Merlinda Dalipi
Summary
Dynamic Medical Underwriting Consultant with a proven track record at UnitedHealthcare, excelling in financial analysis and contract negotiation. Expert in developing pricing strategies that enhance client satisfaction and retention. Adept at regulatory compliance and project management, driving profitability through innovative solutions and strategic recommendations.
Overview
7
7
years of professional experience
Work History
Medical Underwriting Consultant
UnitedHealthcare
09.2024 - Current
- Managing financials for a defined book of business, for any variety of products, PPO, HMO, Stop Loss, Pharmacy, Self-Funded, ASO/Fully Insured for group or individual clients.
- Developed pricing options, leading to measurable client satisfaction and retention.
- Evaluate plan designs, recommending changes based on comprehensive economic analysis.
- Collaborating on proposals, ensuring accuracy in utilization and experience reporting.
Senior Underwriting
UnitedHealth Group (Optum)
Schaumburg
09.2019 - 09.2024
- Determined pricing for the various products and services we offer, customized for each individual case using a variety of forecast models.
- Build and maintain financial models to assist in the economic analysis, competitive RFP work, as well as market checks, and ongoing ad hoc financial analysis for clients.
- Develop and maintain financial reports to clearly communicate actual results, forecasted performance, and variances to plan.
- Work closely with the business to develop, recommend and establish strategies, plans, and processes to improve profitability and cost efficiencies.
Financial Analyst
Rush University Medical Center
Chicago
10.2018 - 10.2019
- Reviewed high-volume cash transactions, ensuring accuracy and resolving discrepancies.
- Collaborated with departments to address billing issues, enhancing process efficiency.
- Prepared detailed reports for internal and external stakeholders, improving transparency.
- Resolved reconciliation issues on research accounts, maintaining financial integrity.
- Streamlined cash and GL account activities, achieving timely reconciliations.
Project Manager
watchLAB
Chicago
05.2018 - 07.2019
- Assisted with functional and technical knowledge and helped execute complex projects and supporting large programs.
- Assisted in end-to-end execution and problem-solving for the project, including proactive planning to get ahead of delivery, field issues, data reporting challenges, etc.
- Ensuring projects are within project budget, investigating overages and reporting issues and resolutions to management when needed.
Human Resources Executive
Misericordia Home
Chicago
01.2018 - 05.2018
- Reviewed federal and state laws to confirm and enforce company compliance.
- Created and managed confidential personnel records.
- Addressed inquiries from employees and management regarding new-hire activity and ongoing employee relation issues.
- Ran the bi-weekly payroll process.
Education
Bachelor of Science - Health Systems Management, Business Administration
Loyola University Chicago, Marcella Niehoff School of Nursing
Chicago, IL, United States01.2018
Skills
- Contract Negotiation
- P&L Management
- Regulatory compliance
- Microsoft Office
- Adobe
- Financial Analysis
- Project Management
Additional Information
Lakeview Food Pantry, Heart Walk, Greater Chicago Food Depository, Feed My Starving Children Foundation, Member of SOCRA (Society of Clinical Research Associates)
Timeline
Medical Underwriting Consultant
UnitedHealthcare
09.2024 - Current
Senior Underwriting
UnitedHealth Group (Optum)
09.2019 - 09.2024
Financial Analyst
Rush University Medical Center
10.2018 - 10.2019
Project Manager
watchLAB
05.2018 - 07.2019
Human Resources Executive
Misericordia Home
01.2018 - 05.2018
Bachelor of Science - Health Systems Management, Business Administration
Loyola University Chicago, Marcella Niehoff School of Nursing