Brandy Payne
SPRINGFIELD,IL
Summary
Dynamic Management Operations Analyst with over 12 years of experience navigating the complexities of government programs and ensuring compliance with regulatory standards, including Rule 132. Proven track record of enhancing operational efficiency and driving process improvements while maintaining a strong focus on compliance and organizational integrity. Recognized for exceptional organizational and communication skills that facilitate effective collaboration across diverse teams and stakeholders. Committed to leveraging expertise to deliver impactful solutions aligned with organizational goals.
Overview
13
13
years of professional experience
Work History
Management Operations Analyst II
State of Illinois
Springfield, Illinois
11.2020 - Current
- Engage with existing and prospective Community Mental Health Centers (CMHC) to develop strong alliances, facilitating comprehensive community support.
- Advise and support prospective CMHC providers in navigating application requirements and documentation.
- Conduct thorough reviews of prospective CMHC provider applications, focusing on compliance criteria.
- Assist CMHC providers in maintaining precise impact enrollment data to enhance service delivery.
- Engaged with multiple intergovernmental agencies to ensure efficient and timely approvals for CMHC sites.
- Designed and managed detailed provider workflows and checklists, facilitating streamlined processes and improved compliance.
- Designed and optimized internal workflows to enhance operational efficiency.
- Administers multiple databases to ensure data integrity and accuracy.
- Facilitates collaboration with contracted Administrative Service Organization (ASO) to maintain precision and reliability in data management processes.
- Engage with diverse teams to design and implement a comprehensive provider database for enhanced operational efficiency.
- Coordinates efforts with cross-functional teams to create an onsite review application, optimizing the efficiency of the approval process.
NASM Certified Personal Trainer
Fitclub
Springfield, Illinois
10.2021 - Current
- Monitored and renewed AFAA GFI and NASM CPT certification to demonstrate commitment to ongoing professional development in fitness training.
- Maintains CPR/AED certification to ensure readiness for emergency situations.
- Coordinated and delivered dynamic group personal training and fitness classes, fostering a supportive community atmosphere.
- Fostered an inclusive environment for diverse skill levels, enhancing accessibility in group fitness classes.
- Adapted classes to meet needs of participants with varying fitness levels.
- Demonstrated modified routines with regressions and progressions to meet diverse fitness levels.
- Managed group fitness classes of up to 12 members.
- Continuously updated personal knowledge of industry trends and best practices
Management Operations Analyst I
State of Illinois
Springfield, Illinois
09.2019 - 10.2020
- Facilitated user acceptance testing for integrated eligibility system (IES), identifying issues and ensuring alignment with user expectations.
- Reviewed and interpreted eligibility requirements for various social safety net programs to ensure compliance and accessibility.
- Analyzed incoming tickets to verify and confirm defect occurrences.
- Formulated a detailed template for validity reviews, guaranteeing complete coverage of necessary criteria.
- Facilitated cross-team collaboration to streamline testing coordination.
- Led group efforts in release testing to ensure quality and functionality.
- Conducted comprehensive training for new hires to enhance proficiency in ticket review procedures.
Disability Claims Adjudicator
State of Illinois
Springfield, IL
07.2014 - 08.2019
- Reviewed and interpreted documentation for Title II and Title XVI disability applications, providing informed decisions on eligibility.
- Analyzed claimant medical records to support accurate decision-making in claims processing.
- Facilitated ordering of consultative exams to ensure comprehensive patient evaluations.
- Collaborated with agency doctors to conduct comprehensive physical and mental residual functional capacity assessments.
- Evaluated claimants' previous work experience to determine eligibility for benefits.
- Reviewed detailed claimant and third party statements describing activities of daily living for thorough case documentation.
- Engaged with claimants, providers, and legal representatives to ensure timely retrieval of necessary medical records.
- Addressed claimant inquiries regarding program details and eligibility.
- Engaged in ongoing training to ensure compliance with updated rules and regulations.
- Collaborated with SSA field offices to resolve questions concerning claimants' work situations.
Customer Services Representative
The Results Companies
Streator, IL
09.2013 - 07.2014
- Assisted WellCare dual-eligible members and Kentucky Medicaid members by addressing inquiries and resolving issues effectively.
- Elevated customer satisfaction by proactively resolving concerns and delivering precise information.
- Applied active listening techniques to build rapport and address customer needs effectively.
- Managed counter order processing for members with applicable benefits.
- Facilitated member access to in-network providers within local areas.
- Engaged in ongoing training to ensure alignment with updated plan protocols.
- Ensured compliance with quality and adherence standards across all processes.
- Addressed customer complaints empathetically, fostering loyalty and repeat business.
Education
Master of Health Administration - Health Administration
St. Louis University
St. Louis, Missouri05-2013
Bachelor of Science - Psychology
Bradley University
Peoria, Illinois05-2011
Skills
- Client and Provider support
- Effective time management
- Strong verbal and written communication abilities
- Microsoft Office proficiency
- Medicaid compliance expertise
- Eligibility Eligibility System (IES)
- Illinois Medicaid Program Advanced Cloud Technology System (IMPACT)
- Rule 132 regulatory compliance expertise
- Fitness coaching
- Operational analysis
- Strong organizational abilities
- Team-oriented project participation
- Attention to detail
- Problem-solving abilities
- Dependable
- Adaptability
Timeline
NASM Certified Personal Trainer
Fitclub
10.2021 - Current
Management Operations Analyst II
State of Illinois
11.2020 - Current
Management Operations Analyst I
State of Illinois
09.2019 - 10.2020
Disability Claims Adjudicator
State of Illinois
07.2014 - 08.2019
Customer Services Representative
The Results Companies
09.2013 - 07.2014
Master of Health Administration - Health Administration
St. Louis University
Bachelor of Science - Psychology
Bradley University