Melissa Rogers
Andover,KS
Summary
Results-oriented Senior Project Manager with a proven track record of leading cross-functional teams to deliver impactful solutions. Expert in collaborating with multiple teams to develop and enhance processes that address member critical health challenges.
Overview
11
11
years of professional experience
Work History
Sr. Manager, project program management
Aetna better health of kansas
02.2022 - Current
- Acts as a top-level specialist on project and program planning and develops comprehensive program plans that encompass objectives, deliverables, timelines, and resource allocation
- Adapts project and program plans to ensure alignment with business objectives and reinforce organizational standards
- Applies highly developed knowledge of financial management principles to manage cost estimation, tracking, and budget reporting for programs and projects
- Coaches junior-level project and program managers on how to utilize key performance indicators (KPIs) to measure progress and analyze project and program outcomes
- Coordinates knowledge sharing among project teams to highlight success stories and improve project and program management practices through insights
- Establishes and designs a continuous improvement plan for the project and program department to enhance delivery processes and outcomes while reducing obstacles and risks.
Network Relations Manager
Aetna Better Health of Kansas
04.2019 - 02.2022
- Monitor service capabilities and collaborates cross-functionality to ensure that constituent needs are met, and escalated issues are handled timely to resolution
- Analyze operational complaints such as claims auditing, database management, credentialing, and contract coordination
- Educate providers and internal teams on compliance with contract policies, compensation process, technologies, health plan policies and billing guidelines by facilitating meetings to obtain desired outcomes
- Collaborates with internal operations to achieve compliance metrics which includes review of claim projects and encounters resubmissions
- Participates in the implementation of Kansas State policies that includes claim configuration, payments, provider, and program changes as a SME.
Senior Office Administrator
Hanger Clinic: Prosthetics & Orthotics
Wichita, KS
10.2017 - 04.2019
- Reported timely key statistics to market and corporate management for sales, revenue, and patient flow utilizing Microsoft tools
- Analyzed reported statistics and identify emerging issues that prevent completion of assigned workflow, address concerning issue and facilitating meetings to seek shared solutions
- Coordinated collaborative communications with payers to ensure accurate billing practices
- Enhanced encounter reimbursement opportunities to achieve organization case collection targets
- An increase of 125% during my employment
- Directed quality assurance programs to ensure patient satisfactory with Hanger Clinic services
- Maintained a system of internal controls to ensure proper coverage for patient appointments, review of clinician documentation and ensures appropriate patient billing
- Manage, train and direct office staff to ensure the highest level of customer service.
Claims Resolution Specialist
Cancer Center of Kansas
Wichita, KS
12.2014 - 10.2017
- Researched and investigated medical claims disputes according to established policies, contracts and procedures
- Responsible for larger more complex accounts totaling +$2M in accounts receivable while exceeding department standards
- Verify enrollment status and policy coverage to answer complex medical claim inquiries from members and employers
- Engage in appropriate communication with patient, Third Party Payer and/or Collection agency
- Manage daily electronic and physical deposit for Main office as well as 21 satellite offices over the state
- Implemented and spearheaded charge of all Veteran/Governmental insurer programs
- Conducted training and supervisory role to two departments within employment.
Clinical Allergy Specialist
United Allergy Services
McPherson, KS
07.2013 - 12.2014
- Responsible for managing the daily operations of an allergy clinic within a medical office
- Accountable for meeting the strategic goals and objectives of the company pertaining to assigned clinic productivity and revenue
- Created marketing materials to educate and promote services to physicians and patients
- Exhibited expertise in the immunotherapy processes to include the administration of quality allergy testing, and the formulation and preparation of the allergy medication
- Responsible for the handling and submission of all billing documentation to the appropriate office.
Education
MASTER’S IN BUSINESS ADMINISTRATION -
Kansas Wesleyan University
BACHELOR OF ART in Sociology -
Fort hays state university
Skills
- Detailed user stories
- Navigation of SQL Report Writing
- Insightful Decision-Making Skills
- Empowering and collaborative style of Communications
- Strong Technical Analysis Skills
- Organized documentation abilities
Websites
Timeline
Sr. Manager, project program management
Aetna better health of kansas
02.2022 - Current
Network Relations Manager
Aetna Better Health of Kansas
04.2019 - 02.2022
Senior Office Administrator
Hanger Clinic: Prosthetics & Orthotics
10.2017 - 04.2019
Claims Resolution Specialist
Cancer Center of Kansas
12.2014 - 10.2017
Clinical Allergy Specialist
United Allergy Services
07.2013 - 12.2014
MASTER’S IN BUSINESS ADMINISTRATION -
Kansas Wesleyan University
BACHELOR OF ART in Sociology -
Fort hays state university