Marco Gonzalez

Vice President Operations @Mymatrixx By Evernorth

Tampa/St. Petersburg, FL, US

Personally coordinated the migration of approximately 400 clients and close to 1M patients between platforms while maintaining greater than 98% retention rate.• Responsible for bridging business, technology and user experience to support product innovation, design and performance. • Responsible for data governance and IT coordination to ensure data integrity, develop best practices, support Pharmacy Operations and improve user experience. • Provide business leadership of the user experience through collaboration with Pharmacy Operations, Business Analysts, and Development for user stories, user acceptance and testing, and ticket prioritization. • Management of EDI operations including claims processing, eligibility, claim and PA history, formulary, and import/export quality assurance. • Monitor and triage product operations and RxOS, Oculus, Portal, and MARS system dependencies to enable compliance with key performance metrics and revenue goals. • Responsible for accurate knowledge and documentation of client-specific business and regulatory rules. • Manage claims processor vendor (Script Care) relationship and performance, including weekly technical calls and monthly/quarterly Service Level Performance reviews. • Manage plan set-up and maintenance in vendor claims processing system (Pharmscreens) in coordination with Implementation, Clinical, Client Services and Pharmacy Operations. • Provide Implementation with pre/post support for eligibility, history, formulary, group level edit requirements. • Serve as product operations subject matter expert and point-of-contact for Client Services, Pharmacy Operations, Implementation, Clinical, Finance, AR and Development. • Support internal product training and education to promote departmental self-service.

University of South Florida

B.S, Management of Information Systems