1. DAVID E. HARRELL
71 Cilewood Court Phone: 904-994-7656
Jacksonville Beach, FL 32250 Email: dharr109@yahoo.com
SUMMARY
Healthcare executive with over 20 years experience as both a Payer and a Vendor. Proven success in
leading B2B technical implementations, teambuilding, budgeting, and developing long-term strategy and
KPIs for both large corporations and small start-ups. Drives cross-functional collaboration among internal
and external stakeholders at all levels.
AREAS OF EXPERTISE
 Project Management
 Process Improvement
 Business Development
 Operational Leadership
 Strategic Planning
 External Communications
 Creative Problem Solving
 Customer Satisfaction
 Client Relations
 Data Management
 Product Strategy
 Media Relations
 Teambuilding
 Conflict Resolution
 Six Sigma Red Belt
 LEAN methodologies
 Cost Reduction
 IT Enhancements
 Budgeting
 KPI Development
 Contract Negotiation
EXPERIENCE
SUNSHINE HEALTH (CENTENE CORPORATION SUBSIDIARY), SUNRISE , FL 2013 - 2014
VICE PRESIDENT, OPERATIONS
Provided leadership and management of claims, encounters, configuration, data management,
credentialing, call centers, and provider relations in support of insurance products.
 Ensured effective communication occurred during a time of substantial growth by designing and
implementing governance committees
 Scaled Operations to support a doubling of membership within a six-month timeframe
 Reduced credentialing turnaround time from 180 days to under 45 days.
 Ensured Service Level Agreements (SLAs) with the Agency for Health Care Administration (AHCA) were
attained by developing and implementing a staffing plan
 Avoided exposure to liquidated damages by ensuring operations-related SLAs for AHCA were met
 Improved call routing, decreased handle times, and increased self-service utilization by identifying and
implementing IVR enhancement opportunities
 Increased quality-related metrics by implementing an end-to-end training organization
BLUECROSS BLUESHIELD OF FLORIDA, JACKSONVILLE, FL 2007 - 2013
SENIOR DIRECTOR, BLUECARD OPERATIONS & CLAIMS (2011 – 2013)
Led the highest revenue-generating Operations area within the company, including BlueCard Claims &
Contact, Plan-to-Plan, Medical Records Unity, and the Local Provider Call Center.
 Achieved positive budget variance between 2-7% for five consecutive years by reducing expenses,
increasing automation, and improving performance

2. David Harrell Resume, Page 2
 Achieved number one peer group ranking for the first time at Florida Blue for three consecutive quarters
 Improved performance from a ranking of 52nd in the first and second quarters of 2012 to 14th in the third
quarter and 12th in the fourth quarter
 Earned top quartile peer group ranking performance nationally for two consecutive quarters
SENIOR DIRECTOR, CLAIMS CORE PROCESS (2010 – 2011)
Responsible for overall E2E claims process for all BCBSF, totaling 55MM annual claims. Ensured all
internal, BCBS Association, and group-specific performance guarantees were met. Represented Claims
Organization on the Service Operations Diversity Business Council. Participated on Florida Hospital
Advisory Panel to improve relationships with Hospital network. Made continuous process improvements
utilizing Six Sigma and LEAN methodologies to reduce costs, improve quality, and increase productivity.
 Decreased PMPM cost from $1.24 in 2009 to $0.89 in 2011
 Slashed budget spend from $59MM in 2009 to $41.5MM in 2011 while improving performance
 Increased claims processing automation from 89.1% in 2010 to 92.4% in 2011, reducing 25 full-time-employees
and saving over $1MM in administrative expenses
 Ended 2010 with a positive budget variance of $4MM
 Saved $4.2MM in benefit realization by implementing process enhancements (2010)
 Minimized duplication of IT requests and improved efficiencies by implementing a claims governance
committee to ensure production, project, and process issues could be addressed in an open forum
AVAILITY, LLC, JACKSONVILLE, FL 2001 - 2007
SENIOR DIRECTOR, MARKETING & ALLIANCE MANAGEMENT (2005 – 2007)
Provided direction for Marketing, Business Development, Alliance Management, and Operations teams.
Managed relationships with Health Insurance Plans to ensure alignment of product strategies and IT-related
enhancements. Developed, distributed, and coordinated external communications including press
releases and key messages.
 Founding member of a unique joint venture which grew into one of the largest real-time health
information exchanges focused on reducing costs and improving healthcare while remaining payer
agnostic
 Coordinated with external marketing firm, BCBSF, Humana, and Health Care Service Corporation to
develop comprehensive external communications package, press conference, and media package
regarding the integration of Availty and The Health Information network
 Developed and implemented the Availty 3 – 5 year strategic plan
 Led and executed total rebranding of all collateral and marketing materials
 Presented at the 2006 HIMSS National Conference (the largest healthcare vendor conference in the US)
on Improving Provider Revenue Management Cycle
DIRECTOR, DEPLOYMENT AND IMPLEMENTATION (2003 - 2005)
DIRECTOR, PROVIDER OPERATIONS (2002)
BLUECROSS BLUESHIELD OF FLORIDA, JACKSONVILLE , FL 1990 – 2001
EDUCATION & TRAINING
Master of Business Administration, Jacksonville, University, Jacksonville, FL
Bachelor of Science, Management, Nova Southeastern University, Fort Lauderdale, FL