Debora A. Hennessy
Seymour,USA
Summary
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level [Job Title] position. Ready to help team achieve company goals.
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
31
31
years of professional experience
Work History
AVP of Operations
Griffin Faculty Physicians, Inc.
01.2013 - Current
- Business partner to the VP of the Physician Group
- Developed annual budgets and analytics for monthly financial performance versus budget
- Identified opportunities for improvement and implemented action plans
- Responsible for the Revenue Cycle, Systems Team, Contracting, Provider Credentialling and Reporting
- Own and deliver advancements in quality, content, and efficiency, including monthly financials and key metrics to CEO, CFO and Finance Committee
- Develop annual budgets, long-range strategic and short-range plans for the practice of 25 cost centers
- Manage revenue cycle including credentialling, coding, billing and collection activities
- Reduced days in accounts receivable from 30 days to 23 days while decreasing accounts over 90 days from 18% to below 10%
- Maintained these levels of performance while experiencing a 438% growth over time in total accounts receivable
- Maintain and review charge master, payer contracts and allowable schedules
- Manage Staff of fourteen that support practice operations including Systems Analysts, Business Analysts, Operations Coordinator, Coders and Billers
- Manage payer contract negotiations that resulted in successful multi-year contracts with an average of 3-4% increase per year
- Evaluate, prepare and submit monthly compensation measurement for physician productivity, quality and special incentive payments
- Serve as point of contact for senior management, financial leadership, and local colleagues for report creation, execution, and alignment of reporting process across practices, decreasing lead time for requests
- Analyze downstream revenue and referral patterns, and develop strategies to minimize leakage from network including working with physicians, hospital leaders, managers and office staff
- Create financial reporting, including Ad-hoc analysis to key stakeholders, including provider productivity and quality dashboards, MIPS, patient satisfaction surveys, front end office performance, ACO, etc
- Subject matter expert for advanced payment models to ensure accountability for incentive payments
- Manage central resources for the practice including the Electronic Medical Record and related systems
- Support practice acquisitions, including system integration, onboarding and credentialing of physicians, new providers and staff EMR training
Manager, Health Data Reporting
Health Net of the Northeast, Inc.
01.1996 - 07.2011
- Partnered with VP of Health Data Reporting (HDR) responsible for the development of analytical models and advanced statistical analytics in the Health Care Economics Unit
- Managed the production and testing of standard and ad-hoc reports related to utilization and financial reporting for the Northeast business unit encompassing CT, NY and NJ
- Responsible for development and integration of system solutions for the reporting needs of the stakeholders
- Key responsibilities included evaluating utilization experience and identifying areas for further review
- Led management analysis including investigation and evaluation of utilization/cost patterns related to inpatient, outpatient and physician claims
- Directed, developed and coached team of Reserve Analysts in preparation of monthly lag tables (reserves) and hospital statistics, including bed day calculations for distribution to senior management
- Coordinated, trained and managed staff in data mining/analysis using various querying tools, such as Business Objects, IQ and Access Database creation
- Effectively managed multiple projects while providing leadership to staff
- Finance liaison for Health Net One MC400 conversions including the migration to the new data warehouse and Valutech
Health Economist – Lead System Design
Health Net of the Northeast, Inc.
01.1996 - 07.2011
- Maintained production and testing of standard and ad hoc reports related to utilization and financial cost reporting
- Developed analytical models and querying tools to assist in advanced statistical analysis to provide business partners with key information and recommendations
- Designed processes and documentation for system testing and report validation
- Developed and coordinated reporting activities to ensure data analytics were accurate in identifying and measuring utilization and cost trends
Manager, Service Center Systems Support
Health Net of the Northeast, Inc.
01.1996 - 07.2011
- Led team responsible for claims reporting, call center reporting and scheduling
- Reporting to the Director of Service System Support in the Operations Department
- Oversaw reporting and design of analytics for the Operations Executive Management Team
- Utilized multiple database tools to extract claims data to meet the needs of all senior management
- Designed and implemented queries for claims reporting including identifying trends
- Drove initiatives, improving visibility to internal and external customers with reliable and accurate claims and customer service data that has been tested and validated
- Supported the process and reporting requirements of JCAHO, HIPPA, and HEDIS in relation to Service Operations
- Assessed operational data (Calls/Claims) to generate forecasting and optimize staffing requirements to facilitate performance standards
- Assessed data to initiate and implement process changes and improve service levels
- Responsible for recruitment, training, coaching, and development of staff
Customer Relations / Claims
PRO Behavioral Health
11.1995 - 10.1996
Client Services Representative
M.D. Health Plan Inc.
04.1995 - 10.1995
Benefit Services Representative
M.D. Health Plan Inc.
09.1993 - 04.1995
Education
Master of Science - Organizational Leadership
Quinnipiac University
North Haven, CT05.2019
B.S. - Public Health
Southern Connecticut State University
New Haven, CT01.2001
Skills
- Results Driven
- Critical Thinking
- Data Analytics
- Budgeting
- Forecasting
- Strategic Planning
- Team Leadership & Development
- Systems
- Microsoft Office
- Business Objects
- MC-400 Interactive Query
- Macess
- Aspect Report Writer
- TCS
- ACL
- Athena
- Expanse
- Reporting and data gathering
- Warehouse management
- Complex Problem-solving
- Professionalism and integrity
Additional Relevant Experience
- Interim Supervisor Service and System Support, 08/00, 09/00
- Analyst, Service and System Support, 11/98, 08/00
- Reinsurance/Reporting Coordinator – Special Accounts, 04/97, 11/98
- Individual Billing Representative - Government Programs, 10/96, 04/97
Timeline
AVP of Operations
Griffin Faculty Physicians, Inc.
01.2013 - Current
Manager, Health Data Reporting
Health Net of the Northeast, Inc.
01.1996 - 07.2011
Health Economist – Lead System Design
Health Net of the Northeast, Inc.
01.1996 - 07.2011
Manager, Service Center Systems Support
Health Net of the Northeast, Inc.
01.1996 - 07.2011
Customer Relations / Claims
PRO Behavioral Health
11.1995 - 10.1996
Client Services Representative
M.D. Health Plan Inc.
04.1995 - 10.1995
Benefit Services Representative
M.D. Health Plan Inc.
09.1993 - 04.1995
B.S. - Public Health
Southern Connecticut State University
Master of Science - Organizational Leadership
Quinnipiac University
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