David Nelson

Experience

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  Miscellanous

  Jan 1985 - Jan 2004

  Additional Relevant Experience

  OptumInsight • Director, Business Operations and Quality • Business Manager, Decision Support Solutions Medica • Manager, Business Governance Architecture and Resource Management • Manager, Project Management Office • Sales Support Manager Diversified Pharmaceuticals (Express Scripts) • Senior Account/Program DirectorUnitedHealthcare - International Division • Account Manager, OperationsHealth Systems Integration Incorporated (HSII) • Program Director, Client Services DepartmentEmperion Corporation • I.T. ManagerJohn Alden Life Insurance Company • Manager - Information Services Show less

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  Optum - Population Health Solutions & Prevention

  Oct 2004 - Jan 2020

  Led 250 professional services team members in providing Operational, Product, and Technology strategic solutions and services to support the Population Health Solutions & Prevention team. As the leader of the Strategic Capabilities team, drove in-year/multi-year strategic plans, participated in ideating and developing new solutions and concepts, deploying pilots and new programs, and measuring results for both National and Community based solutions. 2019 accomplishments include:• Led Solution & Design staff in transforming Optum Product offerings, operational processes, and systems by managing 200+ projects utilizing $37M in Capital.• Successfully managed the Technology Support team in the inception, promotion, and implementation of 126 Automation projects, realizing $5.9M of In-Year savings, with a project pipeline of over $20M.• Drove $4.8M in operational In-Year savings through 17 Six Sigma and Lean process improvement projects. Led Lean / Green Belt staff training.• Shepherded the Value Realization team in creating customer engagement solutions by reviewing NPS data, verbatims, and closed loop call content to gain consumer insights and preferences. Improved NPS scores in over 60% of products year over year.• Introduced multiple Digital solutions to improve member engagement, data gathering, and member satisfaction. Solutions included Member Chat, Health Actions, and Connected Devices.• Led a global growth strategy and plan in 2018 for Optum’s Population Health organization resulting in $3.7M in-year savings and an annual run rate savings of $10M.• Achieved exemplary Employee Experience Engagement and Manager Effectiveness scores of 90+% Show less Partnered with senior business leaders to explore, define, and implement strategic global capabilities and process improvement solutions into business strategies and operational processes that enhanced productivity and quality, while reducing operating costs. Managed and coordinated global transitions, addressed customer concerns and escalations, provided reporting and data analytic updates regarding global productivity, quality, clinical outcomes, and financial savings.• Established Global feasibility assessment process that was utilized companywide to identify, implement, and report on global savings opportunities through staff augmentation, data analytics, and automation.• Achieved a global annual run rate savings of $72M through staff augmentation (1800 FTEs) for Optum’s Clinical and Pharmacy teams over 2015/16. Show less Managed clinical operations teams supporting the healthcare needs of Medicare, Medicaid, and Commercial memberships. Performed business and operational strategy development, implementation of new products and services, data and metric management, clinical affordability, international global team building, account management, process improvement, and staff support and mentoring.• Profitably managed Consumer Directed Health Services in excess of $190M annually.• Led the transition of Medicaid CM / DM staff from UHC Medicaid Plans to Optum. Migrated staff to a common clinical platform. Defined and implemented a best practice clinical model.• Partnered with UnitedHealthcare to enhance Commercial CM/DM telephonic clinical operations by introducing field and facility-based staff focused on specific high cost/high utilization geographies. Implemented Work Force Management tools and processes and Work at Home opportunities. Piloted Global clinical teams.• Implemented clinical programs (Heart Failure, Diabetes, CAD, COPD) simultaneously while maintaining operational target metrics for productivity and quality.• Led the implementation of a clinical pilot partnering with AARP. Initial partner membership with AARP has grown from 100K members to 3.1M members and $18M in revenue.• Successfully stood up the initial international Clinical team for UnitedHealth Group, resulting in a double-digit savings in operational expenses.• Successfully managed clinical operations for Medicare membership experiencing growth from 285K members and $10.5M in revenue, to 11.4M members and $160M in revenue over 6 years. Show less

  • Vice President, Strategic Capabilities - (Population Health Solutions and Prevention)

    May 2018 - Jan 2020

  • Global Engagement Partner - (Clinical, Behavioral, Pharmacy Operations and Business Transactions)

    Mar 2014 - May 2018

  • Operations Vice President - (Population Health Solutions)

    Oct 2004 - Mar 2014
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  Blue Cross of Idaho

  Dec 2020 - Aug 2021

  Enterprise Program Director
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  Optum

  Aug 2021 - now

  • Vice President, Benefit Operations Management (BOM) Optum Rx

    May 2022 - now

  • Director of Affordability and Solutions

    Aug 2021 - May 2022