Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
19
19
years of professional experience
Work History
Senior Plan Build Professional
Humana
Louisville, KY
06.2011 - 02.2024
Interpret Medicare Advantage benefits and load in to the Humana claims administration system
Develop and maintain automated processes for loading of benefits
Worked with cross-functional teams to achieve goals
Determine system functionality for new plan benefit designs
Manage projects
Group Medicare Implementation Consultant
Humana
Louisville, KY
03.2009 - 06.2011
Interpret Group Medicare Advantage benefit design
Create and maintain New Plan Documents (NPD) per group, per year
Work with downstream Plan Build partners to ensure plans are loaded into the Humana claims administration system appropriately
Implement benefit changes as requested by represented Groups.
Conduct plan demonstration to both internal and external client
Group Quality Review Analyst
Humana
Louisville, KY
05.2007 - 03.2009
Performed quality assurance to assess data and validate results.
Reported on common sources of technical issues or questions and made recommendations to product team.
Implemented strategies for automating organizational processes.
Identified opportunities for process improvement
Collaborated with cross-functional teams on projects related to analytics initiatives.
Designed test plans to ensure quality assurance standards were met.
Facilitated training programs to improve employee skillsets.
Plan Load Specialist/Work Content Specialist
Humana
Louisville, Kentucky
08.2005 - 05.2007
Interpret and load Medicare Advantage benefits into the Humana claims administration system
Work pended claims
Validate benefit loading of peers
Resolve upstream and downstream plan load inquiries