Beth Fowler Email & Phone Number

Nashville, Tn, Us

Franklin, Tn, Us

Franklin, Tn, Us

Bloomfield, Ct, Us

Oversight of a team of Subject Matter Experts (SMEs) with focus on support of Customer and Provider Contact Center (Call + Digital) project and non-project work. Ongoing engagement in readiness-related decisions, escalations, process improvement and risk mitigation activities. Partner and collaborate with Enabling Functions partners as well as Operational Leadership to ensure alignment with Operations and Enterprise strategy, priorities, and supplemental opportunities to improve and enhance process(es). Contact Center Enterprise Operations point of contact for sign-off on release-related activities in partnership with Business Deployment and Delivery (release readiness) team. • Accomplishments. Oversee Impact Assessment input and completion as well as coordination of high impact, high priority initiatives (Portfolio funded) to reduce negative experience for frontline advocates and Contact Center Operations teams as it pertains to systems and readiness needs. Project Seed Call Transformation PM Lead | Special Assignment (2/2022 - 9/2022) SME Team Manager and Enterprise Operations Impact Assessment Lead (November 2021 - July 2023)

Bloomfield, Ct, Us

COVID-19 Call Project Manager | Special Assignment (March 2020 - December 2020) • Cigna in partnership with Express Scripts (ESI) - Medicare and non-Medicare cross coverage team stand-up)

Bloomfield, Ct, Us

Responsible for delivery and success of Value Stream initiatives from a holistic viewpoint in collaboration with Value Stream leads with focus on driving decisions around prioritization, risk mitigation and readiness timeline development. Collaborate with and facilitate communication across Value Streams to ensure alignment for end-to-end delivery and success. Define schedules, identify dependencies, develop solutions to business problems as well as ensure updates and shift across enabling functions and scheduling as priorities and scheduling changes occur. Influence change and improvement within the Intake and Impact Assessment process spaces as well as partner to implement technology-driven replacement tools for Intake and IA enhancement and growth. Ensure assessment processes and focus align with Operational stakeholder needs via ongoing touchpoint and partnership.

Nashville, Tn, Us

Responsible for the overall direction, guidance, and leadership of HealthStream's implementation operations, including maintaining and reporting on implementation metrics, executing complex implementations, staffing, and managing the professional development of the implementation personnel.

Franklin, Tn, Us

*Oversight and management of operational systems and processes related to call center ops; including management of 5 remote direct reports. *Cross-departmental collaboration to identify and execute activities related to operational processes with a focus on productivity, elimination of waste, enhancement of program effectiveness and reduction of overall costs associated with systems and processes. *Serve as a SME for all areas of assigned operational processes. Provide support for call centers, as needed, and serve as a resource on operational questions. *Responsible for establishing, documenting, maintaining and managing all assigned operational processes while focusing on and exploring opportunities to improve efficiency and effectiveness. *Utilize a very metric/data-driven approach to ensure that operational processes are functioning as designed to deliver desired results. *Work closely with external vendors to identify cost effective solutions to address improvement opportunities for operational processes. Collaborate with sourcing department on these activities inclusive of vendor selection and management. *Establish process success metrics and develop standardized enterprise reporting. *Manage the implementation of any change to these processes including development/revision of policies, procedures and process success metrics. Responsible for identifying impact, fully testing, piloting and measuring all changes in process. *Manage the scheduling and execution of any changes to these processes to enhance Call Center Operations productivity. *Interface across all Org departments and within Call Center Ops to build consensus around all changes, issues and rollout plans. Work with Call Center Leadership to ensure timely execution. *Review financial statements, vendor invoices, & other performance data to measure productivity, cost and other related process success metrics to determine areas needing cost reduction and program improvement.

Franklin, Tn, Us

*Maintenance of 100+ state UR/UM and TPA licenses (inclusive of initial and renewal applications as well as annual reporting, when applicable)*Monitoring of regulatory tracking system – StateScape – and ongoing communications with Legal Department to determine application of legislation and regulation to HWAY business units*Management of 500+ corporate policies and procedures with direct oversight of the development process and annual review(s)*Creation and maintenance of four (4) SharePoint sites representing Policies and Procedures, Compliance and Accreditation, Working Documents (Policy and Procedure Version Control), WholeHealth Networks Clinical Oversight Committee *Organizational resource for health plan accreditation and certification programs (NCQA and URAC)*Assist Privacy Officer in the ongoing review of HIPAA-related incidents with focus on privacy and security

Franklin, Tn, Us

* Responsible for the audit of 783 health plan contracts (Credit Balance, Overpayment Recovery Services (ORS), Coordination of Benefits (COB), Specialty Audit Services (SAS), Subrogation, etc)* Managed HIPAA-related audits and ongoing reporting for twenty (20) national account health plan contracts* Researched state regulations and amended legislation specific to overpayment recovery and coordination of benefits* Direct report to corporate Compliance Officer

* Review of regional financials, billings and contract renewals * Assist in the development and review of proposals for potential new/renewal business* Active participation in the QI and UM programs * Responsible for orientation and ongoing training of site administrators for the Southeast Region include accreditation standards and credentialing requirements for all practitioners (on-site and off-site)* Responsible for developing and administering training for all incoming site administrators specific to Credentialing Program and requirements for licensure of all practitioners* Supported the Regional Medical Director and Division Vice President in the oversight of operations and monitoring contract compliance at the site level* (all services listed below under “Regional Analyst”)

* Operations position with emphasis and focus on regional activity including twenty-four (24) facilities within the southeast region. * Support the Regional Medical Director and Division Vice President in the oversight of operations and monitoring contract compliance at the site level. * Responsibility for maintaining ongoing compliance with the corporate credentialing program for MD, DDS, DO, NP, PA, LPN and RN disciplines (i.e. Access database oversight and maintenance; Corporate Credentialing Committee member – 3 years). * Traveled to facilities to conduct "new-site start-ups" to include needs assessments, orientation, and other requirements* Reviewed invoice submissions for need and accuracy

* Paid subcontractors (independent contractors) through payroll (ADP and ProBusiness) and A/P (Macola) * Collaborated with Network Development representatives on development of Vendor contracts based on operational needs and budgetary requirements* Assistant to Corporate Controller and Assistant Controller* Aided in month-end journal entries* Trained on fixed assets and bank reconciliations

* Completed federal, state, and local tax "set-ups" * Reviewed quarterly reports and researched tax laws for newly obtained sites* Reviewed contracts for and paid subcontracted (1099) employees for approximately 220 sites nationwide* Verified and reviewed employee wage and employment information* Researched wage garnishment and union regulations (state requirements)