Chad Wilson - CFE
Raleigh,NC
Summary
Accomplished leader with 10 years of supervisory management experience, known for fostering a stable environment that empowers team members and supports departmental goals in alignment with enterprise strategy. Recognized for excelling in cross-functional initiatives and delivering impactful results. Specializes in network support management and team leadership in analytics, credentialing, reporting, and compliance. Experienced in operations and contract management for clients such as CVSH and EXL. Expertise in streamlining processes to improve efficiency, accuracy, and compliance in pharmacy network operations. Possesses a solid foundation in operations and 16 years of audit expertise. Advancing proficiency in strategic oversight of provider network demographics, access, and performance.
Overview
20
20
years of professional experience
Work History
Program Manager
CarelonRx
10.2024 - Current
- Cultivates a motivated and cohesive team environment by consistently demonstrating enthusiasm and a can-do attitude, achieving same-day inbox response time goals and enhancing team productivity and engagement to meet this objective.
- Cataloged all Network Management SOPs from 2020 to 2025, reviewed and updated those applicable for 2025, retired non-relevant ones, and ensured access via the shared Network drive. Implemented a numbering system for seamless assignment of new SOPs, ensuring compliance with enterprise and regulatory standards and mitigating future audit nonconformities.
- Completed the full migration of documents from CMS to the DocTract system and updated the SOP to reflect on new procedures. Ensured all 4th quarter P&P approvals are finalized by November 30 each year, preventing any carryover into December.
- Spearheaded the adoption of a SF automated aging report, to ensure direct users were properly creating, maintaining, and closing cases while properly communicating with CVSH on ordinary and escalated matters where report distribution includes our CVHS partner and assists the Staff VP when matters are escalated with their CVSH counterpart.
- Developed and implemented project management frameworks for the FL Waiver process, achieving 100% state reporting accuracy for 2025 and preventing fines of approximately $200K.
- Collaborated with cross-functional teams to successfully deliver the Business Continuity Plan for all processes under the President CRx PBM, ensuring timely completion and risk mitigation in the event of an unplanned interruption.
Auditor/Investigator
NCREC
03.2017 - 10.2024
- Licensed North Carolina Real Estate Broker.
- Led the team for four years, managing new hire training and complex case collaborations among experienced investigators and staff attorneys, while also handling my own case load to ensure accurate investigative steps and comprehensive documentation.
- Responsible for assessing investigator performance to determine probation status, implementing corrective action plans, and making termination decisions.
- Investigated allegations of financial fraud, misrepresentation, and unlicensed brokerage activity, consistently exceeding departmental performance measures in cases completed and achieving outcomes that supported the Commission's initiatives.
- Prepared summary reports for legal counsel to assist in determining probable cause for hearings, presented findings to state-appointed commission members, and assisted licensed brokers with trust fund accounting regulatory compliance.
- Certified Investigator/Inspector through CLEAR Basic Training Program
DOD Firefighter
USAF Reserves
05.2013 - 05.2019
- Two years of leadership experience guiding Airmen in maintaining the standards of enlisted life as Reservists and ensuring their operational readiness for deployment.
- Selected as the 916th CEF CPR Instructor and Career Counselor.
- Awarded Airman of the Quarter for Q4 of 2016.
- Louis F. Garland Fire Academy Distinguished Graduate for Outstanding Academic Achievement.
- Certifications: Firefighter I/II, Aircraft Rescue and Fire Fighting, Pumper and Mobile Water Supply Fire Apparatus Operator, Instructor I, Inspector I, and Hazardous Materials Technician.
- FEMA Center for Domestic Preparedness Field Force Extrication Tactics certified.
Director of Operations
Strutmasters
11.2014 - 11.2016
- Supervised and managed 30 direct reports and processes associated with the manufacturing, customer service, sales, research and development departments.
- Maintained and updated $750K in workers' compensation, liability, and automotive insurance policies to minimize costs and reduce potential financial liabilities.
- Reviewed financial positions involving $500K in receivables and payables to accurately forecast cash requirements.
- Improved departmental processes by optimizing resource allocation and aligning company goals with departmental objectives.
- Increased sales by 19% through enhanced script monitoring, improved key performance indicators, and more efficient scheduling.
- Streamlined the research and development process, achieving a 56% reduction in time, cutting the timeline by fifty days from conception to completion.
Road Trooper
OSHP
10.2010 - 06.2014
- Managed the afternoon shift for two years, collaborating with less experienced troops on issues such as probable cause, search and seizure, criminal and crash investigations. Acted independently to resolve matters at the troop level, preventing escalation to the Sergeant, especially when the Sergeant was preoccupied or on PTO.
- Fostered a healthy competitive environment to motivate peers in line with the Division's goals.
- Provided quality communication, adapting message complexity to suit various audiences, including courts, supervisors, peers, and the public.
- Prepared detailed and accurate reports for court proceedings.
- Skilled in strategic analysis, gathering information, and implementing timely solutions.
- Proficient in enforcing traffic laws, conducting crash investigations, and investigating criminal incidents within statutory jurisdiction.
Transitional Work Experience
Walgreens Pharmacy
03.2009 - 09.2010
- Part of the workforce reduction during the E.W. Scripps Company corporate spin-off. Subsequently accepted into the Ohio State Highway Patrol and attended the Academy while employed during the application process. Commenced the seven-month training program at the Ohio State Highway Patrol Academy in October 2010.
Senior Financial Auditor in the Multimedia Industry
E.W. Scripps
12.2006 - 02.2009
- Planned and executed financial, control, and compliance audits, as well as other non-routine reviews.
- Evaluated current control designs and recommended improvements and efficiencies.
- Assisted in implementing control audit findings.
- Selected to assist in developing and performing initial testing of audits for the corporate Treasury and Financial Service Center's integrated financial and IT applications.
- Designated to conduct initial testing of the benefits and newsprint inventory financial audits.
Auditor - Serving Healthcare Clients
Ernst and Young LLP
09.2005 - 12.2006
- Assisted in planning, budgeting, and coordinating fieldwork for audits.
- Proficient in determining proper segregation of duties within company processes and among personnel.
- Performed various accounting and auditing functions, including testing of financial accounts, disclosures and controls, as well as evaluating and documenting accounting systems, procedures and operations.
- Conducted inventories to ensure accurate valuation and proper completion.
- Investigated, analyzed, and documented financial transactions to identify audit discrepancies, accounting errors, and financial irregularities.
Education
Associate of Applied Science - Fire Science
Community College of The Air Force
Maxwell AFB, AL10-2019
Airman Leadership School -
USAF
SJAFB, Goldsboro, NC02.2017
Louis F. Garland Fire Academy -
USAF
GAFB, San Angelo, TX12.2013
Basic Training -
USAF
LAFB, Bexar County, TX08.2013
Ohio State Highway Patrol Academy -
OSHP
Columbus, OH04.2010
Bachelor of Business Administration - Accounting
University of Cincinnati
Cincinnati, OH06.2005
Skills
- Project Management and Operational Expertise: Project management experience with a deep understanding of operational processes
- Healthcare Leadership Experience: Proven leader within Network Oversight and FWA Team, focusing on management and services for internal partners, clients, and vendors
- Cross-Functional Collaborator: Effective team player, fostering partnerships across diverse functional teams
- Skilled at Executive Communication and Presence: Strong presence and communication skills for creating impactful results
- Strategic Thinker and Problem Solver: Exceptional abilities in strategic planning, decision-making, and adaptability
- Experienced at Stakeholder Engagement and Influence: Confident in engaging applicable stakeholders and influencing decision-making
- Advanced Communication Skills: Proficiency in negotiating and communicating with clarity across various channels
- Proficient in Microsoft Office Suite: Skilled in Excel, Teams, Outlook, PowerPoint, and Word
Timeline
Program Manager
CarelonRx
10.2024 - Current
Auditor/Investigator
NCREC
03.2017 - 10.2024
Director of Operations
Strutmasters
11.2014 - 11.2016
DOD Firefighter
USAF Reserves
05.2013 - 05.2019
Road Trooper
OSHP
10.2010 - 06.2014
Transitional Work Experience
Walgreens Pharmacy
03.2009 - 09.2010
Senior Financial Auditor in the Multimedia Industry
E.W. Scripps
12.2006 - 02.2009
Auditor - Serving Healthcare Clients
Ernst and Young LLP
09.2005 - 12.2006
Bachelor of Business Administration - Accounting
University of Cincinnati
Associate of Applied Science - Fire Science
Community College of The Air Force
Airman Leadership School -
USAF
Louis F. Garland Fire Academy -
USAF
Basic Training -
USAF
Ohio State Highway Patrol Academy -
OSHP