully launched along with the CareMore expansion product

Responsible with assisting the product development team with process improvement initiatives for Medicare Advantage products and supported the product team through the bid planning and marketing material reviews

Managed and administrated product development SharePoint sites to ensure content is current and informative.

Assisted and managed cross-functional teams with resolving enterprise- wide issues and discrepancies across claim-platforms with benefit adjudication, definition, and pricing of benefits.

Supported and managed the product database activities to ensure product content is delivered timely and accurately to our business partners.

Provided support to the Medicare Advantage product management team with performing analysis and implementation of new and renewing Medicare Advantage HMO and PPO products.

Network Provider Relations Specialist

Anthem Blue Cross and Blue Shield, North Haven, Connecticut — Jan 2009 - Dec 2011

Developed and maintained positive relationships with the provider community by periodic on-site visits, communicated administrative or programmatic changes and facilitated the resolution of provider issues. Recruited providers to build a cost effective, high quality provider network. Conducted negotiations and led contracting efforts with providers to build and maintain a cost effective, accessible provider network. Researched, analyzed and recommended resolutions for contract dispute, non-routine claim issues, billing questions and other practices.

Coordinated communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.

Coordinated prompt claim resolution through direct contact with providers as a liaison with the claims department and Provider Inquiry units.

Conducted seminars to support the understanding of Medicare Advantage products as well as Unicare and Blue Cross and Blue Shield policies and procedures.

Identified network access and deficiencies and developed recruitment and contracting strategies. Coordinated and conducted provider training including developing and distributing provider relations materials.

Provided outreach to Medicare Advantage / Private Fee for Service providers regarding changes made with CMS regulations and education on claim trends to increase provider.

Analyzed weekly and monthly claims reports, which identified claim trends that tied into weekly regulatory compliance reviews and weekly meetings.

Senior Outreach Care Specialist Lead

Anthem Blue Cross And Blue Shield, North Haven, Connecticut — Jan 2006 - Dec 2009

Assisted with making doctors' appointments, scheduling transportation, and helping members get the best care possible. Provided initial contact between the Disease Management Program and specifically identified members. Provided direct supervision for conducting outbound motivational calls to eligible members to provide information regarding program benefits.

Provided leadership to associate-level staff as the lead with expertise in difficult cases.

Updated and maintained the productivity management tool used to evaluate and monitor individual productivity and quality. Conducted weekly reviews of productivity with non-exempt staff.

Led the outreach team in rolling out a new cost-of-care initiative (Baby Reach) and delivered presentations to over 200 network providers' offices in CT, with successful outcomes.

Attended state legislative meetings and served as a department liaison for Anthem's Blue Care Family Plan (CT Husky A & B) regarding Medicaid changes and/or updates.

Care Coordinator

Anthem Blue Cross and blue Shield, North Haven, Connecticut — Jun 2003 - Jan 2006

Ensured that appropriate member treatment plans were followed on less complex cases and proactively identified ways to improve the health of members and meet quality goals.

Assessed Medicaid Husky A members' compliance with medical treatment plans via telephone or through on-site visits. Identified barriers to plan compliance and coordinated resolutions.

Identified opportunities that impacted quality care goals and recommended process improvements. Recommended modifications to treatment plans and determined the need for additional services in conjunction with case management and provider services.

Coordinated the identification of and referrals to local, state, or federally funded programs in CT. Occupational Health and

Rehabilitation, 2003

Skills

Data Analysis Strategic Planning

Market Research

Compliance Management

Training Development

Stakeholder Engagement

Process Improvement

Network Relations

Implementation and Execution of new/existing products

Program Strategy and Design

Membership and Product Validation

Claims Management

Innovative Product Development

Project Management

Process Improvement

Competitive and Market Analysis

Program Development

Tactical Planning and Execution

Education

Medical Insurance Health Claims Processor Certification,

Branford Hall Career Institute-Southington Campus, Southington, Connecticut — Oct 1998 - Apr 2000

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