Peni Moxim

Cigna

Drive product strategy, roadmaps, and go-to-market strategy for regulated clinical healthcare data exchange, HEDIS modernization, and AI innovation initiatives; 5 direct reports

• Productize complex regulatory requirements into both compliance & value API products to reduce friction and improve provider prior auth workflow process; API products include real-time coverage determination, documentation automation, and electronic prior authorization submission; enterprise scale
• Productize HEDIS data capture, data consumption, data translation, aggregation, and measurement calculation into FHIR API products as a part of NCQA & HEDIS modernization initiatives
• Identify & pilot AI product opportunities; includes patient-centered prior authorization inquiry, FHIR standards explorer, vendor performance dashboard, prior auth policy extraction, prototyping practices using AI

Slope

Drive product strategy and multi-year roadmap for biospecimen and inventory management app developed for clinical trial management

• Conduct user research in clinical trial domain to identify workflows and pain points of trial administrators and lab sites
• Develop product strategy, roadmaps, go-to-market strategy for clinical trial administration portal
• Develop & present clinical operations workflows to engineering teams for solution buildout
• Coordinate closely with trial sponsors which included pharmaceutical companies such as Roche, Novartis, and others

Evernorth Health Services

Drive product strategy & execution for regulated healthcare data exchange between payers, providers, patients, & third-party mobile apps

• Productize complex regulatory requirements into an interoperability platform & related API products to enable patients to access their own healthcare data via any external third-party mobile app; platform components included patient consent, developer portal, third-party app authentication, and API endpoints for data exchange
• Delivered 100% compliance with 21st Century Cures Act across 7+ product teams and 100+ team members
• Own end-to-end solution management: planning, scope, prioritization, cross-team dependencies, delivery
• Originate & design the compliance framework that became foundation for ongoing product development beyond regulatory requirements

Cigna

Identify client, clinician, and customer-facing product opportunities as part of a Product Lab; manage the ideation, discovery, build & delivery of selected products through proof of concepts, product pilots, and targeted beta launches; Product Lab timelines typically 90 days

• Customer-facing product ideation & delivery for Fortune 500 clients: JPMorgan Chase, Macy's, Marriott and others
• Innovative, leading-edge product ideation such as runtime A/B testing system using reinforcement learning; improved appointment bookings with clinical coaching by 4% in 90 days
• Lead NLP chatbot and telehealth initiatives from concept through successful production deployment

Cigna

Identify product improvement opportunities within enterprise payer eligibility & claims adjudication modules; manage the build & delivery of product improvements through both agile & waterfall SDLC methodologies; 8 direct reports

• Modularize provider contracts & fee schedule lookup capabilities in support of real-time claims adjudication
• Productize eligibility processing rules into a callable API service
• Lead requirements and delivery for transaction processing optimization—pricing logic, workflow automation, adjudication rules

BBVA

Lead IT infrastructure buildout for acquired retail banking sites & operations centers

• Lead infrastructure identification & buildout for Banking Ops center in McAllen, TX
• Lead site migration for failing banks at retail sites throughout TX; 48 hour turnaround SLA from failed bank brand to BBVA brand

DST Systems

Define multi-year product roadmaps for claims, eligibility, provider contracting and benefits platforms

• Product development for US-based and international payer clients; front-end and backend solutions across patient, provider, claim, utilization management
• Sales support and product pitch to Gartner, Forrester, payer prospects

DXC Technology (formerly CSC)

Provide consulting and solution implementation of enterprise payer solutions for US-based and international payers

• Implemented enterprise claims adjudication systems for major payers: BCBS Texas, MA Medicaid, NY Medicaid, BCBS Florida, Aetna International, more
• 100% travel across US and international markets implementing claim adjudication & related processing systems