DIAMOND ELLIOTT
Summary
Healthcare operations professional with 5+ years of experience in Medicaid/Medicare managed care environments. Skilled in regulatory compliance support, audit readiness, risk identification, corrective action tracking, and cross-functional healthcare operations. Experienced in analyzing healthcare data, documenting processes, and supporting compliance reporting and performance monitoring.
Overview
6
6
years of professional experience
Work History
Business Systems Analyst (Implementation Operations)
UnitedHealth Group
MN
06.2022 - 01.2026
- Support Medicaid/Medicare healthcare operations ensuring alignment with regulatory and contractual requirements.
- Facilitated audit readiness through documentation collection and operational process validation.
- Collaborate with Medicaid operations, clinical, and compliance teams on workflow improvements.
- Support corrective action planning through root cause analysis and issue tracking.
- Develop KPI dashboards and operational performance reports for leadership.
- Assist with audit readiness by collecting documentation and validating operational processes.
Care & Operations Specialist
Keystone Health
PA
09.2019 - 06.2022
- Identified eligibility concerns, service gaps, and high-risk cases for timely escalation or intervention.
- Documented member interactions, care plans, and service activities in compliance with healthcare policies and regulations.
- Collaborated with interdisciplinary teams to ensure appropriate service delivery and adherence to healthcare program standards.
- Tracked member outcomes and supported operational reporting to enhance quality improvement and compliance initiatives.
- Ensured accurate documentation practices aligned with organizational compliance requirements and healthcare regulations.
- Supported Medicaid and Medicare members by coordinating healthcare services in accordance with plan requirements and program guidelines.
Education
Master of Science - Biology
Eastern Illinois University
Charleston, IL03-2020
Bachelor of Science - Biology
Pointpark University
PA06-2017
Skills
- SQL
- Tableau
- Power BI
- Excel
- SAS
- Requirements gathering
- Salesforce
- JIRA
- Process Mapping
- Project Management
- Collaboration Tools
Timeline
Business Systems Analyst (Implementation Operations)
UnitedHealth Group
06.2022 - 01.2026
Care & Operations Specialist
Keystone Health
09.2019 - 06.2022
Master of Science - Biology
Eastern Illinois University
Bachelor of Science - Biology
Pointpark University