Robert Balcarek
@robertbalcarek
Director of enterprise transformation in healthcare payers, building governance, automation, and measurable operational outcomes.
United StatesWhat I'm looking for
I’m a transformation leader with 25+ years of healthcare payer experience, focused on connecting strategy to execution in complex, regulated environments. I define roadmaps, build governance and performance reporting structures, and align business, technology, finance, operations, and compliance teams to deliver measurable outcomes.
Most recently, I led the transformation of fragmented financial and regulatory reporting into a unified enterprise capability across Medicare, Marketplace, and 30+ Medicaid markets. I built an enterprise Financial & Regulatory Reporting Center of Excellence from the ground up, standardized reporting routines and playbooks, and used AI-assisted analysis to improve executive visibility into trends, variances, financial exposure, and regulatory risk.
Experience
Work history, roles, and key accomplishments
Led the transformation of fragmented financial and regulatory reporting operations into a unified enterprise capability across Medicare, Marketplace, and 30+ Medicaid markets. Built a Financial & Regulatory Reporting Center of Excellence, standardized reporting playbooks and routines, and improved executive visibility into trends, variances, regulatory risk, and audit outcomes.
Senior Program Consultant/PM
Florida Blue / GuideWell
Jan 2018 - Jan 2023 (5 years)
Directed enterprise strategy and transformation execution across data strategy, Medicare Advantage operating model improvement, and business/technology alignment initiatives. Managed cloud migration and modernization delivery, including end-to-end transformation execution and large-scale Agile planning alignment across workstreams.
Led enterprise strategy and transformation execution across data strategy, Medicare Advantage operating model improvement, and business/technology alignment initiatives. Managed cloud migration and data platform modernization and delivered a $42M Medicare Advantage transformation program, including enterprise Agile planning for the program.
Directed technology-enabled transformation across Individual and Marketplace businesses by coordinating product, technology, vendor, and business stakeholders. Led multiple product teams in a SAFe Agile release train, drove systems roadmap and delivery plans, and implemented a Model Office program to prepare Medicare Service Operations for platform migration.
Built and led enterprise financial operations and process improvement capabilities, including operating models and technology-enabled workflows. Established an ACA-focused financial operations function and implemented data compilation across 14 billing and enrollment systems, plus FSA automation that improved adjudication workflows and generated annual savings.
Education
Degrees, certifications, and relevant coursework
Central Connecticut State University
Bachelor of Science (B.S.), Accounting
Earned a Bachelor of Science degree in Accounting from Central Connecticut State University.
Central Connecticut State University
Bachelor of Science, Accounting
Earned a Bachelor of Science in Accounting from Central Connecticut State University.
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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