Megan Rasp
Southgate,MI
Summary
Strategic business operations leader with 10+ years of experience connecting people, processes, and technology to solve complex operational challenges within Medicare healthcare. I partner across business, technology, compliance, and operations to turn complex problems into practical, scalable solutions that improve efficiency, strengthen governance, and deliver measurable business outcomes. Known for building trusted relationships, leading high-performing teams, and driving meaningful change through collaboration, data-driven decision making, and continuous improvement.
Overview
14
14
years of professional experience
Work History
Business Systems Analysis Lead
SS&C Technologies (formerly Humana)
Remote
07.2021 - Current
- Lead a team of five Business Systems Analysts responsible for delivering strategic technology solutions that support complex Medicare operations, balancing day-to-day execution with long-term organizational priorities.
- Partner with executive leadership, Operations, Product, Technology, Compliance, Risk, Finance, and external clients to translate complex business challenges into scalable solutions that improve operational performance and strengthen regulatory compliance.
- Drive cross-functional business transformation initiatives by evaluating end-to-end operational workflows, identifying systemic process gaps, and leading the design and implementation of sustainable process improvements.
- Serve as the business owner for critical Medicare claims capabilities, defining business requirements, prioritizing enhancements, guiding user acceptance testing, and ensuring successful implementation of technology solutions that align with operational and regulatory objectives.
- Influence enterprise decision-making by using operational metrics, root-cause analysis, and business insight to prioritize initiatives that reduce risk, improve efficiency, and enhance the customer experience.
- Lead the redesign of Direct Member Reimbursement workflows, helping reduce overall processing time by approximately 70% while improving the experience for both internal users and Medicare members.
- Directed the resolution of a high-impact Medicare claims issue resulting in approximately $600,000 in recovered revenue while implementing preventive controls projected to protect more than $10 million annually.
- Lead enterprise process reviews that identify operational risks, eliminate manual inefficiencies, strengthen governance, and improve organizational readiness for regulatory oversight.
- Oversee quality governance for approximately 9,000 Medicare claims each month, establishing audit strategies and quality standards that balance operational efficiency with CMS compliance requirements.
- Partner with AI and technology teams to identify automation opportunities that reduce manual effort, improve decision quality, and modernize operational processes across the organization.
- Build high-performing teams through individualized coaching, strategic delegation, and performance development, creating an environment that emphasizes accountability, critical thinking, and continuous improvement.
- Successfully guided the organization through multiple CMS program audits with zero findings, reinforcing a culture of proactive compliance and operational excellence.
Senior Pharmacy Claims Professional
Humana
Remote
09.2019 - 07.2021
- Served as the business owner and subject matter expert for critical Medicare claims processing logic, partnering with technology, testing, and operations teams to successfully implement system enhancements while ensuring compliance with evolving CMS requirements.
- Directed the development, review, and governance of CMS-regulated member communications, translating complex regulatory guidance into clear, compliant communications that balanced operational efficiency with member experience.
- Led cross-functional collaboration across Operations, Technology, Compliance, Quality, and Business partners to deliver strategic initiatives, resolve operational challenges, and strengthen enterprise alignment around Medicare processes.
- Evaluated operational workflows, audit findings, and performance data to identify systemic process gaps, recommend sustainable solutions, and improve the effectiveness of business operations.
- Produced executive reporting and operational performance metrics that enabled leadership to monitor key business indicators, identify emerging risks, and make informed operational decisions.
- Served as a trusted advisor to business partners by providing regulatory guidance, operational expertise, and strategic recommendations throughout the lifecycle of business initiatives and system implementations.
- Supported enterprise implementation efforts by defining business requirements, validating system functionality through user acceptance testing, and ensuring successful operational readiness for new processes and technology enhancements.
- Built strong cross-functional relationships that improved communication, accelerated issue resolution, and strengthened collaboration across multiple business and technology organizations.
- Contributed to continuous process improvement initiatives that increased operational efficiency, strengthened compliance, and improved the consistency of Medicare claims administration.
Senior Risk Management Professional
Humana
Louisville, KY
06.2018 - 09.2019
- Led enterprise risk assessments across strategic, operational, financial, and regulatory domains, partnering with business leaders to proactively identify emerging risks and strengthen the organization's overall control environment.
- Evaluated operational processes, audit results, compliance data, and business documentation to identify systemic control gaps, recommend sustainable solutions, and improve the effectiveness of enterprise risk management practices.
- Facilitated cross-functional risk assessment sessions as part of the organization's Enterprise Risk Management (ERM) program, helping business leaders evaluate operational risk, prioritize mitigation strategies, and strengthen governance across multiple business units.
- Performed root-cause analysis on regulatory and operational issues, partnering with operational leaders to develop corrective action plans that resolved underlying issues while reducing future compliance risk.
- Oversaw first-line risk monitoring activities across multiple operational departments, strengthening audit readiness and ensuring ongoing compliance with internal controls, CMS requirements, and enterprise governance standards.
- Managed multiple cross-functional projects simultaneously, coordinating business stakeholders, establishing project priorities, and driving compliant implementation of strategic operational initiatives.
- Built trusted partnerships with operational, compliance, and enterprise risk leaders to promote a proactive risk culture focused on prevention, transparency, and continuous improvement.
- Leveraged data analysis and operational reporting to identify trends, monitor organizational risk, and provide leadership with actionable insights that informed business decisions and resource prioritization.
- Contributed to the continued maturation of the organization's risk management framework by promoting standardized processes, consistent governance practices, and sustainable operational controls.
- Designed and implemented the organization's first standardized first-line risk intake and governance process within Archer, partnering with Enterprise Risk to establish consistent risk prioritization, strengthen visibility, and align operational risk management practices across business units.
Operational Compliance Analyst
Humana
Remote
08.2017 - 06.2018
- Interpreted complex Medicare regulations and internal policy requirements to ensure operational processes remained compliant while supporting efficient business execution.
- Conducted compliance reviews, operational investigations, and root-cause analyses to identify regulatory risks, process deficiencies, and opportunities for sustainable operational improvement.
- Partnered with business leaders to develop and implement corrective action plans that resolved compliance concerns while strengthening long-term operational controls.
- Collaborated across Operations, Compliance, Quality, and Business teams to translate regulatory requirements into practical, scalable business processes that improved consistency and reduced operational risk.
- Monitored operational performance and compliance trends, leveraging data analysis to identify emerging risks, prioritize improvement opportunities, and support informed business decision-making.
- Supported internal audits, regulatory reviews, and compliance initiatives by evaluating business processes, validating adherence to established controls, and preparing documentation for leadership and regulatory stakeholders.
- Contributed to enterprise process improvement initiatives by recommending workflow enhancements that increased efficiency, standardized business practices, and strengthened regulatory compliance.
- Built collaborative relationships across multiple business functions, earning a reputation as a trusted resource for interpreting complex compliance requirements and solving operational challenges.
Quality Analyst, Operations
Humana
Louisville, KY
08.2016 - 08.2017
- Investigated and resolved complex Medicare claims and operational issues, balancing regulatory compliance, customer experience, and business objectives to achieve timely, accurate resolutions.
- Analyzed claim trends and recurring operational challenges to identify root causes, recommend process improvements, and reduce repeat issues.
- Partnered with internal business partners to resolve escalated cases, improve operational workflows, and ensure consistent application of Medicare policies and procedures.
- Built a strong foundation in claims operations, regulatory interpretation, and cross-functional problem solving that supported rapid advancement into compliance and enterprise risk leadership roles.
Resolution Specialist; Medication Intake Specialist
Humana
Louisville, KY
11.2015 - 08.2016
- Processed Medicare pharmacy requests with a strong focus on accuracy, regulatory compliance, and member experience within a high-volume operational environment.
- Collaborated with pharmacists, providers, and internal business partners to ensure timely resolution of medication requests and accurate application of Medicare guidelines.
- Recognized early for analytical problem-solving, attention to detail, and operational performance (99% accuracy rate consistently), leading to rapid promotion into increasingly complex and strategic roles.
Paralegal
Fauver Law Office
Louisville, KY
01.2015 - 11.2015
- Conducted legal research to support case preparation and strategy development.
- Drafted and reviewed legal documents, ensuring compliance with regulations and deadlines.
- Assisted attorneys in trial preparation by organizing exhibits and witness lists.
- Managed client communications, providing updates and gathering necessary information.
- Coordinated discovery processes, including document requests and responses.
- Managed scheduling of court calendars and deadlines to maintain smooth flow of firm operations.
Legal Assistant & Intern Manager
Stenger & Stenger, P.C.
Grand Rapids, MI
01.2013 - 01.2014
- Assisted in case management, tracking progress and maintaining organized case files.
- Trained junior staff on office procedures, improving workflow and team efficiency.
Education
Master of Business Administration - Business Administration
Sullivan University
Louisville, KY05.2018
Bachelor of Science - Legal Studies, Criminal Justice
Grand Valley State University
Allendale12.2014
Skills
Leadership & Strategy
- Business Transformation
- Cross-Functional Leadership
- Organizational Change Management
- Strategic Planning
- Executive Stakeholder Management
- Team Leadership & Development
Operations & Governance
- Process Improvement
- Business Process Optimization
- Enterprise Risk Management
- Operational Governance
- Root Cause Analysis
Program & Delivery
- Program Management
- Process Design
- User Acceptance Testing (UAT)
- Implementation & Operational Readiness
- Performance Metrics & KPI Development
Technical & Analytical
- Data Analysis
- Reporting & Dashboards
- Workflow Automation
- AI Process Enablement
- Microsoft Power BI (if applicable)
- Archer GRC
- JIRA
Timeline
Business Systems Analysis Lead
SS&C Technologies (formerly Humana)
07.2021 - Current
Senior Pharmacy Claims Professional
Humana
09.2019 - 07.2021
Senior Risk Management Professional
Humana
06.2018 - 09.2019
Operational Compliance Analyst
Humana
08.2017 - 06.2018
Quality Analyst, Operations
Humana
08.2016 - 08.2017
Resolution Specialist; Medication Intake Specialist
Humana
11.2015 - 08.2016
Paralegal
Fauver Law Office
01.2015 - 11.2015
Legal Assistant & Intern Manager
Stenger & Stenger, P.C.
01.2013 - 01.2014
Master of Business Administration - Business Administration
Sullivan University
Bachelor of Science - Legal Studies, Criminal Justice
Grand Valley State University