Angela Ray
Caldwell,ID
Summary
Versatile healthcare leader with a strong foundation in revenue cycle management and client service. Skilled in strategic planning, quality management, and cross-functional collaboration, committed to fostering innovation and operational improvements that enhance patient and member experiences.
Overview
1
1
Certification
14
14
years of professional experience
Work History
Client Service Account Executive
Optum
Los Angeles, California
03.2025 - 06.2026
- Managed client accounts to ensure satisfaction and retention.
- Developed strategic plans to enhance client engagement and service delivery.
- Facilitated communication between clients and internal teams for issue resolution.
- Resolved customer complaints regarding sales and service.
- Made frequent calls and visits to build and strengthen client relationships.
- Collaborated with cross-functional teams to implement new service initiatives.
- Trained junior team members on best practices in client service protocols.
- Managed multiple projects simultaneously while adhering to tight deadlines.
- Reported complex client issues, questions and needs to management.
Denial Specialist
Optum
Los Angeles, California
03.2024 - 03.2025
- Conducted detailed research on complex denial cases to determine the root cause and appropriate appeal strategy.
- Analyzed denial claims to identify trends and root causes.
- Utilized critical thinking skills to evaluate denial patterns and recommend process improvements.
- Monitored trends in claim denials to identify opportunities for process improvement and training.
- Communicated clearly with internal teams regarding denial processes.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Assisted in the development of policies and procedures related to denial management.
- Organized information by using spreadsheets, databases or word processing applications.
Senior Financial Analyst
Idaho Department of Health & Welfare
03.2023 - 03.2024
- Analyzed fiscal impacts of provider settlements for strategic decisions.
- Negotiated Single Case Agreements (SCA/LOA) to align provider settlements with organizational goals.
- Contributed to CMS SPA and policy initiatives through active participation in project teams.
- Hospital UPL & DSH Review and Management
- Submitted CMS documentation for MACFIN compliance requirements.
- Analytical Research and Process Improvement
Foster parent
State of Washington
07.2022 - 03.2023
- Collaborated with social workers, case aides, and community-based providers to enhance children's health, behavior, and academic performance.
- Cared for three children, addressing their developmental needs to foster growth and stability.
- Tutored and mentored children while overseeing parental visits to support family reunification.
- Successful reunification with biological parents
Associate Director of Quality Assurance
Optum360
01.2019 - 01.2022
- Expanded quality program to multiple new Optum clients, enhancing service delivery and client satisfaction
- Established Quality Improvement Committee to reduce defects, facilitate learning, and improve cash flow and compliance adherence
- Operational Root cause analysis – Denials and connection to Quality defects
- Created comprehensive training and quality assurance frameworks to support departmental functions for most departments in the revenue cycle (HIM, Patient Access, Billing, Collections, Denials, Payer Relations, Cash Posting & Account Reconciliation, Revenue Integrity, and Customer Service)
- Project Management of multiple, simultaneous initiatives to develop Training, Content Management, Process Documentation, and Quality programs.
- Achieved budget reduction through strategic offshoring and effective management of onshore attrition
- Servant leadership provided to global and domestic team of 150+
- Interim Director of Operations Vendor Management while continuing current job duties
Senior Quality Assurance Manager
Optum360
01.2018 - 01.2019
- Achieved 75% reduction in rebuttal rate.
- Executed strategic business planning and implementation, resulting in over 20% reduction in overall department costs.
- Developed systems to track rebuttal trends based on customer feedback.
Senior Quality Assurance Analyst
Optum360
01.2016 - 01.2018
- Led QA and training build for large new client, ensuring alignment with quality standards
- Developed and implemented vendor quality assurance program, improving service delivery standards.
- Developed and delivered acute insurance contract training, improving staff competency
Quality Assurance Analyst
Optum360
01.2013 - 01.2016
- Designed, built, and implemented quality defect codes to improve trend analysis and reporting.
- Led offshore quality transition, delivering results during project phases through effective trending and action planning.
- Designed onboarding plan and facilitated training for 50+ quality analysts, enhancing their integration and effectiveness.
Arizona Medicaid (AHCCCS) Collector
Optum360
01.2012 - 01.2013
- Managed state Medicaid collections for AZ, NV, CA, and OOS, ensuring compliance and accuracy in revenue recovery.
- Exercised collections strategy to enhance production and collection rate, contributing to overall departmental performance.
- Identified and implemented process improvements within Collections Department to streamline operations and enhance effectiveness.
Education
Master of Healthcare Administration -
Capella University
Minneapolis, MN01-2022
Bachelor of Social Science -
University of Nevada, Las Vegas
Las Vegas, NV01-2010
Skills
- Managed care contracts
- Client relationship management
- Medicare and Medicaid
- Denial resolution
- Reimbursement calculations
- Compliance and quality management
- Intermediate Excel proficiency
- Microsoft Word skills
- Learning management
- Epic software knowledge
- Meditech experience
- Claims management knowledge
- Project management
- Quality assurance development
- Organization
- Time management
- Process documentation writing
- Training facilitation
- Analytical review
- Written and verbal communication
- Training and coaching
- Employee development
- Presentation skills
- Team building
- Client-focused leadership
- Inclusion and diversity advocacy
- Change management
- Resource planning
Certification
Project Management Institute, Project Management Professional
Timeline
Client Service Account Executive
Optum
03.2025 - 06.2026
Denial Specialist
Optum
03.2024 - 03.2025
Senior Financial Analyst
Idaho Department of Health & Welfare
03.2023 - 03.2024
Foster parent
State of Washington
07.2022 - 03.2023
Associate Director of Quality Assurance
Optum360
01.2019 - 01.2022
Senior Quality Assurance Manager
Optum360
01.2018 - 01.2019
Senior Quality Assurance Analyst
Optum360
01.2016 - 01.2018
Quality Assurance Analyst
Optum360
01.2013 - 01.2016
Arizona Medicaid (AHCCCS) Collector
Optum360
01.2012 - 01.2013
Master of Healthcare Administration -
Capella University
Bachelor of Social Science -
University of Nevada, Las Vegas