Elayne Penney
Dallas
Summary
Detail-oriented healthcare operations professional with extensive experience in managing eligibility enrollment, client support, and data reconciliation within the PBM industry. A strong track record of resolving complex enrollment issues and ensuring data integrity, contributing to compliance and client satisfaction in fast-paced environments.
Overview
13
13
years of professional experience
Work History
Senior Eligibility Analyst
CVS Caremark
Irving
04.2025 - Current
- Analyzed enrollment trends and reconciled large data sets across multiple systems, ensuring data integrity for compliance and reporting.
- Collaborated with Account Management, Implementation, and external stakeholders to resolve complex eligibility discrepancies and coverage issues, enhancing accuracy in data processing.
- Generated reports and metrics using Excel, Access, and internal tools to support research and facilitate informed decision-making.
- Guided team members by assisting with complex cases and clarifying processes related to SSOE/File Manager and CAG tables.
Independent Business Owner and Operator
Mr. T's Restaurant Penney St. Cravingz Food T
Dallas
03.2023 - 09.2025
- Managed daily business operations, customer relations, vendor coordination, employee scheduling, and financial oversight to ensure smooth operations and enhance customer satisfaction.
- Led business operations, demonstrating multitasking, problem-solving, and communication skills to address challenges and support team objectives.
- Coordinated with suppliers and external partners to maintain operational efficiency and uphold service quality standards.
- Oversaw inventory management, purchasing, and operational compliance.
- Built and maintained customer relationships while resolving service concerns in fast-paced environments.
Eligibility Analyst
CVS Health
Dallas
08.2019 - 04.2025
- Acted as SME for eligibility requirements, enrollment processing, and data transmission protocols.
- Managed, analyzed, and reconciled eligibility for employer groups and health plan clients to ensure compliance and accuracy.
- Partnered with clients, TPAs, carriers, and internal business teams to investigate and resolve eligibility issues, improving client satisfaction.
- Utilize enterprise systems and reporting tools including Excel and Access to support enrollment and fulfill reporting deliverables.
Underwriting Service Assistant
State Farm
Irving
01.2019 - 07.2019
- Processed policy changes while ensuring compliance with state guidelines to mitigate risks.
- Streamlined underwriting operations through data entry and quality verification projects.
- Responded to agent and policyholder inquiries while maintaining a high level of accuracy in data updates.
- Updated policyholder data using RUMBA and internal systems to maintain accurate records.
National Account Management Specialist
ADT (formerly Protection 1)
Irving
10.2016 - 11.2018
- Managed data for high-value national accounts, leveraging Excel dashboards and Power BI to enhance reporting accuracy.
- Monitored signal activity and analyzed performance trends to inform strategic decision-making.
- Maintained detailed client records and delivered data-driven reports to leadership.
- Coordinated updates across national accounts and service teams to ensure consistent communication and alignment.
Water Purification Specialist
Texas Army National Guard
Grand Prairie
08.2013 - 04.2017
- Operated and maintained high-tech water purification equipment, ensuring conversion of raw water from any source into potable water.
- Managed storage and distribution of purified water, supporting soldiers and specialized equipment in the field.
- Collected, tested, and analyzed water sample data, providing accurate insights using lab and digital systems.
Education
Associate of Arts - true
Tarrant County College
Arlington, TX05-2028
Applied Project Management Certificate - Villanova, PA
Villanova University
Villanova, PA01-2022
High School Diploma -
Mansfield Timberview High School
Arlington, TX06-2013
Skills
- Enrollment operations
- HIPAA & Healthcare Compliance
- Client management
- Account support
- Data reporting
- Process Improvement
- Escalation Management
- CRM/ERP Systems - Salesforce/RUMBA
- Cross-functional collaboration
- Microsoft Office Suite - Excel, Access
- Strong communication and issue resolution
Timeline
Senior Eligibility Analyst
CVS Caremark
04.2025 - Current
Independent Business Owner and Operator
Mr. T's Restaurant Penney St. Cravingz Food T
03.2023 - 09.2025
Eligibility Analyst
CVS Health
08.2019 - 04.2025
Underwriting Service Assistant
State Farm
01.2019 - 07.2019
National Account Management Specialist
ADT (formerly Protection 1)
10.2016 - 11.2018
Water Purification Specialist
Texas Army National Guard
08.2013 - 04.2017
Associate of Arts - true
Tarrant County College
Applied Project Management Certificate - Villanova, PA
Villanova University
High School Diploma -
Mansfield Timberview High School