Amanda S. Desrosiers
Longmeadow,MA
Summary
Experienced Eligibility Business Consultant specializing in eligibility configuration and data analysis. Led strategic migrations and improved consumer experiences through innovative solutions. Focused on collaboration and quality improvement to deliver impactful results.
Overview
19
19
years of professional experience
Work History
Eligibility Business Consultant
Optum
Hartford, CT
01.2015 - Current
- Managed delivery of complex eligibility cases for clients, ensuring alignment with intricate product requirements and organizational structures.
- Facilitated requirements discussions with clients and vendors to configure eligibility systems for various Optum products.
- Reviewed eligibility project results and prepared analyses and presentations to inform operational and business planning.
- Used research, data analysis, and business process review to develop solutions that improved consumer experience.
- Conducted peer reviews to ensure accuracy of team implementations.
- Supported strategic migration efforts from HC3 Facets environments to CIP platforms.
- Designed and configured Magellan mappings for custom file implementations.
- Interviewed internal management teams to learn and map end-to-end processes and data flows.
- Partnered with multiple teams to learn, implement, and use new processes and tools.
Senior Quality Analyst
Optum
Hartford, CT
10.2013 - 01.2015
- Executed end-to-end business process activities, including creation, control, and improvement of business processes for incentive insurance plans.
- Diagnosed process improvement opportunities and developed solutions to apply in future quality incentive controls
- Worked collaboratively with various senior leadership teams to determine steps to create optimal process and system improvements for incentive insurance plans
- Participated in Quality Improvement projects to elevate end-to-end quality assurance process for incentive insurance plans.
- Resolved complex issues in self-directed work environment to ensure operational efficiency.
- Designed Incentive In Force Product application reporting tool on SalesForce website to track new business additions, renewals and cancellations
- Developed a post implementation audit process for client incentive plans and presented audit findings across senior leadership
Senior Accountant
UnitedHealth Care
Hartford, CT
08.2011 - 10.2013
- Analyzed daily/monthly reports to identify funding deficiencies preventing UHC liability exposure
- Managed diverse employer group types across UHC segments to ensure compliance and operational efficiency
- Collaborated with senior leaders to streamline operational processes and enhance project deployment
- Fostered intersegment partnerships by collaborating across UHC, National Accounts, Small Business, Short-term Disability, and OptumHealth
- Assisted in migrating the daily process of charging and requesting claim reimbursements for over 1,000 OptumHealth employer groups onto the UHC Self Insured Funding System
- Provided superior customer service both with internal leaders and external customers
- Participated in system testing to successfully execute one of the largest projects ever deployed within the UHC Finance/Banking unit
Financial Analyst
UnitedHealth Care
10.2007 - 08.2011
- Managed self-funded banking process for 500+ national clients and 2000+ small business HRA clients throughout contract life cycle
- Lead the daily accounting, posting, and reporting for all small business HRA clientele within the UHC Banking unit
- Exceeded business segment deficiency goals for three consecutive years by reviewing benefit account activity and resolving funding issues to minimize UHC liability
- Presented the banking funding process of self-funded claims to executives, brokers, and internal UHC leadership
- Generated weekly and monthly ad hoc claim data reports to support decision-making and operational efficiency
- Recorded the monthly activity for small business HRA employer group accounts to ensure all manual charges were allocated to the proper general ledger accounts
Education
Master of Business Administration - Finance and Marketing
American International College
Springfield, MA10-2010
Bachelor of Science - Business Administration, Finance
American International College
Springfield, MA05-2006
Guest Relations Internship -
Walt Disney World
Orlando, FL08-2004
Skills
- Eligibility configuration
- Eligibility analysis
- Requirements gathering
- Process mapping
- Business analysis
- Data analysis
- System migration
Timeline
Eligibility Business Consultant
Optum
01.2015 - Current
Senior Quality Analyst
Optum
10.2013 - 01.2015
Senior Accountant
UnitedHealth Care
08.2011 - 10.2013
Financial Analyst
UnitedHealth Care
10.2007 - 08.2011
Master of Business Administration - Finance and Marketing
American International College
Bachelor of Science - Business Administration, Finance
American International College
Guest Relations Internship -
Walt Disney World