PROFESSIONAL SUMMARY:

• Excellent communication skills; including the demonstrated ability to act as a facilitator between clients and technology experts
• Strong ability to research and apply solutions that leverage new processes and technologies
• Demonstrated ability to review functional requirements and provide consultation on highly complex or broad business processes issues especially in the healthcare industry
• Strong critical thinking and aptitude for identifying and solving operational problems and deficiencies
• Proven ability to work efficiently under pressure and tight deadlines
• Demonstrated ability to effectively handle confidential information and matters
• Provider Data Management Expert (5+years)

TECHNICAL SKILLS:

• MS Office Suite 2007 - 2011, HP Quality Center, DWS, OMS, Cactus, SharePoint, IDX, Kronos, Macess Citrix, Citrix: Sage, PeopleSoft, G&E Centricity, SPSS, Final Cut Pro, QNXT, CEMS,K2 Workflow Administration, Salesforce, Exmedius
• Exceptional in MS Office Suite 2007-2011(Expert in Excel, Visio, Project, Access, PowerPoint, Word, and Outlook) SharePoint, FileNet, Jira, SFTP Management, QNXT, Cactus, E-Fax, IDX, SPSS, Citrix: Sage, Kronos, PeopleSoft, Adobe, Eplan, Primavera

PROFESSIONAL EXPERIENCE:

Confidential, Long Beach, CA

Network Management Program Manager

Responsibilities:

• Verio Healthcare vendor onboarding & implementation (Durable Medical Equipment Vendor)
• Gaine Solutions vendor onboarding & implementation (Provider Data Management)
• Better Doctor vendor onboarding (Provider Data Management)
• SB 137 Implementation
• Program Manager of the Provider Roster Attestation Process
• Provider Directory Redesign
• Implemented a new Letter of Agreement(LOA) Database and Auto - generated (LOA) template
• Standardized and Improved the Provider Data update and change process
• Lead the DOFR Redesign project
• Created more than twenty end-to-end operational process flowcharts using MS Visio

Confidential, Orange, CA

Project Manager

Responsibilities:

• Lead all project management efforts for the Community Network Project
• Created a process flow and training material for the Alternative Language Request process
• Built a transparent Issue Tracking Log for all Operational Departments
• Updated and managed the departmental SharePoint site for the PMO
• Created a PPT presentation that explained the role and functions of the PMO to new employees
• Constructed a transition/coordination of care checklist to be used in case of a provider termination

Confidential, Glendale, CA

Operations Analyst / Project Manager

Responsibilities:

• Documented the As-Is and To-Be National Ad processes using MS Visio
• Created operational workaround processes for Digital Express products using MS Visio
• Documented all the cycle times and database interactions of the systems involved in the National Ad Process
• Provided process improvement recommendations using Six Sigma using DMAIC methodology
• Identified process pain points and outlined mitigation plans
• Collaborated with various Operational Managers to identify possible solutions for current operational issues

Confidential, Los Angeles, CA

Project Manager

Responsibilities:

• Led and coordinated the PS3 RVU and Genie Go 2 Beta efforts
• Created a checklist that captured all steps in order to successfully execute a Beta from end to end
• Created fact sheets for the RC-71B, new remote control, and Order History Page Projects
• Created an As-is and To-be Deck to dictate the changes being made to the OMS and DWS History Pages
• Documented all business requirements relating to the Order History Page subproject within the Order Modification project
• Analyzed and documented the current pricing and offers for Advanced Products 
• Created test plans and test scripts for the Wireless Genie National Launch
• Recorded Project time in Eplan
• Setup and managed the SharePoint site for the Order Modification Project
• Created and managed several projects sites on CORE in order to make project status quickly identifiable to stakeholders
• Produced weekly dashboards and status reports for multiple projects

Confidential, Long Beach, CA

Business Analyst /Project Manager

Responsibilities:

• Worked with claims production and encounter data to determine requirements for data, reports, and analytics
• Analyzed and reported on possible claims process improvements and strategy matters
• Conducted JAD sessions to gather requirements for Phase II of the Claims and Encounters Management System (CEMS) Enhancement Project
• Created a project roadmap for the Encounter Redesign Project, a two-year project, using MS Visio; that project roadmap became a template for other projects
• Documented all business and functional requirements for CEMS Enhancements, New Business Encounter Implementation and HIPPA Rejection Reports Projects
• Created tests plans and test scripts for a sub project Encounter Redesign Phase II Project
• Updated and edited project charter on the PDMP project
• Conducted User Acceptance Testing (UAT) and documented testing results of over 300 enhancements made to the Claims and Encounters Management System (CEMS)
• Educated 50+ end-users of the new enhancements made to the CEMS II application
• Created and maintained weekly project status and capacity planning reports
• Documented a complete list of required artifacts and processes needed to set up the encounter system for a new acquired Health Plan
• Served as either a Project Manager or Business Analyst on seven projects simultaneously.
• Managed and mentored two interns within the Projects and Initiatives Department
• Worked as a liaison between the National Contracting Team and the Configuration Team in order to bridge communication gaps and to track contract configuration requests
• Simultaneously managed the status on seven National Contracts for eleven states
• Defined the AS-IS process and constructed the TO-BE process in the K2 Workflow Transition (Technical Writing)
• Administrated the department SharePoint site; administrative duties include: Building new sub sites and document libraries, configuring new sub sites and document libraries, adding subfolders for new projects, and providing user access
• Produced weekly dashboards and status reports for multiple projects
• Facilitated a biweekly National Contracts meeting to discuss status updates, new contracts, issues, and concerns
• Updated action item and IRAAD lists for project managers
• Created agendas and recorded minutes for department, team, and project meetings
• Analyzed statistical data of past marketing campaigns to improve future marketing efforts

Confidential, Torrance, CA

Contract Coordinator II

Responsibilities:

• Prepared, printed, copied, organized and routed all provider contract routing forms and contracts per policies and procedures. Tracked provider contracts and set-up forms and announced contracts. Created contract folders, mailed and received contracts, and input provider data using Excel
• Consolidated provider data from a variety of internal and external sources; as well as, assisting the Director of Contracting in monitoring data integrity of data using IDX 
• Utilized Cactus and various web-based research to coordinate and regulate the credentialing status verification of provider contracts
• Validated and ensured that only credentialed providers are loaded in the contracting database
• Logged provider contract activity using internally developed software based on MS Access
• Served as an analyst on the paperless contracting project

Confidential, Los Angeles, CA

Accounting Assistant & Administrative Assistant

Responsibilities:

• Organized company cash receipts and reconciled company bank accounts using Sage: Citrix.
• Assisted in the preparation for yearend financial audits.
• Maintained and updated the records of fiscal transactions; posted payments and refunds received to the appropriate account or cost center
• Validated and balanced documents in relation to accounts payable and accounts receivables for vendors to correct errors; routed payment documents for approval and processing.
• Aided in the development of a new payroll process
• Performed basic accounting tasks using Sage: Citrix
• Assisted operations and file management under the Chief Financial Officer