Alexander Earlywine

Independent advisory firm delivering fractional executive leadership, AI-enabled operating model design, and enterprise transformation across healthcare, private equity, and technology. Engaged at the executive level to resolve misalignment across business, technology, and leadership — and drive execution where initiatives stall.

- Engaged at the executive level to resolve misalignment across leadership, operations, and technology. Diagnose the system first. Redesign across people, process, and technology simultaneously.

- Active co-marketing advisor to Newgen Software — contributed to products earning IDC MarketScape Leader designations in CCM (2024) and U.S. Provider Data Management / PLM (2025–2026), plus Forrester Leader (Content Platforms Q1 2025) and Strong Performer (Digital Process Automation Q3 2025). Designed Newgen's payer-vertical ROI calculator; currently designing provider vertical with Epic, Oracle Cerner, EHR, PBM, pharmacy, and facility integrations.

- Advise PE firms through GLG, Guidepoint, AlphaSights, and ProSapient on SG&A benchmarking, vendor strategy, AI workflow deployment, and operating model efficiency.

- Direct delivery across enterprise transformation, AI-enabled operating models, M&A integration, executive facilitation, vendor ecosystem strategy, and journey-mapping methodology paired with time studies and ROI modeling.

- Salesforce hands-on practitioner across Marketing Cloud, Sales Cloud, and Service Cloud. Microsoft stack: Active Directory, Exchange/M365, Azure, end-user computing, enterprise IT architecture.

Italy-based EU resident with US presence in Tampa, Florida. Available for 3–6 month fractional engagements and full-time interim leadership across Europe and the United States.

Reporting to Chief Clinical Officer. Final title: SVP. Title progression: Internal Consultant/Director Strategic Initiatives & M&A → Staff VP Population Health → VP Operations → SVP. Fortune 25 health insurer.

- M&A Integration Portfolio: Led Claims Integration across multiple acquisitions — WellCare, Arizona, Meridian, New York Fidelis Care, and Health Net of California. Claims was the largest, most complex workstream of the $17B WellCare acquisition; delivered $10M+ YoY synergies and established the enterprise integration model. Guided the Centene–WellCare integration as the highest-ranking VP on the integration team, reporting directly to the C-suite. Brought templates and processes from prior M&A at Coventry/Aetna, Highmark, Universal American, and WellCare; adopted across workstreams.

- Vendor Ecosystem & Recontracting: Managed $1B+ annual vendor spend and 15,000+ vendor-associated staff; drove $117M+ in annualized savings from a single recontracting initiative through RFP cycles and strategic consolidation.

- Operating Model & Platform Transformation: Redesigned the intake and case management operating model, then built the enabling low-code business process management platform from board approval to go-live in 6 months; $4M → $1.5M cost; 40 → 10 staff; CMS Best Practice citation.

- Salesforce Marketing Cloud & Medicare Automation: Led the SFMC enterprise implementation as internal engagement manager directing Accenture. Member engagement unit economics moved from $2–4 phone-based to $0.05–0.25/contact digital event-driven; adopted enterprise-wide. Messagepoint automation delivered $12M annualized savings.

- Quality & Audit Operations: Led Quality, Appeals, Clinical Nurse Review, Grievances, CTMs, and CMS audit readiness for 2,000+ employees enterprise-wide. Drove $31M in quality revenue recovery.

- Total measurable impact across Centene tenure: $250M+ annualized.

Brought in as Director of Appeals, Member & Grievances; promoted to Senior Director within months with expanded scope including medical policy, retrospective utilization management, mailroom, medical expense, and additional functional areas. Reporting to Chief Clinical Officer. 500+ clinical and non-clinical staff. True Integrated Delivery Network (IDN) co-governed by Highmark BCBS and Trinity Health, with provider partnerships across Allegheny Health Network and ChristianaCare DE.

- $100M+ Annual Revenue & Cost Savings: Medical and Payment Policy development with data scientists and nurse auditors; STARS improvement to 4–5 in timeliness and decision-making; CMS corrective action fully remediated and cited as Best Practice.

- $4M YoY SG&A Reduction: Reduced vendor dependence while strategically outsourcing in key areas.

- Owned end-to-end Medicare and Medicaid product operations at a true IDN — benefit design, network alignment, regulatory compliance, and STARS improvement.

- Led Member & Provider Services, Appeals, Grievances, Clinical Provider Disputes, LTSS, Retrospective Utilization Management, Quality Auditing, Medical Payment Policy, and Process Improvement.

- Provider-side healthcare delivery experience: ACO/LPO physician board meetings, value-based care network design, multi-site coordination across Allegheny Health Network and ChristianaCare DE.

- Foundation for AI-enabled platform deployment surfaced later at Centene: low-code business process management platform replatforming, enterprise care management redesign.