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Human Resources Manager Resume Profile

KEY STRENGTHS:

  • A good oral and written communicator with skills and patience to work with off-shore staff
  • An aggressive IT professional with excellent problem solving and research skills.
  • A self starter, team player who enjoys challenges and meeting deadlines early.
  • B/A Lead for Offshore Contractors.
  • Excellent oral and written communication and interpersonal skills. Ability to communicate effectively through a variety of media to individuals or groups in a manner that engages the audience and helps them to understand and retain the message.
  • Technical understanding of the federal certification and accreditation life safety and physical environment standards for hospitals, including OSHA, and CMS.
  • Interpret technical issues and provide recommendations to management.
  • Ability to organize and prioritize work to meet job demands.
  • Strong decision-making identifies and understands issues, problems and opportunities compares data from different sources to draw conclusions. Uses effective approaches for choosing a course of action or developing appropriate solution. Takes action that is consistent with available facts, constraints and probable consequences.
  • Ability to develop and use collaborative relationships among team and departments to facilitate the accomplishment of work goals.
  • Ability to supervisor/train for enhanced skill development.

Technical skills:

  • Platform SOFTWARE/SYSTEM
  • Mainframe Platform:
  • COBOL
  • TSO/JCL
  • MMIS Recipient
  • MMIS Provider
  • Edifecs Testing
  • MTV
  • BADGER
  • CAS
  • Medisoft
  • Web Platform:
  • BILLING/ENROLLMENT System:
  • Company Group Benefit setup, maintenance and Customer Service administration
  • Infra ES Operations
  • Enrollment Systems Dashboard
  • PC Software:
  • MS WORD
  • MS EXCEL
  • MS ACCESS
  • MS PowerPoint
  • MS Visio
  • XQMF SQL

PROFESSIONAL HISTORY:

Technical/Tester and Software Researcher

Confidential

  • Work with End-User to created and organized Memorandum of Understanding MOU in regards to testing and implementation accuracy.
  • Provide testing online screen completed by programmers.
  • Create test criteria to ensure online edits were working properly.
  • Document pass or fail results for sign-off or retesting.
  • Generate reports via batch Job submission for test results review.
  • Document batch and online problems found during testing.
  • Created documentation for out-of-scope changes found during testing.
  • Assisted providers with EDI transaction testing using EDIFECs.
  • Worked with BIZ-Talk developers to derive the applicable EDI transaction Companion Guide.
  • Worked on ICD-10CM and ICD-10 PCS development design based on overall concept.
  • Developed overlapping codes between ICD-9 and ICD-10 documentation.
  • Worked on backward and forward mapping strategies between ICD9 and ICD10 to be used by developers and testers.
  • Analyzed and test the MMIS Provider Enrollment/payment process.
  • Reviewed current system write-ups and new system rules to ensure that all areas were included and data discrepancies were known.
  • Created 4010 companion guides and data cross-walks required for the following X12 transactions: EDI: 820 834 837-I 837-D, 837-P.
  • Worked with the programming staff to reconcile required data fields and the compliance EDI X12 820 and 834 fields as well as required mainframe processing fields.
  • Created test results using SQL data retrieval using XQMF database.

Billing and Enrollment Specialist/Customer Service

Confidential

  • Implement and build web enrollment pages for groups who have contracted with Humana using a documented process.
  • Participated in conference calls with groups and Humana Associates to plan the group web implementation.
  • Perform testing of system enhancements to ensure all processes performed correctly.
  • Send correspondence to beneficiary pertaining to incomplete applications, capacity issues, selection choices and other discrepancies as needed.
  • Special assignments, investigations, and other duties as requested by management.
  • Responsible for ensuring that customers had a positive web experience when resolving customer errors.
  • Coordinate with multiple departments to resolve the errors as one of the top error resolution producers on the project.

Human Resources Manager

Confidential

  • Organize and prioritize work to meet job demands.
  • Maintain a good working relationship with peers, superiors and subordinates while working under stressful or emergency situations.
  • Supervised /train for enhanced skill development.
  • Prepare new hire documentation.
  • File proper documents
  • Provided aid to employees in matters involving their work performance
  • Prepared documents that evaluate each employee's performance.

Skilled Labor/Forklift Driver

Confidential

  • Responsible for making concrete an mortar for commercial and residential projects.
  • Building scaffold.
  • Setting up brick and cmu for masons.
  • Driving Forklift to distribute masonry materials to masons.
  • Ability to lift 75lbs or more.

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