Susan Svingala
Schenectady,NY
Summary
Goal-driven Analyst polished in managing and breaking down large volumes of information. Proactive at heading off issues in operations, workflow and production by uncovering trends affecting business success. Over 25 years of experience in Health Insurance industry. Analytical professional with technical knowledge and critical thinking skills to thrive in data-driven environments. Tackles challenges with positivity and drive to overcome. Works great alone or with others and consistently exceeds expectations.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Lead Quality Analyst
Elevance Health
Indianapolis, IN
11.2016 - 10.2023
- Led quality assurance initiatives by conducting quality audits, performing root cause analysis, and implementing testing processes to successfully achieve service quality of 98% or higher.
- Collaborated with cross-functional teams on projects related to analytics initiatives.
- Provided recommendations based on data analysis results.
- Wrote and submitted reports on industry trends, prompting managers to develop business plans.
- Conducted detailed analysis on key trends and findings to summarize findings for leadership.
- Evaluated needs of departments and delegated tasks to optimize overall production.
- Implemented strategies for automating manual processes within the organization.
- Participated in regular meetings with management to assess and address issues and identify and implement improvements.
- Utilized formulas to extract data from queries into Excel spreadsheets.
- Utilized visualization tools such as Tableau or Power BI to present findings.
Quality Analyst
Anthem BCBS
Indianapolis, IN
01.2008 - 11.2016
- Have worked with Medicare Supplemental and Medicare advantage plans.
- Maintained quality assurance procedure documentation.
- Collaborated with cross-functional teams to ensure that product specifications are met or exceeded.
- Assisted in the development of Quality Assurance procedures and protocols.
- Identified training opportunities to drive increased levels of quality through various projects.
- Participated in continuous improvement initiatives by suggesting changes or modifications to existing processes or procedures.
- Successfully evaluated enrollment and billing associates by capturing data and utilizing data analysis tools to produce data-driven insights.
- Audited ACH payments.
- Leveraged Six Sigma principles to identify and communicate compliance risks and quality improvement opportunities.
- Conducted root cause analysis to investigate the source of problems in production process.
Education
Master's Degree - Business Administration
Kaplan University
05-2014
Bachelor of Science - Business Administration
Kaplan University
05-2010
A.A.S - Criminal Justice
SUNY Schenectady County Community College
05-1998
Skills
- SQL and Databases
- R
- Tableau
- Power BI
- Citizen Developer (UIPath automation)
- Root Cause Analysis
- BI Dashboards
- Documentation and Reporting
- Lean Six Sigma Green Belt Certified (Management & Strategy Institute)
- Experience with Medical/Rx benefits,claims and Grievance and Appeals (both members and providers) Audited enrollment, billing and life for members
- Extensive experience with FCR (First Call Resolution) doing root cause analysis, and call coaching within a Large call center
- Knowledge of MS (charts, pivot tables, functions and formulas), SharePoint (lists and trackers), and MS TEAMS
- Process Improvements
Websites
Certification
Lean Six Sigma Green Belt - Management & Strategy Institute
References
References available upon request.
Timeline
Lead Quality Analyst
Elevance Health
11.2016 - 10.2023
Quality Analyst
Anthem BCBS
01.2008 - 11.2016
Master's Degree - Business Administration
Kaplan University
Bachelor of Science - Business Administration
Kaplan University
A.A.S - Criminal Justice
SUNY Schenectady County Community College
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