Aug 2020 – Mar 2024 · 3 yrs 7 mos

• Contribute to advancing Enterprise Operations through a strategic delivery ecosystem, governing end-to-end change, enabling business technology transformation, and delivering operational value and enhancements to the client, member, and provider experience. Understand the business vision and goals to contribute to the capability roadmap to align tactical operations with business strategies. Executing cross-functional collaboration and oversight of a direct reporting team.
• Lead a team of data, reporting and business analysts.
• Functioned as Product Owner and business SME for replacement of a legacy system; $2.5M portfolio; 50% automation of manual work; 33% productivity gain; reduction in paper submissions by 25%
• Drive transformation to improve customer experience, enhance back-end efficiency, and reduce total cost by leveraging improvements in the areas of people, process, and technology
• Act as internal process optimization advisor
• Partner with Business, Product, and Technology to identify go-forward strategic plans in alignment with organizational goals
• Create roadmaps focused on departmental strategy to meet organizational objective
• Partner with leadership from other areas of organization to collaborate on improving cross-functional processes
• Develop metrics, reports, and presentations for senior leadership
• Collaborate with internal and external stakeholders, functioning as a subject matter expert on projects.
• Work as liaison and translator between business stakeholders and technical teams
• Validate and ensure compliance with organizational and government regulatory requirements
• Use of JIRA for user story creation and backlog management and prioritization
• Change management planning
• User acceptance testing (UAT)
• Develop policies, procedures, communication plans, and training materials as part of implementations
• Balance managing multiple projects simultaneously while leading a team

Aug 2020 – Aug 2021 · 1 yr

• Lead a team of Data and Reporting Analysts and Business Analysts
• Manage end-to-end delivery of a portfolio of projects making up a program, from the initial kickoff to coordinating major launch milestones to maintaining and enhancing program performance over time.
• Guide stakeholders through key decisions, communicate and coordinate activities internally and across departments
• Responsible for developing and managing a particular enterprise function, developing strategies (including analysis, new program ideas, and communications), and overseeing a program budget.
• Serve as a liaison between the enterprise program area of responsibility, Product Management, and Technology
• Product Owner for technology implementation to replace a legacy application.

Jun 2019 – Aug 2020 · 1 yr 2 mos

• · Lead Corporate Re-Engineering process improvement (PI) projects from initiation to implementation.
• · Create current state process flows (Visio), Value Stream Maps, and other documentation regarding as-is and to-be processes.
• · Use Lean and Six Sigma Tools and methodologies to enhance the success of corporate and departmental level projects.
• · Ability to identify potential projects risks and contingencies.
• · Consider root cause analysis and identify process improvement opportunities in the development of future state proposals.
• · Collaborate and communicate with all levels across the organization, from front line works to C-level executives
• · Understand how teams work, and the ability to influence, motivate and get along with others
• · Strong change advocate who pursues organizational change across the business
• · Stay on top of the organization’s business strategy to ensure projects increase the company’s competitive advantage, financial performance, and are connected to the organization’s strategic business objectives.
• · Understand team dynamics including how to motivate a team to accomplish the task at hand while fostering an environment of cohesiveness and a sense of purpose
• · Anticipate future issues or asks and incorporates scalability into developmental activities.
• · Conduct transition planning and conducts post implementation tracking and remediation as needed.
• · Ability to recognize process inefficiencies where they occur, seek remediation, and work with business areas to implement solutions.
• · Relate practical application and industry knowledge to decision making and strategic initiatives.
• · Take action, make decisions, and effectively influence others to reflect the organization's visions and values.
• · Develop decision criteria considering factors such as cost, benefits, risks, timing, and buy-in; select the strategy most likely to succeed.

Jun 2018 – Jun 2019 · 1 yr

• · Technical understanding of system applications and data storage techniques with the ability to assist IT with technical specs.
• · Design, develop, and run data capture processes using multiple standard industry tools, including an understanding of downstream impacts.
• · Act as a technical liaison between IT and business areas for developmental activities.
• · Work with business partners to use common business standards as part of writing business requirements.
• · Organize information and data to identify and explain major trends, problems, and causes.
• · Apply existing knowledge to new applications or processes to quickly understand functionality to the point of making technical and business re-engineering recommendations.
• · Provide support and guidance to department staff at all levels on research and analysis assignments.
• · Take active steps to learn new processes, applications, and techniques in support of assigned activities.
• · Present verbally and in writing advanced analytical research or explanation of processes. Communicate and messages in a thoughtful persuasive manner and modifies communication so that it is clear, concise, and appropriate for the intended audience.
• · Communicate any delays, risks or impacts to departmental management and business areas.
• · Effectively facilitate meetings with cross-functional teams and document outcomes.
• · Lead work teams and effectively communicate with project sponsors, team members, SME's, and business areas regarding assigned work activities.
• · Advanced problem-solving and structured analysis/design techniques, including understanding complex inter-related systems and to independently resolve business and technical problems encountered.
• Quantify and prioritize assigned activities, adapt to changing priorities, and perform duties with minimal supervision. Act both independently and as part of a team.

Mar 2017 – Jun 2018 · 1 yr 3 mos

• · Support core functional application/tasks and demonstrate a thorough understanding of the technical aspects of the job. Includes understanding of end to end processes and downstream impacts. Provides well supported reasoning and documentation for technical recommendations and operational solutioning.
• · Demonstrate effective project management and leadership skills to manage department and corporate projects with cross-functional team members. Includes communicating project team status updates verbally and in writing to any audience. Identify potential projects risks and contingencies, conduct root cause analysis and identify process improvement opportunities.
• · Make complete technical and business re-engineering recommendations. Understand both the application configuration and process changes required to achieve greater efficiency or cost savings. Communicate downstream impacts and full end to end processes related to subject matter. Serve as a subject matter expert for five (5) or more business processes and technical detailed knowledge.
• · Strong leadership skills and willingness to lead work teams and project teams in an exemplary, professional manner.
• · Communicate in all settings to various audiences. Communicates and messages in a thoughtful persuasive manner. Take action to initiate multiple channels of communication in order to alert and inform staff and management. Summarize verbally and in writing advanced analytical research to all audiences. Communicate delays, risks and/or impacts to upper management and business areas. Effectively facilitate meetings and workshops and cross-functional teams and document outcomes.
• Communicate effectively with all levels of internal/external personnel to prepare written materials and oral presentations for technical and non-technical audiences.
• Adapt to constantly changing environment. Work with minimal supervision.

Jan 2016 – Mar 2017 · 1 yr 2 mos

Jul 2015 – Jan 2016 · 6 mos

• Demonstrated competency in Windows (Outlook, Word, Internet Explorer, Excel and Powerpoint)
• Demonstrates ability to understand and interpret detailed policies and procedures and to be able to apply them to various situations.
• Demonstrates ability to communicate effectively and professionally both verbally and in writing.
• Knowledge of CMS guidance, in particular, Chapter 6 (formulary), Chapter 13 and Chapter 18 appeals regulations and processes.
• Knowledge of Medicare compliance obligations
• Knowledge of Medicare marketing and sales regulations and obligations
• Knowledge of NCQA, BCBSA MTM, and HIPAA quality and timeliness guidelines and standards to ensure they are consistently met or exceeded.
• Knowledge of multiple online inquiry and appeal systems and coding structures of files to interpret data used in responding to appeals.
• Knowledge of systems used to support the Medicare enrollment exchange processes including CMS regulations, policies and procedures.

Apr 2019 – Apr 2023 · 4 yrs · Summerdale, Pennsylvania · Remote

• Develop and teach courses as part of a high-quality academic program that prepares students for professional success
• Sensitivity to and understanding of students from diverse educational backgrounds.
• End-to-end instructional design
• Prepare lesson plans, classroom presentations and student assignments
• Create engaging lessons that promote student involvement and application of the material, including use of experiential design methodology
• Evaluate students to measure their progress in achieving course objectives and informs students in a timely manner of their progress
• Mastery of course content
• Demonstrate leadership skills with a style that emphasizes collaboration, teamwork, and facilitation
• Excellent oral and written communication skills and interpersonal skills
• Commitment to diversity, with an ability to appreciate alternative viewpoints; Ability to work effectively with a wide variety of people
• Demonstrate interest in interdisciplinary teaching, service learning, learning technologies, course development, and adult learning methodologies including collaborative learning, learning communities and distance learning
• Commitment to academic excellence, exceptional service and providing a dynamic climate for life-long learning
• Demonstrated ability to develop and implement instructional approaches such as service learning/civic engagement, learning communities, and the effective use of technology
• Ability to use effective strategies to engage students in their learning
• Courses instructed: Healthcare Quality Management, Organizational Change Management, Electronic Business, Project Management, Operations Management, Spreadsheet Applications, Organizational Process Improvement

Jan 2014 – Apr 2017 · 3 yrs 3 mos · Harrisburg, Pennsylvania Area

• Taking meeting minutes, preparing monthly agendas, use of Microsoft Office (Word, Excel, PowerPoint), effective communication in response to emails, assisting at community events and activities.

Sep 2012 – Jul 2015 · 2 yrs 10 mos · Mechanicsburg, PA · On-site

• Communicate effectively.
• Remaining current with Medicare Part A or B guidelines and department procedures.
• Providing technical, operational and procedural guidance to section employees specifically as it pertains to the processing of department workload.
• Resolving processing problems and issues and assuring consistency and accuracy in processing instructions.
• Providing policy clarification and assuring written procedures are current and changes to procedures are documented and reviewed by the Appeals Business Coordinator.
• Continuously looking for process improvement opportunities.
• Providing technical and procedural coaching for improved employee performance and development of independent thinking.
• Monitoring department workflow and assuring the accurate, consistent and timely resolution of workloads.
• Recommending operations and procedural changes for improved processing.
• Worked with developer to implement inventory tracking and monitoring application.
• Assisted with requirements and user acceptance testing (UAT) for implementation of Medicare Appeals System (MAS) Enhanced Web Services for Part A Medicare Administrative Contractors

Jan 2011 – Jan 2012 · 1 yr

• Reconciled internal and General Ledger (GL) accounts, provided internal customer service, and researched and resolved discrepancies in internal accounts.

Jan 2009 – Jan 2011 · 2 yrs

• Oversaw thirteen bank tellers, including training, scheduling, auditing, disciplinary issues, annual review preparation, and employee relations.