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Work Background
Centene CorporationProgram Manager
Sep. 2023 - Feb. 2024Team Lead for Centene, managing and coordinating Health Payer platforms for Epic systems. Project management for care providers, Researching practices and health care systems for Epic platform implementation, delegating meetings with SMEs. Managing the implementation via Workfront tool.
Emergent HoldingsHealth Care Analyst
Mar. 2023 - May. 2023Detroit Metropolitan AreaWorking with the RX side on STARS measure to maintain best quality adherence for BCBSM clients. Create reports for measure over CS results on a weekly basis. Maintain weekly DNC list for third party clients and internal purposes. Ad-hoc assignments in a team enviorment.
AdvantasureExpert Analyst
Jun. 2021 - Aug. 2022Greater Detroit AreaStrategy development reporting for Blue Cross Blue Shield of Nebraska and Kansas, Risk-Adjustment, ACA support. Generating reports, PowerPoint meeting decks, dashboards and KPI strategy for clients for optimum revenue return. Transitioned to Strategy implementation for Kansas and Nebraska and Blue Cross Blue Shield ACA. Created project plans, raid issue logs and oversight of plans in Smartsheet software and JIRA. Handled JIRA file oversight and tracking. Created Smartsheet tracking plans for clients and their products. Acting liaison between multiple teams to ensure project plan is on track. Project management in admin role for clients. Looking to obtain PMP Certification.
AdvantasureSr. Analyst
Jan. 2017 - Apr. 2020Greater Detroit AreaWorked service operations for clients in Risk-Adjustment in MA, ACA, RADV, medical record retrieval, vendor support, Client support, Provider Outreach, solution Implementation, project executing, process improvements and ad-hoc projects. Managed clients such as, BCBSM, Horizon, Blue Cross Arkansas, Metro plus and Healthfirst. Worked with vendors such as Inovalon, Verscend, Healthport and CIOX. Hosted Vendor meetings, data retrieval and Provider site Issues. Implemented a system for metric retrieval reporting and internal documentation. Analyzed and resolved data missing/data mismatch for MS Excel add –in issues. VLOOKUP and concatenation of data and datasets. Designed Internal MS Access Databases. Coordinated with internal IT team to streamline future project deliverables. Established 3rd-Party copy house business relationships to create partnerships and solutions in project efficiency. Created personal relationships with Clients and providers to alleviate Provider abrasion, and/or misinformation. Assist in Data entry, JIRA ticket creation for file delivering, bugs/defects, maintenance, and undeliverable mail from providers. Paper Gap, Remote CDI and EMR. Ad-hoc.
Blue Cross Blue Shield of MichiganBusiness Analyst
Aug. 2015 - Jan. 2017Greater Detroit AreaMy daily responsibilities are database management health care provide management of issues and inquiries and migration from various vendor metrics, reporting and storage. I provide guidance, assistance, coordination and follow-up on complex risk adjustment service operations problems and ensures resolution. I assists customers on their migration to new or revised products, applications and platforms while meeting business deadlines for multiple projects and initiatives. I’ve worked with Access, Outlook PowerPoint and Excel to SQL applications as well.
Blue Cross Blue Shield of MichiganSr. Analyst
Aug. 2015 - Dec. 2016Greater Detroit AreaComprehensive database management,provide guidance, assistance, coordination and follow-up on complex risk adjustment service operations problems and ensures resolution. Provider inquiry management. Provider issues Medicare Advantage Risk-Adjustment issues. Reporting vendor metrics statstics and retrieval forecast to leadership. Retrospective projects and commercial projects. in conjunction with Blue Care Network as well.
Summit Health, Inc.Data Coordinator
Sep. 2013 - Aug. 2015Novi, MichiganDatabase management,organizing flu and health screening data.Clean and analyze participant data files for flu and wellness events. Record-keeping for various Clients such as Cigna, Sam's Club, Lowe's and so forth. Troubleshooting and problem solving. Fast processing and turn around dates. Data Mining, daily use of Microsoft Excel and its peripherals. Knowledge of systems SQL SAAS applications Utilize problem solving skills to identify and resolve issues pertaining to non-matching participant records.
MetLifeClaims Analyst
Jan. 2012 - Aug. 2013Southfield MichiganI troubleshoot, scrubbed and data mine unclaimed life insurance policies. My responsibilities were to determine policy eligibility for deceased employees for clients, locate and investigate beneficiaries to contact, Processing up at peak time, up to 200-300 records in a three day period. Determine payouts for the insured that qualified and maintaining data for client companies. I am well versed in editing SQL applications. Building Microsoft Excel spreadsheets to work out of and document for recordkeeping, and HIPAA law
Kaplan Test PrepProctor
Nov. 2010 - Nov. 2011Greater Detroit AreaACT/SAT and workshop programs for high school students. Focused on educating parents and students on proper test-taking skills, what colleges look for and services provided to aide.signing up tutoring and practice test workshops.
Money Co USATax Preparer/Manager
Dec. 2008 - Apr. 2011Prepared tax returns for small businesses, individuals and property owners. Supervised over my branch and provided customer service
J. Alexander's RestaurantsServer
Aug. 2007 - Dec. 2007Worked at a highly popular eatery which serves popular American cuisine. Had regular customers and networked with popular local businessmen and entertainers. Cleaned tables, served food, kept up customer service, helped out fellow worked with customer workload. Obtained a wide knowledge of food, service and wine skills because the Information was required to be a stellar server.
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