ANDREA M. SVANDA

Organized Operations Lead with years of experience guiding crucial systems and workforce effectiveness measures. Detailed approach to planning and maintaining operations, recommending change and overseeing day-to-day employee coordination and communication. Resourceful knowledge of intricate government and company mandates to maintain work environment safety and efficiency. Choreographs all aspects of operations and planning. Organized Operations Lead with more than [Number] years of experience guiding crucial systems and workforce effectiveness measures. Detailed approach to planning and maintaining operations, recommending change and overseeing day-to-day employee coordination and communication. Resourceful knowledge of intricate government and company mandates to maintain work environment safety and efficiently. Choreographs all aspects of operations and planning. Strong independent judgment and critical thinking abilities.

Lead Core Ops - Claims  April 2021- PRESENT, 

Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation., Monitors and controls backlog and workflow of claims., Ensures that claims are settled in a timely fashion and in accordance with cost control standards.

• Coordinates workflow and staffing of day-to-day activities as well as assigns and monitors work of staff in order to adhere to productivity and quality standards.
• Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
• Perform daily troubleshooting procedures to support enrollment, disenrollments, claims, and claims support functions as needed.
• Participates in or leads quality improvement efforts to improve claims processes and/or policies.
• Serve as subject matter expert and provide feedback to team personnel and provide training as needed.

Demonstrates personal responsibility and accountability and leads by example through individual performance. I am routinely lead on the Sales Force call for the marketplace team. Inventory control for both Sales force and Examiner’s personal queues, along with Super inventory reports. Assists in the direct training and success of new staff.  I have recently headed the End of the Month claim maintenance. 

Confident, articulate, and professional speaking abilities (and experience)

Communicating with Health plan.

• Collaborated with Marketplace claim leadership to present in KPI’s.

Communication and demonstrations with external departments including vendors.

• Lead for Marketplace on FS calls. Built a strong rapport with FS leadership to provide support for escalated claims processing.

Written communications.

• Email escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.

• Introduction to Business Analytics (top Skills covered)
• Communicating with Confidence By: Jeff Ansell
• Communicating with Emotional Intelligence By: Brenda Bailey- Hughes
• Leadership Communication in the Flow of Work By: Molly Tschang
• The Three Pillars of Effective Communication By Knowable
• Active Listening: The Secret to Effective Communication By: Knowable
• Mental Health Capacity 1 By: PsychHub LLC