Carolyn Noah
Smyrna,TN
Summary
Operations Manager with a strong focus on compliance auditing and workflow optimization. Demonstrated success in enhancing operational effectiveness and implementing strategies that drive performance improvements. Committed to ensuring adherence to CMS and Medicaid requirements for organizational success.
Overview
12
12
years of professional experience
Work History
Operations Manager
HCSC
09.2022 - Current
- Conduct compliance audits to ensure adherence to regulatory standards.
- Collaborate with cross-functional teams to address compliance issues effectively.
- Review internal reports for accuracy and regulatory alignment daily.
- Assist with Universe scrubbing for internal mock auditing.
- Created plans to improve and correct operations to stay compliant.
- Monitor and report on compliance metrics and performance indicators.
- Monitor internal processes to ensure compliance with applicable rules and regulations.
- Work closely with the Compliance team and the Stars team.
Senior Supervisor
CIGNA Healthcare/HCSC
05.2021 - 09.2022
- Monitored productivity and performance standards to optimize workflow efficiency.
- Oversaw production volume, ensuring adherence to service standards.
- Conducted hiring, training, and evaluations to uphold staff quality.
- Collaborated with upper management on policies, procedures, and strategic initiatives.
Appeals Team Lead
CIGNA Healthcare/HCSC
10.2020 - 05.2021
- Monitored workload to assign tasks based on priority and capacity.
- Assisted reviewers in managing appeals by addressing inquiries and facilitating case processing.
- Tracked case reports for timeliness, following up with reviewers to ensure deadlines were met.
Nurse Case Coordinator
Cigna Healthcare/HCSC
04.2013 - 11.2020
- Monitored workload and efficiently assigned cases to enhance team performance.
- Filled in for the supervisor during their leave, maintaining seamless operations.
- Ensured timely completion of assigned tasks to meet organizational goals.
- Collaborated with medical directors on critical decisions and inquiries.
- Conducted pre-certification and concurrent reviews per Medicare guidelines.
- Consulted with peer reviewers and medical directors to ensure quality care.
- Communicated effectively with IPA providers' offices to support healthcare delivery.
- Fostered team morale to boost productivity and engagement.
Education
MASTERS - Business Administration with a focus on Healthcare
COLUMBIA SOUTHERN UNIVERSITY
Orange Beach, AL07.2022
BACHELORS - Healthcare Administration
COLUMBIA SOUTHERN UNIVERSITY
Orange Beach, AL12.2021
Skills
- Effective communication
- Compliance auditing
- Workflow assessment
- Critical thinking
- Conflict resolution
- Leadership and team support
- Time management
- Prioritization skills
- Workload management
- Problem-solving expertise
References
References available upon request.
Timeline
Operations Manager
HCSC
09.2022 - Current
Senior Supervisor
CIGNA Healthcare/HCSC
05.2021 - 09.2022
Appeals Team Lead
CIGNA Healthcare/HCSC
10.2020 - 05.2021
Nurse Case Coordinator
Cigna Healthcare/HCSC
04.2013 - 11.2020
MASTERS - Business Administration with a focus on Healthcare
COLUMBIA SOUTHERN UNIVERSITY
BACHELORS - Healthcare Administration
COLUMBIA SOUTHERN UNIVERSITY
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