Shanee Clemens
Mount Union,USA
Summary
Dynamic and detail-oriented professional with extensive experience as a Senior HIH Retrieval Analyst, HEDIS Pend Specialist, and in SBCO Sales Operations. Exceptional critical thinking, adaptability, and leadership capabilities drive team development through effective training and collaboration on process improvements. A commitment to maintaining a positive attitude fosters a productive atmosphere, while proven time management skills and the ability to solve complex problems ensure the delivery of high-quality work in fast-paced settings. Strong vendor management expertise and effective communication enhance the ability to contribute meaningfully to organizational success.
Overview
11
11
years of professional experience
Work History
Clinical Quality Performance Analyst
Optum
05.2025 - Current
- Analyze performance data to identify trends and recommend improvements.
- Collaborate with cross-functional teams to drive strategic initiatives and enhance operational efficiency.
- Produce reports to facilitate analysis and organization of daily responsibilities
- Coordinate weekly sessions with third party copy services to track Optum inventory and escalate matters when required.
- Perform comprehensive system testing each year to verify accuracy and optimize performance enhancements.
- Coordinate and conduct several end-of-season debrief sessions alongside leadership, internal teams, and third-party copy service vendors to analyze season achievements and explore potential enhancements.
HEDIS Pend Specialist / SBCO Sales Operations Specialist Job Share
United HealthCare
08.2022 - 05.2025
- Flexible in the changing priorities in each position as well as transitioning from Optum Outreach / Pend Operations to SBCO Small Business Sales Operations during each team’s peak seasons.
- Optum Pend Specialist:
- Help assist in HEDIS hybrid medical record collection by performing provider outreach, claim system research, and working with vendors to overcome various obstacles pended to us.
- UHC HEDIS Software and Claims systems for pend research and provider outreach such as RateLIFT, OnBase, iSet, iLead, and Facets.
- Assist with special projects such as rejected chart processing and provider escalations as well as helping assist in training of new employees.
- SBCO Sales Operations Specialist:
- Perform 51+ small business quoting processes for the Southeast region working directly with brokers, Account Sales Executives, and underwriting departments.
- Work directly in SalesForce Solaris system and UHC created Newton systems.
- Work with broker provided data to scrub for critical information to produce quotes include Excel to manipulation, data entry into systems, and pulling quotes reviewing for accuracy.
Florist Assistant
Daniel Vaughn Designs
11.2015 - 01.2020
- Collaborated with vendors prior to large events to coordinate delivery and set up.
- Communicated effectively with customers to determine type of arrangement desired, occasion, date, time and location for each arrangement needed.
- Designed floral arrangements to fulfill customer requests and processed transactions.
Education
Associate of Applied Science - Liberal Arts And General Studies
Pennsylvania Highlands Community College
Huntingdon, PA12-2011
Skills
- Data Entry & Analyses
- Vendor management
- Teamwork & Collaboration
- Effective communication
- Organizational skills
- Critical thinking
- Time Management
- Problem-solving
- Task Prioritization
- Attention to detail
- Microsoft office/ Teams
- Adaptability and flexibility
Honors & Awards
BRAVO awards from fellow team members for teamwork and Collaboration, Selected for special project group for HEDIS Pend Collection ultimately leading rejects
Timeline
Clinical Quality Performance Analyst
Optum
05.2025 - Current
HEDIS Pend Specialist / SBCO Sales Operations Specialist Job Share
United HealthCare
08.2022 - 05.2025
Florist Assistant
Daniel Vaughn Designs
11.2015 - 01.2020
Associate of Applied Science - Liberal Arts And General Studies
Pennsylvania Highlands Community College