STEVEN E. SANTACROCE, FLMI, MBA ACS, CFETemple, TX 76502

717-435-7593 (home) / 404-693-2593 (cell) ▪ stevenesantacroce@yahoo.comhttp://www.linkedin.com/in/stevesantacroce/

SENIOR OPERATIONS & INSURANCE CLAIM ACCOUNT MANAGEMENT EXECUTIVE

Regional Vice President / Vice President of Operations / Account Executive

Seasoned, innovative professional with a unique blend of operations leadership and infrastructure management experience. Specialize in diversified managed care, group insurance and back office operational environments. Innate ability to motivate and empower high-performance teams to accomplish objectives and solve problems to improve human capital, customer relationships, and bottom-line profitability. Forward-thinker who rapidly collects information, controls costs, and minimizes risk, while simultaneously driving strategic planning and execution. Change agent with strong focus on integrating practical business issues from operations and organizational development perspective.

Core Qualifications

Strategic Business Planning Cross-Functional Team Leadership Start-Up Operations Staff Training & Coaching Turnaround & Change Management Claims Management Quality Assurance & Controls Policies & Procedures Development Multi-Site Operations Expense Management Process Reengineering Rightsizing Operations

PROFESSIONAL EXPERIENCE

Scott & White Health Plan – Temple, TX 2013 to PresentOne of the larger integrated health plans in the US. (Part of Baylor Scott & White Health).

Director of Cost Containment – Design, implement and oversee:

▪ Fraud, Waste and Abuse (FW&A) program for health plan claim operations. ▪ Audit, training and root cause analysis of all claim issues, minimizing claim adjudication interruptions. ▪ Audited $25MM with a suspect rate of 18% of $$ audited and recovering 5% of total $$ audited.

Elite Underwriting Services, Inc . – Exton, PA 2011 to 2013One of the largest privately owned Medical Stop-Loss MGUs (Managing General Underwriters) in the US.

Vice President of Operations – Plan, organize, and direct full operations, including Claims Adjudication/Audit, Policy Issuance, Licensure/Appointments, Loss Control and business-level prioritization of IT functions.

Oversee, audit and approve 80 TPA (Third Party Administrator) business partners. Installed Operations Savings Incentive Plan, with over $8 million in claims savings during its 1st year. Resolved inventory of backlogged claims, reducing reserves by over $2 million in the 1st 90 days.

Steven E Enterprises, Inc., Overland Park, KS / Woodstock, GA 2007 to 2012Consulting in Group Benefits, Claims, Insurance Operations, Auditing, Fraud Detection and Expense Recovery

INSURANCE / OPERATIONS CONSULTANT - Conducted a review of group insurance operations (New Business, Premium Services, Customer Service, Claims Adjudication and staff evaluation) to determine efficiencies, flaws and possible conflicts of interest for an off-shore insurance company. Audited numerous catastrophic medical and reinsurance claims for a medium sized health insurer. Participated in numerous discussions with a variety of carriers who required expertise and opinions involving claim adjudication and operational workflows.

MedPlans Partners, Inc. (Subsidiary of Firstsource), Leawood, KS 2005 to 2007Firm concentrating on outsourcing national/regional health insurance claim processing, with revenues of $20+ million annually.

Chief Operations Officer – Strategically overhauled the operational aspects of 3 (100+ seat) service centers in KS, IL, and KY. Managed rebranding initiatives and directed 11 Six Sigma green belt projects. Oversaw operational claims processing, HR, IT, business analysis and facilities. Supervised 320 indirect and 7 direct reports.

Increased annual revenue from less than $10 million to more than $22 million (+175%) from a 9% to a 23% margin (+229%) in less than 3 years.

Produced nearly $500K in prior undocumented savings and netted more than $250K in 1 quarter, by leading 12 Six Sigma green belt projects.

Gained 100% of new accounts from client referrals, constituting $5 million in new revenue through prospect visits, quality production and exceptional customer service.

Saved $2.4 million annually and increased margins through efforts in downsizing operations 30%.

STEVEN E. SANTACROCE, FLMI, MBA ACS, CFE Page - 2

Great West Healthcare, Ft. Scott, KS 2004 to 2005$37 billion group health insurance company focusing on group health claim processing, call center, and quality initiatives.

Assistant Vice President of Service Center Operations – Oversaw claim adjudication and in-bound call center facility with 360+ full-time employees. Visited national client sites to monitor and reinforce customer satisfaction.

Centralized mailroom facilities to a new location, which eliminated duplication of services and decreased employee staffing of 16 FTEs.

Drove a culture change by hiring 3 new directors, assuring optimal matches of their core competencies to key management roles.

Devised and executed forum for employees to express opinions/ideas along with ability to be recognized for achievements, resulting in higher productivity and more positive employee morale.

IMA of Kansas, Topeka, KS 2002 to 2004Largest private insurance brokerage firm in the State of Kansas.

Account Executive – Oversaw employee benefit plans for 25 employer groups, involving renewals and fiduciary issues. Partnered with carriers in designing benefit plans tailored to employer needs. Facilitated resolution of service-related issues, including employee ID cards, renewal meetings, claims resolution, and the client / carrier relationship. Saved nearly $300K in labor and benefits by visualizing and implementing initiative to centralize all group benefit administration.

AEGON Insurance Group, Baltimore, MD 1997 to 2002$150 billion holding company for marketing insurance and financial services products.

Vice President of Operations (2001 – 2002) – Oversaw IT and Claims Adjudication departments for the 2nd largest wholesale travel MGU in the industry. Claims included trip interruption, trip cancellation, accident & medical claims world wide, overseas evacuations and repatriations. Led crisis management (9/11) initiative to eliminate 300% increase in claim volume in less than 5 months, and eliminate 250% increase in regulatory inquiries in that time.

Director of Reinsurance Claims (1997 – 2001) – Supported the business relationships ($150 Million of annual revenue) of 13 MGUs and TPAs with respect to claims (Group Health, Worker’s Comp, Wholesale Travel, Occupational Accident, Student K-12), customer service, systems and regulatory issues through leadership and facilitation within the specific locations to obtain the desired results. Worked with reinsurers and intermediaries concerning back end risk exposure, retention limits and reinsurance claim filings. Reduced regulatory complaints 48%+ in 2 years. Developed and hosted annual claim seminars for company divisions, MGU’s and TPA’s.

John Alden Life Insurance Company, (Now part of Assurant Health) Miami, FL 1989 to 199710th largest life insurance company in America, specializing in small group insurance products

Director, Managed Care Central Services – Coordinated 5 departments (Provider File Administration, Automated Claim Repricing, Managed Care Network Directory Publication, B-Notice – 1099 Back-up Withholding and Policy Certificate Issue) supporting the back office of John Alden’s managed care insurance program.

Systematically improved service time 22% by consolidating 1.5 million medical provider records. Automated back-up withholding procedures and increased W-9 efficiency 48%. Slashed expenses $497,000 annually by centralizing assembly and shipping of all coverage certificates. Saved unparalleled $121 million annually through initiatives in automating fee schedules of managed care

networks, eliminating involvement of networks, and reducing numerous manual functions.

EDUCATION

M.B.A., Chadwick University, Birmingham, AL

B.B.A., Marketing & Finance, University of Iowa, Iowa City, IA

PROFESSIONAL TRAINING

Certified Fraud Examiner (CFE) ASSOCIATION OF CERTIFIED FRAUD EXAMINERSFellow, Life Management Institute LIFE OFFICE MANAGEMENT ASSOCIATIONPublic Speaking & Human Relations DALE CARNEGIEInsurance Administration/Associate in Customer Service LIFE OFFICE MANAGEMENT ASSOCIATION