SHARON R. Romeo
Newington
Summary
Results-driven leader with strong background in strategic management and organizational growth. Skilled in developing and implementing effective business strategies, optimizing processes, and driving team performance. Known for adaptability, effective collaboration, and delivering measurable outcomes in dynamic environments. Strong communication and problem-solving abilities, coupled with focus on fostering productive and positive team culture.
Overview
28
28
years of professional experience
Work History
Director Credentialing Operations
Aetna, a CVS Health
08.2024 - Current
- Manage Aetna’s Credentials Verification Organization (CVO) for our directly contracted providers including individual, facility, and ancillary providers of care. Manage a leadership team of 6 direct reports and a department of 90-100 employees in addition to vendor supported operations. Ensure compliance with all state mandates, federal regulatory and accrediting entity requirements.
- Successfully manage and maintain a provider network credentialed and recredentialed consistent with the National Committee for Quality Assurance (NCQA) and Utilization Review Accreditation Committee (URAC) as well as state and federal requirements – Centers for Medicare and Medicaid Services (CMS).
- Successfully achieve and maintain full CVO certification with NCQA and URAC.
- Ensure all service guarantees are met or exceeded in accordance with established internal metrics, and state mandate requirements.
- Provide oversight and business project support for tactical and strategic credentialing projects and initiatives, as well as financial cost benefit analysis and feasibility studies.
- Liaison for vendor arrangements including work guidelines, deliverables, financials, reporting expectations, compliance, and oversight.
Sr Manager
Provider Data Services
10.2018 - Current
- Manage Centralized Batch Processing & ERA/EFT
- Oversight for Offshore Vendor CBPA & Manual Processing
Manager
Provider Data Services
09.2010 - 01.2018
- Oversight over Coventry Contract Integration, Nonpar, Error Correction, Accenture Vendor Relations, IRS, Behavioral Health, COLA & Smart Front End
Coordinator/Team Lead
Provider Data Services
12.1998 - 09.2010
- Various Team Lead positions within PDS including Error Correction, National, Behavioral Health, IRS, RIIT, & Smart Front End
Service Center Representative
Aetna Service Operations
10.1997 - 12.1998
- Aetna College Intern Middletown CT
- Allentown/Blue Bell Service Center Representative
Education
High School -
Newington High School
06.1996
General Studies
Central Connecticut State University
09.1997
Skills
Networking
Team Building
Strategic and Operational Planning
Decision Making and Problem Solving
Time Management
Process Reengineering
Quality and Continuous Improvement
Business Planning
CONTACT
- 162 Hunters Lane
- Newington CT 06111
- (860)977-8700
- EMAIL: Sharon.Romeo@aetna.com
ACTIVITIES
- Member of Aetna CRG Caregivers 2018- Present
- Volunteer for Aetna sponsored ConnecticutKids- Sr. Mentor 2022- Present
- PDS Career Fair Rep 2021,2022 &2023
OBJECTIVE
Looking to obtain next level leadership position within the Provider Data Services organization. I pride myself on being an example of successful internal development, participating and leading numerous company sponsored mentor/mentee programs. Advocate for working cross functionally to drive and lead change.
Timeline
Director Credentialing Operations
Aetna, a CVS Health
08.2024 - Current
Sr Manager
Provider Data Services
10.2018 - Current
Manager
Provider Data Services
09.2010 - 01.2018
Coordinator/Team Lead
Provider Data Services
12.1998 - 09.2010
Service Center Representative
Aetna Service Operations
10.1997 - 12.1998
General Studies
Central Connecticut State University
High School -
Newington High School
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