Summary
Overview
Work History
Education
Skills
Websites
Accomplishments
Certification
Timeline
Generic

Brandy Cole

Owenton,KY

Summary

Visionary Product Leader with 15+ years in healthcare tech, specializing in Agile product strategy, scalable delivery, and cross-functional execution. Adept at aligning business, tech, and compliance to deliver solutions that meet regulatory standards and drive measurable value. Certified SAFe Product Owner/Product Manager with a proven record of leading cross-functional teams through Agile transformation and multi-million-dollar solution rollouts.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Sr. Product Manager, Clinical Technology Enablement

Optum
01.2023 - Current
  • Led Agile planning and prioritization across cross-functional healthcare tech teams, driving 2-week sprint cycles and monthly releases
  • Translated high level business and compliance objectives into executable feature roadmaps, enabling a 25% acceleration in delivery without sacrificing quality or regulatory integrity.
  • Drove stakeholder alignment and executive buy in (VP/SVP) for new capability investments through clear impact modeling and agile planning
  • Directed the strategic development and evolution of core capabilities for new Utilization Management (UM) and Transition of Care programs within Optum Clinical Manager.
  • Led end-to-end implementation of new client cohorts, ensuring seamless onboarding and operational readiness including SOP development, training, user provisioning, and production support.
  • Owned and prioritized the product backlog; drove feature elaboration, sizing, and release planning in alignment with business goals.
  • Spearheaded automation of multi-channel provider and member communications, including phone, fax, EMR, portal, and print fulfillment.
  • Set strategic direction for the team, resolved escalations, and provided mentorship to ensure high performance.
  • Championed AI/ML-driven design solutions to optimize workflows, reduce costs, and enhance scalability.
  • Directed comprehensive testing efforts including UAT, regression, smoke, and end-to-end validation.
  • Collaborated with engineering, architecture, marketing, UI/UX, and regulatory teams to align product delivery with enterprise timelines.
  • Developed and maintained detailed project plans to support successful implementation and stakeholder transparency.
  • Recognized with multiple Bravo Awards for exemplary leadership and cross-functional impact.

Senior IT Business Performance/Process Improvement Consultant, IT Vendor Management Office

Humana
12.2021 - 12.2022
  • Collaborated with cross-functional teams to gather business requirements and lead the design of applications in OnSpring
  • Oversaw intake backlog for the Center of Excellence (COE), prioritizing initiatives and ensuring timely delivery of high-impact projects.
  • Served as system administrator for OnSpring, maintaining data integrity, application performance, and user access controls.
  • Monitored and analyzed IT performance metrics to identify improvement opportunities and drive operational efficiency.
  • Ensured vendor compliance with SLAs and contractual obligations through proactive performance management.
  • Transformed departmental reporting by designing and implementing automated, interactive executive-level dashboards, significantly improving executive visibility and decision-making.
  • Partnered with IT, cybersecurity, risk, and contract management teams to conduct comprehensive vendor performance assessments, resulting in actionable insights and improved partner accountability.
  • Designed and implemented KPIs, KRIs, OKRs, and balanced scorecards to measure and optimize IT service delivery and project outcomes.
  • Authored and maintained detailed documentation including SOPs, process flows, and project requirements to support knowledge transfer and audit readiness.
  • Led strategic initiatives to identify, measure, and track right-source savings, resulting in enhanced cost transparency and operational efficiency.

Sr. Business Systems Analyst/Technology Consultant, Client Implementations

Optum
04.2021 - 12.2021
  • Owned end-to-end delivery of new client implementations and external data file integrations, ensuring seamless onboarding and operational readiness.
  • Led complex data mapping and requirements sessions with external clients and vendors to support the deployment of enterprise software solutions.
  • Managed and mentored a team of three junior analysts, providing continuous training and development throughout the implementation lifecycle.
  • Conducted ad-hoc data and disruption analyses to support implementation needs and prepare data for downstream systems.
  • Directed User Acceptance Testing (UAT) efforts, including test planning, criteria definition, backlog management, and results validation for a new enterprise database.
  • Authored and maintained comprehensive documentation including SOPs, workflows, validation protocols, and configuration specifications.
  • Ensured data quality and integrity across all deliverables by identifying anomalies and enforcing data standards.
  • Projects & Process Improvement
  • Spearheaded the implementation of a new enterprise data warehouse (RxVeritas).
  • Led the Copay Card program initiative, improving data integration and reporting capabilities.
  • Recognition
  • Received multiple Bravo Awards for leadership in UAT, cross-functional collaboration, and associate training.

Sr. Technical Consultant, Claims Cost Management Subrogation

Humana
08.2020 - 04.2021
  • Built strong partnerships with internal stakeholders, vendors, and business process owners to deliver scalable solutions across subrogation, pre-pay, post-pay, financial recovery, and FP&A functions.
  • Led the successful migration and development of 31 Power BI reports, enhancing visibility into operational performance and financial outcomes.
  • Facilitated cross-functional requirements sessions to ensure reporting tools were intuitive, actionable, and aligned with end-user needs.
  • Applied deep expertise in Medicare, Medicaid, and Commercial health plans—including COB, MSA, workers’ comp, and PIP—to inform reimbursement strategies and audit accuracy.
  • Developed project plans, led daily stand-ups, and coordinated across departments to ensure timely delivery of high-impact initiatives.
  • Projects & Process Improvement
  • Data Exchange Program
  • Implementation of “Author by Humana” for subrogation

Clinical Program owner, Payment Integrity

Humana
08.2018 - 04.2020
  • Served as program owner for a portfolio of clinical audit reviews, driving continuous improvement and measurable cost savings.
  • Identified and corrected critical gaps in the commissions process, enabling retroactive vendor billing and recovering $6M in missed revenue.
  • Led a major process improvement initiative to standardize clinical audit operations, including SOP development, knowledge sharing, and mentoring programs.
  • Conducted in-depth claims analysis using SQL to evaluate audit program performance, including hit rates, savings, and selection accuracy.
  • Implemented enhancements to the Itemized Bill program, contributing to a $20M+ increase in annual savings.
  • Improved Home Health audit program hit rate by 90% through data-driven updates to claims selection criteria.
  • Delivered KPI presentations to senior leadership, influencing departmental and C-suite strategy.
  • Facilitated regular business reviews with vendor partners to ensure alignment, performance, and accountability.
  • Process Improvement
  • Clinical Audit Selection Optimization
  • Commissions Process Redesign
  • Program Owner SOP and Knowledge Management Initiative
  • Recognition
  • Shining STAR Award for analytical excellence (OrthoNet Mod C program)
  • Multiple High Five Awards for collaboration and training

Education

MBA -

SpringHill College

BS - Healthcare Management

Sullivan University

Skills

  • Agile Product Management (Scrum, SAFe, Scrumban)
  • Feature Prioritization & Roadmap Ownership
  • Cross-Functional Team Leadership
  • Scaled Delivery in Regulated Environments
  • Stakeholder Alignment & Executive Communication
  • Sprint Planning, Release Readiness, and Operational Support
  • Backlog Grooming, PI Planning, and Incremental Delivery
  • Business Technology Translation
  • Lean Portfolio Management
  • Strategic planning
  • Technical Proficiencies: Excel, Word, Power point, Outlook, Salesforce, CAS, MTV, Power BI, Tableau, CISPro, Qlikview, RxComet, RxVeritas, Service Now, RxClaim, PPirates, SQL/Toad, Access, Microsoft project, OnSpring, AHA, OCM, ICUE, Rally, etc

Accomplishments

  • Led end-to-end implementation of capabilities within Optum Clinical Manager 2.0, delivering scalable clinical software solutions for care and utilization management programs from concept through enterprise rollout.
  • Directed the development and launch of vendor management and clinical audit platforms, enhancing operational oversight and compliance.
  • Transformed Humana’s Claims Cost (Payment Integrity) audit programs by integrating predictive modeling, process optimization, and advanced analytics—resulting in measurable performance improvements.
  • Redesigned Humana’s exclusion list strategy, driving a $20M+ increase in program performance within the first year of implementation.
  • Recovered $6M in missed revenue by identifying and correcting commission process gaps, enabling retroactive vendor billing and sustainable process improvements.

Certification

  • Certified SAFe 5 Product Owner/Product Manager Credential ID 35141401-3613
  • Conflict Management Certification, Sullivan University
  • CITI Program – Social/Behavioral/Educational Researcher Credential ID 45493357

Timeline

Sr. Product Manager, Clinical Technology Enablement

Optum
01.2023 - Current

Senior IT Business Performance/Process Improvement Consultant, IT Vendor Management Office

Humana
12.2021 - 12.2022

Sr. Business Systems Analyst/Technology Consultant, Client Implementations

Optum
04.2021 - 12.2021

Sr. Technical Consultant, Claims Cost Management Subrogation

Humana
08.2020 - 04.2021

Clinical Program owner, Payment Integrity

Humana
08.2018 - 04.2020

MBA -

SpringHill College

BS - Healthcare Management

Sullivan University

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Brandy Cole