MARIE HULSLANDER BLOMGREN
Rosemount,MN
Summary
Detail-oriented Business Operations Specialist with a robust background in administrative support, provider relations, and compliance within healthcare environments. Proven expertise in researching and applying regulations to maintain compliance, alongside strong analytical skills for evaluating provider eligibility. Demonstrated success in optimizing operational processes and implementing strategic business solutions that enhance efficiency and reduce costs. A commitment to accuracy and effective stakeholder communication drives consistently positive project outcomes.
Overview
10
10
years of professional experience
Work History
Appeals and Grievances Federal Specialist
UCare
Minneapolis, MN
04.2023 - 10.2024
- Conduct thorough research and analysis of appeals and grievances concerning healthcare coverage, ensuring timely resolution per regulatory guidelines
- Develop clear and concise communications for members and providers, enhancing understanding of appeal processes and outcomes
- Efficiently prioritize tasks to meet critical regulatory deadlines while maintaining high standards of member service
Provider Relations Specialist Senior / Network Operations Representative
Prime Therapeutics
Eagan, MN
01.2016 - 04.2023
- Developed and maintained key relationships with providers
- Liaised between key stakeholders to resolve escalated issues effectively
- Managed onboarding process of pharmacy network, contract, and payee adds
- Developed pharmacy communications and provided education to enhance provider understanding and engagement
- Managed creation, maintenance, and analytics of databases, including contract records and provider information
- Spearheaded process improvements, enhancing department efficiency and accuracy of documentation
- Served as liaison between departments ranging from 4 to 150 people, ensuring consistent communication and collaboration
Certified Pharmacy Technician
Park Nicollet/Tria Pharmacy
Bloomington, MN
08.2014 - 01.2016
- Managed pharmacy operations, including data entry, prescription processing, and inventory management
- Facilitated clear communication between patients, healthcare providers, and insurance companies
- Maintained accurate records for billing, reconciliation, and inventory processes
- Conducted pharmacy tasks including prescription processing and patient inquiries
- Created sterile compounding workflow standard operating procedures
Education
Bachelor of Arts (B.A) - Liberal Arts
College of St. Catherine
St. Paul, MN05.2025
Skills
- MS Office Suite
- Excellent Verbal and Written Communication
- Direction and Task Delegation
- Independent Analytic Problem-Solving
- Empathetic and Collaborative Team Player
- Detail Oriented
- Project Management
- Contract Negotiation and Management
- Eligibility and Claims Review and Auditing
- Compliance360
- Data Analysis
- Quality Assurance
Timeline
Appeals and Grievances Federal Specialist
UCare
04.2023 - 10.2024
Provider Relations Specialist Senior / Network Operations Representative
Prime Therapeutics
01.2016 - 04.2023
Certified Pharmacy Technician
Park Nicollet/Tria Pharmacy
08.2014 - 01.2016
Bachelor of Arts (B.A) - Liberal Arts
College of St. Catherine
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