Optum

Responsible for designing and implementing standard operating procedures, new processes, and training purposes for new hires.

•	Designed and implemented internal auditing processes to ensure compliance with Medicaid and business license regulations.
•	Pioneered the Case Review documentation process, streamlining research and knowledge sharing.
•	Developed comprehensive standard operating procedures (work instructions) to train current and future team members effectively.
•	Expertly managed daily volume, optimizing the distribution of specialty mail orders to enhance patient services.
•	Led backend system maintenance and effectively resolved escalated issues, ensuring minimal order disruptions.
•	Analyzed diverse data sources to extract meaningful metrics, presenting insights to product owners.
•	Navigated complex scenarios to derive insightful solutions and facilitated timely decision-making.
•	Documented best practices and monitored data, ensuring alignment with stakeholders and fostering continuous improvement.

Sr.Business Analyst, Business Innovation and Operations Support 

Volunteer for free to assist candidates searching for employment with resume building, by helping them navigate through the hostile job market. 

•	Work together with candidates to understand their talents, goals to navigate, and transition existing skills to similar or too different career paths.

Resume writer, career builder

Accredo - An Express Scripts Company

Designed and implemented standard operating procedures for training purposes for new hires.

•	Conducted in-depth data analysis, providing actionable insights to product owners.
•	Collaborated across multiple data sources to identify and define critical metrics for the Reliability team.
•	Documented and shared best practices, ensuring organizational alignment and performance improvement.
•	Effectively communicated critical issues, trends, and root causes to organizational stakeholders.

Business Operations Analyst

Identified root cause analysis and closed processing gaps by working with operational leadership to develop appropriate mitigation.

•	Led root cause analysis efforts, closing processing gaps and ensuring operational efficiency.
•	Collaborated with internal teams to meet new requirements and implement streamlined processes.
•	Monitored and reported work progress, aging, and critical metrics, facilitating issue resolution.
•	Oversaw program operations, including billing, prescription fulfillment, and authorizations.

Program Manager Pharma support 

Identified gaps in the workflow to help redesign the order classification system and Drove root cause analysis and trending related to client’s and patient’s accounts

•	Spearheaded a workflow redesign, resulting in a 20% reduction in turnaround time.
•	Provided data-driven coaching to the team, improving daily metrics and reducing turnaround time.
•	Identified areas for service improvement through root cause analysis.
•	Resolved client's benefits setup issues, prior authorizations, and patient concerns, achieving a 0% missed commitment rate.

Provider Relations- Emerging Leader

Coaching, mentoring, and creating job aids for proactively working with rejected adjudicated claims.

•	Created a job aid to train Ship Clearance Representatives in understanding adjudication and claim processing.
•	Implemented a new process called pre-work (work ahead); it was replicated in the department, creating a new team to reduce missed comments.
•	Trained the team on early adjudication, removing the downstream upstream, resulting in a 45% turnaround time and increased patient satisfaction rate of an average of 98% to 100%.

Claims Processing Team Lead         

Implemented new a concept throughout the organization. Led a unique cross-functional team using incubation methodology to expedite escalated orders to fulfillment; this was replicated throughout the organization.

•	Reduced missed commitments to less than 2% weekly, saving costs and optimizing workflows.
•	Led a cross-functional team to address process gaps, resulting in improved claims processing and Fulfillment process.
•	Audited client's contract for the discrepancy and exposed an estimated $1.5M cost of savings owed to Accredo.

Business Analyst Team Lead                                                                          

Proven Business Analyst | Pharma support | Helping Companies Translate Their Business Goals to Reality.

Dynamic Collaborative leader, in identifying the root causes in issues to converting complex scenarios, processes into effortless and actionable steps for operations.

Effective coach, and mentor with demonstrated successes in directing cross-functional teams to make the most of learning opportunities to maintain organizational standards, quality, and performance that make an impact on business goals. Client-focused, training professional offering expertise in planning and developing learning experiences for a wide range of employees, determining scope and deliverables with required resources and timing for new initiatives.





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