William Wagner

About William Wagner

Healthcare strategist with payer-side experience, targeting Strategy Manager, Healthcare Consultant, and Product Manager roles. I lead strategic analysis, business cases, and implementation planning across utilization management, benefits, vendor strategy, and analytics—translating complex problems into clear options, KPI frameworks, and executive-ready recommendations that improve performance and deliver measurable savings. Selected Healthcare Strategy Highlights · Built business cases across medical policy and product roles, including a medical policy change that reduced unnecessary maternity ultrasounds and saved ~$1M per year. · Defined KPI frameworks and executive dashboards to improve visibility into performance and enable faster leadership decision-making. · Developed 6–12 month implementation roadmaps across vendors and internal teams, aligning owners, dependencies, and milestones. · Established governance artifacts (RACI, processes, metrics) for a Vendor Management Center of Excellence adopted across the organization. · Authored training materials to standardize processes and support operational change management. I partner closely with clinical, product, analytics, and operations leaders to align stakeholders, clarify decisions and owners, and drive execution from recommendation through rollout—an approach I bring to Strategy Manager, Healthcare Consultant, and Product Manager work.

Experience

1. Business Intelligence Analyst

   Blue Cross NC

   Jun 2025 — Present · Durham, NC, US

   Investigate provider and facility fraud, waste, and abuse (FWA) and summarize findings to support payment integrity decisions.• Owned a statistically valid sampling and reporting process, identifying over $10M in fraud, waste, and abuse (FWA).• Built leadership dashboards to surface SIU performance metrics and enable faster decisions.• Designed and launched a standardized investigative case sheet to capture critical data and improve financial impact reporting.• Built an executive dashboard providing a quick view of key metrics for senior leadership.• Authored two training manuals to standardize the sampling process and the case-tracking form.

Education

• Central Michigan University

  Masters Certificate, Health/Health Care Administration/Management

  2014 — 2015

• Central Michigan University

  Master of Science (M.S.), Business Administration and Management, General

  2008 — 2011

• Lutheran High School Northwest

  High School Diploma, College/University Preparatory

  1993 — 1997

• Concordia University Ann Arbor

  Bachelor's degree, Social Studies Teacher Education

  1997 — 2002

Skills

• Healthcare
• Call Centers
• Policy Analysis
• Data Analysis
• Diversity & Inclusion
• Master Mason
• Insurance Software
• Hipaa
• Customer Service
• Medicare
• Medical Education
• Fundraising
• Claims Handling
• Claims Resolution
• Training Delivery
• Insurance
• Event Planning
• Insurance Regulatory
• Claim
• Icd-9
• Employee Benefits
• System Administration
• Employee Training
• Team Building
• Insurance Background
• Medical Terminology
• Business Analysis
• Presentations
• Health Insurance
• Leadership Development
• Systems Analysis
• Business Process Improvement
• Customer-Focused
• Charity Work
• Medical Coding
• Troubleshooting
• Leadership
• Disaster Recovery
• Mainframe
• Vendor Management