Amanda Howze
Springfield,Illinois
Summary
Dedicated and detail-oriented professional with a proven track record in process compliance audits. Adept at ensuring accuracy, compliance, and consistency in operational activities against established procedures. Seeking a challenging position as a Quality review and Audit Analyst at Cigna Group where my extensive experience and skills in root cause analysis, trend monitoring, and process improvement can contribute to organizational success.
Overview
16
16
years of professional experience
Work History
Senior Quality Auditor
CVS Health
01.2022 - Current
- Conducted over 100 comprehensive process compliance audits, ensuring accuracy, compliance, and consistency in operational activities
- Specialized in call handling, email handling, and audit processing, resulting in a 15% reduction in errors
- Collaborated with the Quality Auditor Team Senior, Team Supervisor, Senior Supervisor, and Audit Team Manager to define and execute assignments, leading to a 10% increase in audit efficiency
- Conduct root cause analysis on audit findings, develop action plans, and prevent recurring discrepancies, reducing repeat findings by 25%
- Monitor performance trends, implement action plans, and identify improvements in audit and operational processes, improving overall efficiency by 20%
- Collate and report audit findings to Senior Management accurately and within specified timelines, maintaining a 98% on-time reporting record
- Act as a subject matter expert, providing support and coaching to fellow Auditors, contributing to a 15% improvement in team performance.
Data Analyst II
MULTIPLAN CORPORATION
Naperville, Illinois
03.2008 - 04.2021
- Developed operational reports for clients, using Excel and visual aids for value-based negotiation strategies
- Created and analyzed complex Excel models, resulting in a 50% increase in new business sales
- Identified process improvement opportunities, offering logical recommendations, including rate improvement strategies and fee schedule suggestions
- Served as a key point of contact for multiple projects, using Jira for effective workflow and communication
- Conducted user acceptance testing for a data modeling tool, reporting inaccuracies, and suggesting enhancements
- Generated Variance reports for customer service, sales, and senior management, effectively communicating complex concepts
- Analyzed large datasets to determine pricing strategies based on market, geography, provider specialty, and Medicare pricing standards
- Administered tailored training to improve internal processes and communication, collaborating with the development team on Healthcare Economics insights.
Senior Medicare Analyst
CVS Health
- Successfully conduct Case review audits and effectively communicate audit findings and trends, continuously exceeding quality metrics
- Mentor junior analysts, resulting in increased audit performance and positive rapport with junior analysts and senior management
- Selected to work on various advanced projects based on total performance metrics and excellent audit results, leading to decreased Medicare out-of-compliance cases, and improved overall audit results.
Education
Bachelor of Business Administration - Healthcare Management
American InterContinental University
Skills
- Microsoft Office
- Excel
- PowerPoint
- Dashboards
- SQL Queries
- Salesforce
- PivotTables
- Quality Assurance
- Process Compliance Audits
- Quality Control Processes
- Standards Compliance
- Root Cause Analysis
- Continuous Improvement
Investigation Leadership
- Performance Improvement
- Audit Process Coordination
- Process Implementation
- Compliance Standards
Professional Highlights
- Achieved a 15% improvement in audit performance metrics, surpassing the set quality standards.
- Led projects resulting in a 20% reduction in Medicare out-of-compliance cases.
- Improved overall audit results, contributing to a positive decrease in overall inventory.
Timeline
Senior Quality Auditor
CVS Health
01.2022 - Current
Data Analyst II
MULTIPLAN CORPORATION
03.2008 - 04.2021
Senior Medicare Analyst
CVS Health
Bachelor of Business Administration - Healthcare Management
American InterContinental University