Tameka McPherson
Virginia Beach,VA
Summary
Results driven healthcare professional with five years’ experience in healthcare administration. Demonstrates leadership abilities to develop strategies on operational improvements and technical changes within operations. Exceptional capability to build and retain relationships with internal and external partners along with customer focus in Government business.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Business Analyst III
ANTHEM, INC
01.2020 - Current
- Develop and/or modifying requirements, business design specifications, user training and documentation
- Research and documents business issues
- Translates business requirements to technical staff to ensure that requirements are incorporated into system design
- Support Medicaid/Medicare business in ensuring monitoring of performance metrics in a productive matter to address government benefit validation.
Provider Services & National Provider Relations
ANTHEM, INC
07.2019 - 12.2019
- 4-weeks of training to learn departmental lines of business and how to perform analyzes of benefit coverage and pricing inquiries from requestors in other lines of business
- Utilize Facets and Macess claims systems to retrieve information on Provider reimbursement, member claims, clinical notes and other necessary information as needed
- Perform analyzes for pricing and benefit coverage requests for Anthem Medicaid/Medicare markets.
PROJECT ADMINISTRATOR (Leadership Development Program)
ANTHEM, INC
06.2018 - 12.2019
- 18-month rotational program; participants are assigned to three cross-functional departments within the Corporate Business Development, Provider Services and Medicaid Health Plan operations that are intended to expose the participant to tactical and strategic initiatives of the business.
Maryland Health Plan
01.2018 - 06.2019
- Created and maintained MD Marketing SharePoint site
- Supported internal communication channels including Provider and Member newsletters messaging by interviewing Providers and Community Based Organizations (CBO), researching and social media
- Assisted to Marketing Director and Manager in departmental and regional tasks including organized quarterly health forums, designed a layout in Publisher of the Teacher Appreciation photos and wrote event articles for publication in the Regional newsletter
- Produced and sustained a tracker for Community Outreach Representatives yearly goals
- Designed templates and process forms and uploaded documents to team SharePoint site
- Attended Amerigroup sponsored events and other community events to provide information on benefit coverage, answer questions and to create partnerships with other community organizations.
Business Development
06.2018 - 12.2018
- Assisted with streamlining the Win/Loss Pipeline to ease navigation
- Created competitor health profiles for Virtual and Agilon Health
- Performed deep dive of CAHPS and HEDIS quality measures on Anthem and Anthem top Competitors RFPs from FL, KS, KY, NM and WA markets to identify quality measures scores per said markets
- Executed an analysis on Competitor capabilities, updated Anthem and Competitor Capabilities Alert SharePoint site and MCI Capabilities tracker to track their movement in the Medicaid space and uploaded capabilities for Growth Directors
- Reorganized the HUBs vendor list and uploaded each file to the HUBs library
- Completed global edits and production processes of several RFPs
- Updated quality management Score Library for RFP releases as it related to member quality and uploaded to the Score Library, updated RFP and RFI timeline tracker for all RFPs in 2018 and calculated the response timeframe
- Supported the updates of the BD Process Playbook (P&P), by uploading and modernizing new P&P processes to team SharePoint site, created PowerPoint presentation and presented an overview of the process with deliverables to Growth Directors and supported process owners
- Aided fellow team members with WebEx calls, took notes and submitted to Growth Director.
Massage therapy program coordinator
Centura college
08.2016 - 06.2018
- Responsible for the daily operations of Massage Therapy department
- Increased MBLEX pass rate by over 60% in eight months by identifying the problems and restructuring course content and implementing MBLEX practice test software
- Assisted in curriculum review and development
- Organized departmental meetings with staff and Professional Advisory Committee (PAC) meetings with SME monthly and quarterly; respectively
- Supported students’ educational processes through academics, advising, mentoring and managing their day-to-day progress in class and provided support after graduation.
Clinic coordinator/instructor
Medical careers institute
04.2015 - 08.2016
- Provided administrative supported to Massage Therapy Program Director
- Established community relationships by attending community events for students to practice chair massage
- Taught courses in Anatomy & Physiology, Medical Terminology, as well as other program specific content
- Responsible for the daily operations of the Massage Therapy clinic by supported students throughout their clinical process.
Clinic administrator (CA)
Massage envy SPA
06.2013 - 02.2015
- Led a 40-member team across various departments that included sales, marketing, massage therapy and esthetics
- Created a strategy to restructure employee behaviors by implementing employee monthly goals and incentive program
- Exceeded and maintained reaching membership goal within 90 days as CA
- Surpassed revenue goal during Christmas holiday gift card sales and annual Healing Hands for Arthritis event
- Implemented a Massage Therapy Mentorship Program to assist Massage Therapists that had challenges with meeting/exceeding a 85% survey score from members and retention of clientele
- Coordinated monthly meetings to provide organizational and regional operations updates, discuss personal performance and re-establish monthly goals.
Education
Masters In Healthcare Adminstration - Healthcare Administration
Walden University
Minneapolis, MN02.2017
Bachelor Of Applied Science - Health Services Management
Norfolk State University
Norfolk, VA12.2014
Certificate - Massage Therapy
Virginia school of technology
09.2006
Skills
- Adaptability
- Ability to Multitask
- Attention to Detail
- Trainer
- Medical Claims
- Quality Auditing
- Medical Knowledge
- Effective Time Management
- Healthcare Administration and Operations
Accomplishments
- Quality assurance
- Developed and implemented quality control audit process to improve benefit coverage code validation across 24 market within benefit execution to ensure quality expectation were above 98%
- Training/Documentation
- Build an annual training program which includes a buddy system post training to ensure a 95% success rate and documentation specialist.
- Leadership
- Managing direct reports with experience working with offshore partners. I have the ability to motivate others setting clear expectation through effective communication fostering strategic growth in a high pace environment.
Associations
- National society of leadership and success
- APEX
- Women in Business
- Eastern Star affiliate
Certification
CURES White Belt
Timeline
Business Analyst III
ANTHEM, INC
01.2020 - Current
Provider Services & National Provider Relations
ANTHEM, INC
07.2019 - 12.2019
PROJECT ADMINISTRATOR (Leadership Development Program)
ANTHEM, INC
06.2018 - 12.2019
Business Development
06.2018 - 12.2018
Maryland Health Plan
01.2018 - 06.2019
Massage therapy program coordinator
Centura college
08.2016 - 06.2018
Clinic coordinator/instructor
Medical careers institute
04.2015 - 08.2016
Clinic administrator (CA)
Massage envy SPA
06.2013 - 02.2015
Masters In Healthcare Adminstration - Healthcare Administration
Walden University
Bachelor Of Applied Science - Health Services Management
Norfolk State University
Certificate - Massage Therapy
Virginia school of technology
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