Heather Root
Aston,PA
Summary
Results-driven Data Analyst with extensive experience at AmeriHealth Caritas, adept at leveraging Excel and Facets to enhance data integrity. Proven ability to resolve complex issues independently while demonstrating strong leadership and accountability. Successfully contributed to critical projects, ensuring timely data cleanup and compliance across multiple lines of business.
Overview
21
21
years of professional experience
Work History
Data Analyst
AmeriHealth Caritas
04.2022 - Current
- Interacts with internal/external clients in a professional manner and responds to inquiries.
- Able to identify issues and work to resolve with little to no supervision.
- Collecting, analyzing, and cleaning large datasets to resolve errors within Facets for all LOBs.
- Assigns and monitors data cleanup assignments.
- Works with entire PES Team and the Plan as needed to correct data base.
- Make updates to NPI Crosswalk as needed/requested.
- Manager support and backup when unavailable to attend meetings and/or answer questions related to provider data.
- Attends all meetings related to PLM (formerly LIFT) – these meetings include data cleanup, PMO Team, Demos, finalizing of rules, and Sprint meetings.
- Performs UAT, Mock, and Smoke Testing for PLM.
- Attends all meetings for IPQ and NPI Crosswalk.
- Performed testing on new IPQ WEB tool.
- Helps with IPQ and PES Production Inventory when needed.
Sr. Provider Maintenance Technician
Keystone Mercy Health Plan/AmeriHealth Caritas
08.2006 - 04.2022
- Maintains the provider database and complete changes according to department accuracy and turnaround standards for participating and non-participating providers.
- Interacts with internal/external clients in a professional manner and responds to inquiries.
- Handles priority issues/projects delegated by PDM Supervisor or Manager.
- Ability to research and resolve complex issues which impact claims and provider capitation.
- Supervisor support and backup when unavailable to attend meetings and/or answer questions related to Provider Data Management.
- Assist supervisor and manager in various supporting roles.
- Consistently exhibits leadership qualities, high level of accountability and a positive attitude.
- Helps as needed with new business.
- Tested and successfully managed MDM. Trained associates on how to use the new database.
- Trained new associates for all Pennsylvania LOBs as needed, as well as cross trained already established associates.
- Able to identify issues and work to resolve with little to no supervision.
- Maintains quality and production standard that is expected.
- Proactively research and monitor Online Help topics to assure the file is up to date and correct.
- Works multiple LOB’s.
- Part of the NPI Resolution work group to fix the NPI Crosswalk issues that PDM experiences.
- Worked in a Business Analyst capacity since September 2017 in PDM for P360 (Appian). Duties included attending daily meetings/grooming sessions, writing Business Requirements. Reporting and following up on P360 productions issues and testing of P360 from UAT down to Production.
- In December 2020 started working on the Lift Project. Duties include attending daily meetings, testing, building process flows and requirements. Reporting and following up on any defects or enhancements as well as data clean up in Facets for go live.
Provider Maintenance Technician
Keystone Mercy Health Plan
02.2005 - 08.2006
- Was a temporary employee from February 14, 2005, until hire date of June 13, 2005. During this period, I strictly maintained the Invalid Provider Queue for LOB 700 (Horizon NJ Health).
- After June 13, 2005 – Provider Maintenance Technician I:
- Maintain the provider database and complete adds/changes/deletes according to department accuracy and turnaround standards for participating and non-participating providers.
- Communicates and coordinates panel transfers for terminated providers in a timely manner.
- Interacts with internal/external clients in a professional manner and responds to inquiries.
- Handled priority issues/projects delegated by Provider Maintenance Supervisor.
- Review, correct and follow-up on the Capitation Audits and Daily Systematic Queries.
- Ability to research and resolve complex provider database issues which impact claims and provider capitation.
- Consistently exhibits leadership qualities, high level of accountability and a positive attitude.
- Was cross trained to support multiple LOBs.
Education
High School Diploma -
Penn Wood Senior High School
06.1998
Skills
- Excel
- Access
- Facets
- EXP
- P360 (Appian)
- SharePoint
- Salesforce
Previous Experience
Previous job experience prior to employment with AmeriHealth Caritas is available upon request.
Timeline
Data Analyst
AmeriHealth Caritas
04.2022 - Current
Sr. Provider Maintenance Technician
Keystone Mercy Health Plan/AmeriHealth Caritas
08.2006 - 04.2022
Provider Maintenance Technician
Keystone Mercy Health Plan
02.2005 - 08.2006
High School Diploma -
Penn Wood Senior High School