ANNISE MOON
Summary
Business operations leader who turns complex, high-volume workflows into accurate, scalable execution across regulated enterprises. Combines root-cause analysis, enterprise data reconciliation, requirements translation, and frontline leadership to resolve systemic issues before they create downstream risk. Identified a defect affecting approximately 200,000 member records and recommended a process correction that enabled approximately $2.7 million in recovery.
Overview
11
11
years of professional experience
Work History
Business Operations Analyst
CENTENE CORPORATION
02.2023 - Current
- Own end-to-end reconciliation of 200–2,000 member records daily, safeguarding eligibility, enrollment, provider, and demographic data across enterprise systems.
- Resolve approximately 200 discrepancies per day by analyzing reports, tracing root causes, and correcting records before issues affect members, providers, or claims processing.
- Isolated the root cause of a systemic defect affecting approximately 200,000 member records and recommended a revised process that enabled approximately $2.7M in recovery.
- Partner with leaders, business analysts, and IT to diagnose workflow failures, convert frontline findings into technical requirements, and improve system reliability.
- Earned promotion to Lead III and repeated Top 10 Performer recognition; selected to train and mentor 15–20 employees on systems, troubleshooting, and operating standards.
Behavioral Health Care Coordinator
HCA HEALTHCARE
09.2021 - 07.2022
- Managed approximately 200 calls per shift while advancing active cases, urgent placements, and time-sensitive stakeholder requests.
- Coordinated behavioral health placement and transportation from intake through completed transfer, maintaining accurate documentation and compliance.
- Evaluated clinical records, facility criteria, and insurance information to support accurate placement and authorization decisions.
- Aligned hospitals, behavioral health facilities, transportation vendors, and insurers to remove transfer barriers and preserve continuity of care.
- Trained new coordinators on case workflows, documentation standards, escalation practices, and placement procedures.
Eligibility & Family Services Specialist
EARLY LEARNING COALITION OF BROWARD COUNTY
10.2016 - 05.2021
- Managed 40–50 eligibility cases daily, validating documentation and applying state requirements to maintain accurate, timely determinations.
- Led complex ChildNet foster-care and homeless-family caseloads requiring sensitive coordination across families, providers, agencies, and community partners.
- Orchestrated multi-child family cases spanning multiple facilities, age groups, transportation needs, and extensive supporting documentation.
- Detected documentation discrepancies and potential fraud through detailed eligibility reviews, escalating issues and resolving gaps before approval.
- Recommended improvements to the Child Attestation Form and served as a trusted resource for complex cases, eligibility questions, and workflow guidance.
Operations Analyst
TEAMHEALTH
04.2015 - 10.2016
- Produced and quality-controlled operational reporting across six hospitals, validating admissions, discharges, length of stay, census activity, and utilization data.
- Investigated missing fields and reporting discrepancies across Meditech, Cerner, and Epic, improving data accuracy before leadership review.
- Maintained Excel trackers, dashboards, and reporting documentation used to monitor hospital activity and surface issues requiring investigation.
- Equipped weekly physician operational reviews with validated reporting insights and clear follow-up items for unresolved data issues.
- Resolved coworker reporting questions and workflow issues, strengthening consistency across hospital data collection and review processes.
Education
Bachelor of Applied Science - Supervision and Management
Broward College
Skills
- Business Operations
- Operational Excellence
- Process Improvement
- Root-Cause Analysis
- Workflow Optimization
- Business Process Analysis
- Data Reconciliation
- Enterprise Data Integrity
- Cross-Functional Leadership
- Stakeholder Management
- Requirements Translation
Executive Impact
- Enabled approximately $2.7M in recovery by isolating a systemic defect affecting approximately 200,000 member records and recommending a revised operating process.
- Promoted to Lead III, repeatedly recognized as a Top 10 Performer, and selected to train and mentor 15–20 employees.
- Delivered high-volume execution across regulated environments spanning 200–2,000 records daily, approximately 200 calls per shift, 40–50 cases daily, and six-hospital reporting operations.
Technology
Power BI, MicroStrategy, Microsoft Excel, SharePoint, MSIS (AMISIS), UMV, State Medicaid Portal, TrueCare Cloud, TrueCare Classic, Cypress Web, EDI, Control-M, Meditech, Cerner, Epic
Timeline
Business Operations Analyst
CENTENE CORPORATION
02.2023 - Current
Behavioral Health Care Coordinator
HCA HEALTHCARE
09.2021 - 07.2022
Eligibility & Family Services Specialist
EARLY LEARNING COALITION OF BROWARD COUNTY
10.2016 - 05.2021
Operations Analyst
TEAMHEALTH
04.2015 - 10.2016
Bachelor of Applied Science - Supervision and Management
Broward College