Sandy Knudson
Provider Network Admin Specialist
Highlands Ranch,CO
Summary
Proven leader in healthcare data management with a track record of enhancing data accuracy and provider network performance at Optum. Skilled in data engineering and analytical problem solving, I've driven process improvements and decision-making efficiency. Recognized for a strong work ethic and attention to detail, I excel in fast-paced environments, consistently exceeding business objectives. Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.
Overview
18
18
years of professional experience
Work History
Provider Network Admin Specialist
Molina Healthcare
09.2024 - Current
- Oversees receipt of and coordinates data from the provider network for entry into the plans provider management system.
- Reviews and analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
- Audits loaded provider records for quality and financial accuracy and provide documented feedback.
- Assists in configuration issues with corporate team members.
- Assists in training staff and new hires as necessary.
- Conducts or participates in special projects as requested.
Provider Data Analyst Lead
Optum
09.2017 - 05.2024
- Enhanced data accuracy by implementing rigorous quality assurance processes and procedures.
- Load/Audit in SYMPLR/EVIPS for provider credentialing.
- Optimized provider network performance by conducting regular audits and addressing discrepancies in a timely manner.
- Developed comprehensive training materials, enhancing team members’ understanding of provider data management best practices.
- Facilitated effective communication between different departments involved in managing providers’ records, fostering a collaborative work atmosphere that enhanced productivity levels overall.
- Streamlined provider data management through the development of automated systems and tools.
- Conducted in-depth analysis of provider data, identifying key trends and patterns for informed decision making.
- Participated in professional development activities to stay abreast of emerging trends and best practices regarding provider data management, contributing to continuous improvement efforts within the team.
- Leveraged advanced analytics techniques to uncover actionable insights from large sets of structured and unstructured data related to providers’ activities.
- Collaborated with cross-functional teams to ensure seamless integration of provider data across multiple platforms.
- Maintained compliance with industry regulations by ensuring accurate documentation and reporting of all relevant provider information.
- Produced monthly reports using advanced Excel spreadsheet functions.
- Participated in requirements meetings to understand business needs.
- Used statistical methods to analyze data and generate useful business reports.
- Collaborated with business-unit leaders to identify and prioritize problems.
Customer Service Representative
Waste Management
07.2013 - 09.2017
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Updated account information to maintain customer records.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Analyzed customer service trends to discover areas of opportunity and provide feedback to management.
- Utilized data analytics tools to monitor performance trends regularly, identifying areas for improvement and implementing necessary changes.
- Trained new personnel regarding company operations, policies and services.
- Cross-trained and backed up other customer service managers.
Assistant Manager
Walmart
01.2007 - 07.2013
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Maintained a clean, safe, and organized store environment to enhance the customer experience.
- Developed strong working relationships with staff, fostering a positive work environment.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Helped with planning schedules and delegating assignments to meet coverage and service demands.
- Mentored junior staff members in their professional development by offering guidance/support in their assigned roles.
- Assisted in recruiting, interviewing, hiring, and onboarding of new employees to maintain adequate staffing levels.
- Mentored team members to enhance professional development and accountability in workplace.
- Collaborated with the management team to develop strategic plans for business growth and improvement.
- Enforced company policies consistently while handling disciplinary actions when necessary with fairness and respect.
- Increased sales through effective merchandising strategies and targeted promotions.
- Scheduled staff shifts to ensure proper coverage during peak shopping hours without exceeding labor budgets.
- Facilitated clear communication between employees and upper management through regular meetings and updates.
- Boosted employee morale by recognizing outstanding performance and celebrating team accomplishments.
- Coordinated with vendors to ensure timely delivery of products and resolve any supply chain issues.
- Ensured compliance with all safety regulations by conducting regular inspections of equipment/operations within the store.
- Reviewed sales and gross profit report to assess company efficiency.
- Monitored security to protect employees, customers and property.
- Monitored sales trends to adjust pricing strategies accordingly for optimal profitability.
- Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
- Leveraged data and analytics to make informed decisions and drive business improvements.
Education
High School Diploma -
Agua Fria High School
Avondale, AZNo Degree - Accounting And Finance
Estrella Mountain Community College
Avondale, AZSkills
- HIPAA Compliance
- Healthcare Industry Knowledge
- Provider Credentialing
- IEX -VCC Phones
- CSP Facets / Facets / Macess
- NDB / NICE / Amaardi
- Phycon
- NPPES
- Microsoft Office (outlook, excel, word)
- EPIM
- Omega
- Customer Service/Call center
- CPT Codes / Diagnosis Codes
- GPS
- Enterprise
- Navigator
- SYMPLR / EVIPS-Credentialing
- UHC Provider data Search Engine (NDAR)
- Data-driven decision-making
- Strong Work Ethic
- Analytical Problem Solving
- Business Management
- Process Improvement
- Business Needs Analysis
- Data Cleaning
- Microsoft Access
- Qnxt
- Salesforce-Conga, V12
- Iserve
- Caqh
- Dmas
Languages
Spanish
Native or Bilingual
Timeline
Provider Network Admin Specialist
Molina Healthcare
09.2024 - Current
Provider Data Analyst Lead
Optum
09.2017 - 05.2024
Customer Service Representative
Waste Management
07.2013 - 09.2017
Assistant Manager
Walmart
01.2007 - 07.2013
High School Diploma -
Agua Fria High School
No Degree - Accounting And Finance
Estrella Mountain Community College
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