Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Iris Waddell

Summary

To obtain a challenging management-based position that will benefit from my cultivating rapport with individuals to optimize project goals and output, resolve complex problems and deliver innovative improvement strategies. as well as 14 years of health care expertise, while offering room for professional growth.

Overview

14
14
years of professional experience

Work History

Business Operations Specialist

Optum Health
06.2021 - Current
  • Streamlined business operations by implementing efficient process improvements and organizational strategies.
  • Optimized workflow efficiency by analyzing current processes and identifying areas for improvement.
  • Project support with cross-functional teams to develop turnaround times for accountability and streamline processes for utilization management. Manage project plans and complete tasks by the timelines.
  • Develop FedEx change management by developing effective communication strategies that ensured accurate instructions for all Care Advocates involved in the process.
  • Mentoring and Subject Matter Expert for artifacts such as Project Charter, Business Use Case, and Cost Benefit Analysis.


Clinical Administrative Coordinator

Optum Health
11.2020 - 06.2021
  • Supported the Inpatient Care Management team by obtaining member / patient status, disposition, and discharge dates..
  • Streamlined administrative processes for increased efficiency in supporting clinical staff members.
  • Assisted Case Manager Nurses in viewing clinical information to confirm member status, obtain medical record numbers for facilities, and assign special cases to nurses for members in long term care. Created and approved prior authorization's for patients with outpatient servies.

Care Management Associate

Aetna, A CVS Health
11.2019 - 11.2020
  • Completed initial review and triage of Care Team tasks. Identified principal reason for admission, facility, and member product to correctly apply intervention assessment tools.
  • Streamlined care management processes for increased efficiency and better resource allocation.
  • Monitored non-targeted cases for entry of appropriate discharge date and disposition. Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff.

Provider Data Analyst | Sr. Customer Care SME

United Healthcare Group
10.2009 - 06.2019
  • Reviewed, researched, and audited provider demographic data in NDB, COSMOS, PVO, PDA systems and faxes for vision, dental and medical physician’s records. Audited provider advocate calls ensuring they updated all the providers information and created documents to support defect findings while ensuring defects are corrected after acceptance
  • Identified gaps in resolution process and trained new hires on all auditing procedures. Analyze and updated procedures to improve efficiency.
  • Served as Team Lead assisting with printing and sending out Adherence reports. Coaching CCP on all metrics. Handled escalated supervisor calls. Company Travel to attended and assisted with Open Enrollment activities. Contributed to the Compliance team as a lead by checking appeals and grievances to eliminate errors for team members.

Education

Certificate Diploma - Accounting And Business Management

Brookstone College of Business - Charlotte
Charlotte, NC
11.2000

Skills

  • Intermediate in MS Word, Excel, PowerPoint, Access, and Visio
  • Various System Knowledge across all functional areas
  • Workflow Optimization and Quality Assurance
  • Strategic Planning, Content Development and, Issue Resolution
  • Proven Analytical and Problem Solving
  • Cross-functional Collaboration Project Management
  • Process Improvement and Stakeholder Engagement
  • Team Leadership and Staff Training
  • Operational Efficiency with Demonstrating strong ability to work independently and meet deadlines

Accomplishments

  • Outstanding QVC Achievement Tier 1 Top Performer 2010, 2011, 2012| Achievements for Top Performer 2013, 2014
  • Topaz Recognition Award for Integrity, Collaboration, and Performance 2015 | 2016
  • Diamond Recognition Award for Excellence and Performance 2015 | Sapphire Recognition Integrity Award 2018
  • National Volunteer Award Spotlight 2019 for SEHS Guilford $500 | Awarded $500 Volunteer Donation for SEGHS 2017, 2018, 2019
  • Service Hero Nominee 2019
  • Diamond Recognition Awards for Performance, Collaboration, Relationship, Development for New Hire, and Quality July 2021| (3 awards) October 2021| March, June, and July 2023| February, March, April, May, June, July, August, December 2023 | January 2024

Timeline

Business Operations Specialist

Optum Health
06.2021 - Current

Clinical Administrative Coordinator

Optum Health
11.2020 - 06.2021

Care Management Associate

Aetna, A CVS Health
11.2019 - 11.2020

Provider Data Analyst | Sr. Customer Care SME

United Healthcare Group
10.2009 - 06.2019

Certificate Diploma - Accounting And Business Management

Brookstone College of Business - Charlotte

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Iris Waddell