Lauren Crandall
Rancho Santa Margarita,CA
Summary
A well-versed leader in quality with over 14 years of professional experience. Possess the ability to perform independently and effectively in a fast paced environment, while maintaining and over exceeding personal goals. Diverse and knows how to take initiative in situations in a proficient, yet personal manner. Innovative problem solver, strategic decision maker and detailed communicator who demonstrates success.
Overview
14
14
years of professional experience
Work History
Quality Auditor
Elevance
Remote
07.2013 - 10.2023
- Conducted internal audits to ensure compliance with quality standards
- Investigated and identified quality issues to uncover root causes and explore potential corrective actions to remedy situations
- Created reports and analyzed date to identify gaps and recommended changes in processes
- Participated in cross-functional teams to review new designs and suggest modifications
- Worked with compliance to help identify possible breaches
- Monitored product performance and identified areas for improvement
- Participated in SWAT and MTM calls to discuss monthly findings for Legacy, ACA and billing to ensure the implementation of our best process strategies
- Used as the resource expert for HealthLink and UniCare audits – Conducted SOX HealthLink audits
- Facilitated the Empower Peer Team- Used to discuss business and process improvement
- Used as a department Mentor and handled Executive Concierge and VP Cases
Member Service Lead
UniCareHealthLinkHealthLinkElevance (CareMore)
Cerritos, CA
12.2009 - 07.2013
- Liaison between the Member Service department and other business partners (claims, appeals and grievance, authorization and sales)
- Assisted with any escalated member issues over the phone or in person
- Used as an informational resource for over 140 representatives within three different sub units, and assisted with daily supervision of 40 representatives at an offsite location
- Reported to management daily activities and proposed recommendations for improvement
- Coordinated with various departments within the company to ensure customer requests were completed
- Handled employee relations, attendance, break schedules and performance counseling
- Managed the implementation Healthy Journey and ensured appropriate documentation was maintained
- Helped build our Facets platform to meet department needs
Education
Associate of Arts -
Southern New Hampshire University
Hooksett, NHSkills
- Quantitative and Qualitative Analysis
- Driving Process Change
- Internal and SOX Auditing
- Compliance Requirements
- Project Management
- Documentation and Reporting
- Process Improvements
- Leadership and Mentoring
Affiliations
Volunteers as a voted in member of the Board of Directors for the non-profit youth basketball league, RSM National Junior Basketball. Director of All-Stars who is responsible for designing and running the RSM NJB all star program since March 2022. Works as a liaison between the RSM chapter and headquarters, while managing over 11 teams, with 110 athletes.
- Ensures all teams are within organization compliance
- Builds and maintains business relationships with directors, coaches and parents
- Works closely with accounting to maintain or improve budget by bringing in revenue
- Facilitates meetings across all levels
- Coordinate events for over 200 attendees
- Handles any escalations
- Continuesly improves program to enhance player experiance
References
References available upon request.
Timeline
Quality Auditor
Elevance
07.2013 - 10.2023
Member Service Lead
UniCareHealthLinkHealthLinkElevance (CareMore)
12.2009 - 07.2013
Associate of Arts -
Southern New Hampshire University