Ja' Net Evans
Summary
Experienced and skilled Knowledge Management Specialist with strong background in document control and processing systems. Technically-astute leader and project manager with expertise in Atlassian and Google Suites. Creative Operations Specialist skillful in executing effective operating rhythms and management systems structures. Expertise in analyzing, articulating and solving various problems. Analytical and organized professional comfortable working independently or as part of team.
Overview
7
7
years of professional experience
Work History
Operations Specialist
Interlaced
06.2022 - 09.2023
- Collected, arranged, and input information into database system.
- Tracked and analyzed reports to determine needed improvements.
- Motivated and trained employees to maximize team productivity.
- Compiled training materials for new employees and tracked skill development.
- Assisted various departments with change by communicating new improvement plans and expectations.
- Created and managed project plans, timelines and budgets.
- Supported development of program materials to advance inclusion and diversity awareness, learning and action planning.
- Created and implemented forward-thinking initiatives to improve employee engagement.
Knowledge Management Specialist
Oscar Health
07.2021 - 06.2022
- Identified process gaps, determined solutions and implemented updates to drive efficiency improvements
- Set up, optimized and enforced consistent document management policies
- Monitored activities to assess compliance with records policies and document management regulations.
- Maintained organized and efficient document flows by using excellent planning and multitasking skills.
- Transmitted documents, organized revisions and tracked changes.
- Collaborated across departments and levels of management to gain consensus on procedural documentation.
Clinical Review Expert
Oscar Health
07.2019 - 07.2021
- Created and maintained onboarding and continuous training
- Identified key performance indicators and guided team members on refining procedures to improve outcomes
- Offered one-on-one support for team members and managers to drive continuous improvement
- Assisted in developing and refining standard operating procedures for prior authorization dept.
- Analyzed operational performance to identify pain points and provided actionable solutions to management.
- Analyzed business problems, identifying root causes and developing robust solutions.
- Collaborated with management to identify and prioritize new development concepts.
Clinical Review Processor
Oscar Health
04.2016 - 07.2019
- Support the team's development and operational improvement by raising issues and identifying cause to guide resolution
- Maintained confidentiality of client records to comply with HIPAA guidelines.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers
- Conducted authorization requests and provider inquiries by phone, mail or fax to verify member eligibility and benefits.
- Follow regulatory and operational expectations and guidelines
- Contacted physician offices to obtain missing information from authorization requests as requested by medical director.
- Notified care access, monitoring nurses and case managers of hospital admissions and changes in member status to facilitate up-to-date recordkeeping.
- Worked within care access and monitoring team to offer clerical and data entry support for members requiring hospitalization and utilization review for healthcare services.
Education
Bachelors of Arts - Psychology
Kean University
Skills
- Training & Development
- Atlassian Platform
- Microsoft Office/Google Suites
- Data Management
- Project management
- Document Management
- Program Management
- Root cause analysis
- Microsoft Office
- Planning and Coordination
- Departmental Operations Management
- Daily Operations Management
- Customer Care
- Continuous Quality Improvement (CQI)
- on Boarding Design
Timeline
Operations Specialist
Interlaced
06.2022 - 09.2023
Knowledge Management Specialist
Oscar Health
07.2021 - 06.2022
Clinical Review Expert
Oscar Health
07.2019 - 07.2021
Clinical Review Processor
Oscar Health
04.2016 - 07.2019
Bachelors of Arts - Psychology
Kean University
Similar Profiles
Michael GilesMichael Giles
Operations Specialist at TalentBurstOperations Specialist at TalentBurst
John ClementsJohn Clements
Operations Specialist at DHL Same DayOperations Specialist at DHL Same Day
Mitzi HarveyMitzi Harvey
Operations Specialist at Academy Capital ManagementOperations Specialist at Academy Capital Management
Manuel RosarioManuel Rosario
Operations Specialist at U.S. ArmyOperations Specialist at U.S. Army
Nicholas RichmondNicholas Richmond
Emergency Recovery Coordinator/ Business Development Coordinator at Paul Davis of Greater RichmondEmergency Recovery Coordinator/ Business Development Coordinator at Paul Davis of Greater Richmond