Nannette L. Palmer
Clarksville,IN
Summary
I am a result-driven and proven Professional with extensive experience leading and guiding teams to success. My expertise is in issue resolutions and interpersonal communication. I thrive on working with others to see them succeed. I am a firm believer that not everyone learns the same way and having multiple sources for success is necessary. I also thrive on Collaborating with Leaders to get to the root cause and troubleshooting for team success relating to Quality, Metrics, and Compliance. I have extensive knowledge in helping leaders guide their teams to consistently achieve Key Performance Targets while creating a positive health work environment where associates thrive.
An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Overview
16
16
years of professional experience
Work History
Risk Management Professional 2
Humana Inc
Louisville, KY
01.2022 - Current
- Data review, monthly validationand metrics.
- Building relationships with operations leadership, to drive success for their teams.
- Process updates, error review and training
- Staying on top of CMS Changes and guidelines.
- Staying ontop of processes, to maintain the best relations with the areas i work with.
Team Lead CCM (Compliance Control Monitoring) Team
Humana Inc
Louisville, KY
01.2019 - 01.2022
- Formed partnerships with internal departments and vendors to ensure members issues were addressed timely and had a positive outcome with Humana Inc
- Case review, procedd updates, and review for vendoss leadership.
- Resolved escalated customer complaints or queries promptly and efficiently.
- Monitored team performance against targets, taking corrective action where necessary.
- Projects, and building trainings for associates, built on their learning needs.
- Making sure each associate had the tools they needed to perform their job
- Associate 1x1, coaching’s and schedule review to verify all business needs are addressed.
PDP (Prescription Drug Plan) IRT Team
Humana Inc
Louisville, KY
01.2018 - 01.2019
- Case file creation for Maximus (Auto Forwards, and Case file Request)
- Research and time management
Appeals Specialist
Humana Inc
Louisville, KY
01.2016 - 01.2018
- Sent appeals request for clinical review
- Subject Matter Expert
- Communicated with clinical and outside vendors
- Special projects
Critical Inquiry Specialist
Humana Inc
Louisville, KY
01.2015 - 01.2016
- Updated member files
- Recon Reviews
Onsite Janitorial
Fenley real estate
04.2014 - 10.2015
- Cleaned offices for multiple buildings owned by Fenley real estate
Customer Service
Speedway
10.2011 - 05.2012
- Cleaning and stocking
- Worked with KY lottery and cash register
Customer service specialist
Trover Solutions
09.2008 - 09.2011
- Took subrogation calls for multiple major insurance companies
Education
MBA -
University of Phoenix
Tempe, AZ12.2022
Bachelor of Science - Business
University of Phoenix
Tempe, AZ08.2021
Certificate in Operation Management -
University of Phoenix
Tempe, AZ02.2021
Skills
- Production Monitoring
- Key Performance Indicators (KPIs)
- Training
- Microsoft Office
- Issue Resolution
- Task Prioritization
- Analytical and Critical Thinking
- Planning
- Leadership
- Multitasking Abilities
- Self-Directed
- Verbal Communication
- Organizational Skills
- Attention to Detail
- Remote Office Availability
- Interpersonal Communication
- Training & Development
- Relationship Building
- Conflict Resolution
- Team Management
Hobbies and Interests
- Arts and crafts
- Animals
Timeline
Risk Management Professional 2
Humana Inc
01.2022 - Current
Team Lead CCM (Compliance Control Monitoring) Team
Humana Inc
01.2019 - 01.2022
PDP (Prescription Drug Plan) IRT Team
Humana Inc
01.2018 - 01.2019
Appeals Specialist
Humana Inc
01.2016 - 01.2018
Critical Inquiry Specialist
Humana Inc
01.2015 - 01.2016
Onsite Janitorial
Fenley real estate
04.2014 - 10.2015
Customer Service
Speedway
10.2011 - 05.2012
Customer service specialist
Trover Solutions
09.2008 - 09.2011
MBA -
University of Phoenix
Bachelor of Science - Business
University of Phoenix
Certificate in Operation Management -
University of Phoenix