Nate Decker

Director New Business Activation @AmeriHealth Caritas

Led Implementation of three Medicare Advantage D-SNP products for Pennsylvania and South Carolina and managed team of project managers, subject matter experts and business analysts through product life cycle with a future state projected operating income of $51 million. •Led overall team of Project Managers through project plan design, business requirement discovery, documentation, workflow design, implementation and post product launch activities with multiple external vendors including Health Plan CRM (Sales), Trizetto (Enrollment and Claims), Corporate Call Center (Telephonic Sales), C3 (Member Services), McKesson (Claim Check), Midlantic (Id Cards), Universal (General Printing), JIVA and NaviNet (Medical Management/Provider), Subcontract vendors for Vision, Dental, Prescription and Behavioral Health. •Identified requirements with internal PMO leads to support connected health of Medicare data provided by external vendor to support in-house medical management data integration. •Project managed several core teams including Medical Management, Provider Network Management, and Training teams. •Launched data driven approach to provider data management and integrated internal contracted provider data, credentialing data and subcontractor provider data, created paper provider directory and tested and launched Online Provider Directory. •Led User Acceptance Testing team and designed testing scenarios, scripts and testing data to support enrollment, claims, customer service routing and workflow, letter fulfillment, reporting, subcontractor loads and data exchange.