Dynamic leader with extensive experience at Accenture/TMHP and HHSC, excelling in critical thinking and stakeholder management. Spearheaded business process improvements, significantly enhancing project delivery and stakeholder satisfaction. Expert in data analysis and operations management, adept at fostering teamwork and resolving conflicts, ensuring high-quality outcomes and strategic growth.
Business professional with strong background in analysis and supervision. Skilled in data interpretation, process improvement, and stakeholder communication. Focused on team collaboration and delivering impactful results. Reliable and adaptable to changing needs, with expertise in project management, critical thinking, and problem-solving.
Overview
17
17
years of professional experience
Work History
Business Analyst Supervisor
Accenture/TMHP
02.2019 - Current
Conducted thorough market research to identify opportunities for growth and expansion.
Enhanced project management capabilities for better team coordination and productivity.
Streamlined data analysis with advanced tools, leading to more informed decision-making processes.
Conducted risk assessments to proactively address potential issues before they escalated into larger problems.
Supervise 11 staff in the claims department for fee for service Texas Medicaid. Assist in daily inventory of production and provide analysis of incoming trends. Assist in projects with State stakeholders and legislative staff. Train staff as needed and assist in writing guidelines and responsible for the analysis and management of claim files within their unit. Supervision includes claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, reserve accuracy, effective negotiation and appropriate resolution. Meet with State Stakeholder with adjudication guidelines to present edit and audit that affect Medicaid providers on how they bill. Oversee quality assurance and research analyst that process Texas Medicaid claims.
Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
Managed a diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards.
Monitored team performance, enforcing compliance with corporate claims processes and procedures.
Increased stakeholder satisfaction by consistently delivering high-quality products within established deadlines.
Maintained strict confidentiality with all personal data as per company guidelines.
Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
Researched claims and incident information to deliver solutions and resolve problems.
Analyzed information gathered by investigation and reported findings and recommendations.
Senior Program Specialist
Health and Human Services Commission, HHSC
07.2007 - 08.2017
Enhanced program efficiency by streamlining processes and implementing innovative solutions.
Devised, implemented and monitored program plans and schedules.
Monitored program performance, utilizing data analysis to identify trends and recommend adjustments as needed.
Delivered engaging presentations on program successes at industry conferences, showcasing organizational expertise in the field.
Monitor customer calls, completed administrative assignments and addressed escalated complaints.
Develops and implements program policies and procedures, develop priorities and standards for achieving program goals.
Implement, evaluate and monitor program activities.
Oversees the analysis of program operations and recommends modifications to the program operations.
Review complex complaints by researching, investigation, analyzing and resolving concerns regarding HHS agencies and programs. Interpret complex rules. Provide customer service to consumers via email and verbally. Prepare Microsoft Excel and Word documents for daily reports.
Serves as the primary department liaison to clients and providers. Monitor and maintain complains data.
Assist Medicaid eligible clients in accessing and determining the appropriate transportation services.
Providing information and assisting the public via email. Receiving issues and complaints from clients, providers, health facilities, legislators, government agencies, advocacy groups and other customers.