Jasmine Chastang
Converse,TX
Summary
Dynamic and results-oriented Risk Operations Manager with over 10 years of experience in risk management, fraud detection, and trend analysis within public health and healthcare sectors. Proven track record in developing and implementing strategies to mitigate risk, enhance compliance, and drive operational efficiency. Expertise in Software Quality Assurance (SQA), identifying fraud trends, and fostering cross-functional collaboration to protect organizational integrity.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Risk Operations Manager
Bayside Support Services
02.2022 - Current
- Lead a team of risk analysts to identify and analyze fraud trends within business financial operations, reducing fraudulent claims by 30% over two years.
- Develop and implement comprehensive risk management strategies in compliance with state and federal regulations, enhancing overall organizational compliance rates.
- Collaborate with IT and SQA teams to ensure the integrity of risk management software, identifying system vulnerabilities and implementing corrective actions.
- Conduct financial investigations related to suspected fraud, utilizing forensic accounting techniques to trace illicit transactions.
- Create and present detailed reports on financial anomalies and fraud trends to senior management, driving informed decision-making.
Senior Claims Manager
Florida Blue - Blue Cross Blue Shield Of Florida
04.2018 - 02.2022
- Managed a department of claims adjusters and processors, managing day-to-day operations to ensure timely and accurate claims processing.
- Developed and implement claims processing workflows and best practices, resulting in a 30% improvement in turnaround times and a 20% reduction in errors.
- Analyzed claims data to identify trends, assess risk, and inform management decisions regarding claims strategy and process improvements.
- Analyze claims data to identify trends, assess risk, and inform management decisions regarding claims strategy and process improvements.
- Collaborated with compliance teams to ensure adherence to regulatory standards and internal policies.
- Analyzed complex loss scenarios to determine appropriate coverage limits, fostering informed decision-making across the organization.
- Negotiated favorable settlements on behalf of the company, minimizing potential exposure to costly litigation proceedings.
- Managed high caseloads while maintaining excellent attention to detail throughout each claim''s lifecycle from initial reporting to final settlement or litigation process.
Benefits Plan Manager
United Health Care Services Inc.
08.2014 - 08.2018
- Lead the design and management of employee benefits programs for a diverse workforce, improving employee satisfaction ratings by 25% over three years.
- Implement cross-selling strategies for ancillary benefits, resulting in a 30% increase in enrollment in voluntary benefits programs.
- Analyze benefits utilization data to identify trends and inform recommendations for program enhancements and cost savings.
- Collaborate with HR and finance teams to develop budgets and ensure compliance with federal and state regulations related to employee benefits.
- Conduct regular training sessions for HR staff and managers on benefits offerings and cross-selling techniques to maximize employee engagement.
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
- Reduced operational costs through comprehensive process improvement initiatives and resource management.
Benefits Manager
Nationwide Mutual Insurance Company
08.2012 - 08.2014
- Lead a high-performing team of sales professionals, implementing cross-selling strategies that resulted in a 35% increase in revenue across product lines.
- Developed and execute comprehensive sales strategies to enhance market share and achieve annual revenue targets exceeding $10 million.
- Fostered strong relationships with key clients and stakeholders, ensuring a deep understanding of their needs and delivering tailored solutions that enhance satisfaction and loyalty.
- Conducted regular audits of benefit plans to identify discrepancies and maintain accuracy in records.
- Managed FMLA administration, coordinating leave requests and tracking time off for compliance purposes.
- Managed relationships with external vendors such as insurers and brokers, fostering strong partnerships in support of company objectives.
- Ensured compliance with all federal, state, and local regulations governing employee benefits programs.
- Analyze market trends and performance data to identify opportunities for growth and improvement, leading to the introduction of new product offerings.
Education
Bachelor of Science - Management Information Systems
Lamar University
Beaumont, TX12.2024
High School Diploma -
Karen Wagner High School
San Antonio, TX2008
Skills
- Risk Management & Mitigation
- Fraud Detection & Prevention
- Software Quality Assurance (SQA)
- Trend Analysis & Reporting
- Public Health & Healthcare Regulations
- Data Analysis & Interpretation
- Team Leadership & Development
- Process Improvement & Optimization
- Compliance & Audit Management
- Financial Data Analysis
- Evidence Collection & Preservation
- Regulatory Compliance & Reporting
Certification
- Associate in Claims
- Certified Claims Professional (CCP)
- CIFA - Certified Insurance Fraud Analyst
Timeline
Risk Operations Manager
Bayside Support Services
02.2022 - Current
Senior Claims Manager
Florida Blue - Blue Cross Blue Shield Of Florida
04.2018 - 02.2022
Benefits Plan Manager
United Health Care Services Inc.
08.2014 - 08.2018
Benefits Manager
Nationwide Mutual Insurance Company
08.2012 - 08.2014
High School Diploma -
Karen Wagner High School
- Associate in Claims
- Certified Claims Professional (CCP)
- CIFA - Certified Insurance Fraud Analyst
Bachelor of Science - Management Information Systems
Lamar University
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