Jason Kovaleski
Black Canyon City,AZ
Summary
Accomplished healthcare professional with 25 years of experience in claims, provider data, and customer service operations. Proven leader with over 30 years of experience in operations management and product/vendor relationships. Expertise in driving change, process improvement, and compliance within the Medicare/Medicaid industry. Skilled in strategic use of data, fostering a collaborative work environment, and developing high-performing teams. Strong organizational skills and readiness to learn and grow within a project support environment. Understanding of project workflows and solid proficiency in administrative tasks. Ready to utilize and further develop time management and communication skills in the [Desired Position] role.
Overview
30
30
years of professional experience
Work History
Strategic Project Support Associate Director
UnitedHealthcare
01.2017 - Current
- Lead a team of 100+ direct and indirect reports supporting Provider Data Operations initiatives
- Strengthen and manage connections within the Provider Operations team and with key matrix partners
- Spearhead strategic projects and collaborate with cross-functional teams to achieve business objectives
- Establish and maintain KPIs for MBR and QBRs, providing transparency and insights for annual business processes
- Direct optimization of end-to-end business processes, resulting in measurable increases in quality and efficiency
- Provide overall business knowledge and problem-solving expertise to internal partners and health plans
- Direct annual performance evaluation process, including MAP reviews, merit increases, and Rewarding Results Program
- Enhanced project efficiency by streamlining communication between team members and stakeholders.
- Collaborated closely with cross-functional teams to facilitate smooth execution of projects.
- Assisted in resource allocation decisions by evaluating team member skills, availability, and workload capacity.
- Ensured compliance with company policies and industry regulations throughout all stages of the project lifecycle.
- Ensured prompt resolution of issues or obstacles encountered during the project lifecycle by escalating concerns to appropriate parties when necessary.
- Helped maintain a positive work environment through active participation in company culture-building activities.
AHCCCS Administrator
State of Arizona
01.2014 - 01.2015
- Led Fee for Service division of AHCCCS, including Provider load, Provider Call, and Claims
- Implemented new requirements for Provider Load and Claim submissions to align with other healthcare systems
- Reduced redundancies and implemented better quality reviews of claims to ensure compliance with state requirements
- Oversaw administration tasks and ensured compliance with AHCCCS policies and regulations
- Handled sensitive information discreetly, maintaining strict confidentiality at all times as required by company policy or legal regulations.
- Managed office inventory levels, ensuring adequate supplies were available while minimizing waste and unnecessary spending.
- Established an organized filing system that streamlined document retrieval and reduced misplaced files.
- Improved employee productivity with effective time management strategies for daily tasks.
- Supervised administrative support staff members, offering guidance, feedback, and mentorship that contributed to their professional growth and development.
Business Analyst
UnitedHealthcare
01.2007 - 01.2014
- Responsible for all SAM (Smart Audit Master) application operations, including rule creation, bug fixes, and redesign
- Achieved claims savings in the tens of millions of dollars a month
- Built strong vendor relationships and managed development and execution of technology programs
- Analyzed business opportunities and operational gaps, implementing data-driven solutions to enhance processes and boost customer satisfaction
- Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
- Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
- Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
- Collaborated closely with stakeholders to identify opportunities for process improvements and drive continuous innovation in the organization.
- Supported software development projects by defining clear requirements and effectively communicating them to technical teams.
- Enabled data-driven decision making with advanced analytics tools, generating valuable insights for the organization.
- Optimized workflow processes to enhance overall productivity and achieve operational excellence.
Education
Brookdale Community College
Lincroft, NJSkills
Leadership
Timeline
Strategic Project Support Associate Director
UnitedHealthcare
01.2017 - Current
AHCCCS Administrator
State of Arizona
01.2014 - 01.2015
Business Analyst
UnitedHealthcare
01.2007 - 01.2014
Brookdale Community College
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